Greeks spend nearly 200 million euros per year in under-the-table payments to doctors at state hospitals, according to the results of a survey which found that one in three patients slip their doctor something on the side. According to a study carried out by Athens University’s assessment unit, Greeks make an annual donation to state hospital doctors of 195.4 million euros, a sum which accounts for 11 percent of the health sector’s underground economy. Statistics show that 1.6 billion euros’ worth of payments in the health sector were made without receipts being issued. Meanwhile, the state is losing some 628 million euros per year in unpaid taxes. The study showed that 36 percent of patients claim to have made at least one «unofficial» payment to doctors. Only 4 percent of those asked to give a «little envelope» said they had refused. Also, only 4 percent of doctors refused offers of under-the-table payments. Of the patients who made such payments, 42 percent said they did so to secure better quality care, 20 percent to ensure that theoretically free services were carried out, 18 percent because they figured «that’s what everyone does» and 18 percent out of gratitude. Those due to undergo surgery were 137 percent more likely to make an under-the-table payment. A 61-year-old businessman told Kathimerini that he gave the doctor carrying out an orthopedic operation on his mother 500 euros to «look after her.» And a 45-year-old Albanian woman said she gave 100 euros to the doctor treating her son for appendicitis. «I would have given more if I could,» she said. Another study by pollsters VPRC showed that the health sector has overtaken tax offices as the public service most likely to ask for illegal payments from citizens.