An initiative launched in 2003 by a group of doctors with the aim of cracking down on the widespread practice of doctors taking under-the-table payments has been «a total failure,» one of the medics involved in the initiative has told Kathimerini. «How can it not have failed when even the doctors that we knew were on the take began wearing the rosettes,» said Olga Cosmopoulou, a doctor at the Geniko Kratiko Hospital in Nikaia, near Piraeus, referring to the distinctive badges worn by the doctors involved in the project. Cosmopoulou said that many doctors continued to demand «fakelakia» (literally «little envelopes») for services that are supposed to be free of charge and that even many of those who join the state health system with good intentions end up following the bad example of their colleagues. «When they get to the age of 40 and have families to take care of but are still on 1,200 euros a month, they change,» said Costas Barkas, a neurosurgeon working at the same hospital. Cosmopoulou stressed that the practice of bribe taking remains extremely widespread. «There are very few doctors who do not take money,» she remarked. Of the remaining medics, she added, there are some who do not demand under-the-table payments but accept them when they are offered, which is frequently the case as patients are anxious to receive the best possible treatment. According to recent research, Greeks pay some 194 million euros in fakelakia each year, a figure that represents 13.5 percent of state spending on the health sector. Barkas stressed that the scourge of under-the-table payments is hard to stamp out as it does not exist in a vacuum but in a generally corrupt system. «Unfortunately, the fakelaki is just the tip of the iceberg that is the underground economy of the health service,» he said.