Health sector deficit remains
Then the State settled the public hospitals’ 360-billion-drachma (1.06-billion-euro) debt a year ago, it failed to institute policies to ensure these deficits would not be reproduced. As a result, the deficit for 2001 and the first half of 2002 stands at 700 million euros, including 600 million euros outstanding from social security funds.The funds’ inability to meet debt payments, along with inherent structural problems within the hospital system itself, are causing problems for the Health Ministry’s efforts to improve services. Some hospitals have only 40 percent of their beds occupied. Hospital staff are paid from funds from the state budget. Deficits are due to operating costs and the cost of pharmaceutical products (40 percent), medical supplies (35 percent), machinery (15 percent) and orthopedic supplies (10 percent). Therefore the busiest hospitals are those with the greatest deficits. According to Yiannis Kyriopoulos, health economy professor at the National Public Health School, the mechanism that produces deficits not only is still in existence but is working in overdrive. «Health insurance funds are not in a position to meet even the lowest costs of hospitalization, since they are facing a structural funding problem due to unemployment, undeclared labor, the aging population and the huge rise in the cost of health services because of new technologies, a lack of technicians and poor administrative methods,» he said. Many hospitals’ attempts to reduce waste have failed. «What is needed is an improvement and reorganization of the ‘businesses’ providing health services, since many hospitals have budgets of tens of billions of drachmas,» said Kyriopoulos. «We are talking about solutions that have to do with both the operation of the hospital and policy… calling for the abolition, merging or reorganization of units or wards. What we need is a health policy that is realistic,» he added. Asked whether such a reorganization program would require an increase in health fund contributions, Kyriopoulos felt that at this time such a move would have negative repercussions on investment and employment. He suggested alternatives such as a system in which subscribers contributed to the cost according to their income and in reverse proportion to the medical need, or a complementary fund, as took place in the Netherlands. «In Greece, every year households go bankrupt because of one occurrence causing them to pay for healthcare. A section of the population does not have access to the necessary network of services, even though they may have health insurance. Households pay 1,600- 1,760 euros every year from private sources in order to have adequate access to health services,» he said, pointing out that because of the aging population, health funds’ outlay on services will continually increase. «Because of expectations from technology and the lack of policy regarding clinical medicine, health professionals will have to realize that we are living in a world in which there is a dearth of resources and we cannot have everything in unlimited amounts and whenever we want it,» pointed out Kyriopoulos. «Although Greeks have a satisfactory standard of health, there are great injustices in the distribution of costs and problems in the quality of healthcare.»
