Healthcare in Greece

Healthcare in Greece
Country	Greece
Healthcare	Mixed public-private
Life expectancy	81.1 years (2019)
Infant mortality	3.5 per 1,000 live births (2020)
Health expenditure	7.8% of GDP (2019)
Leading causes	Cardiovascular disease, Cancer, Diabetes

Healthcare in Greece. The healthcare system in Greece is a mixed system, comprising a universal public National Healthcare System (ESY) established in 1983 and a strong parallel private sector. Funded through social insurance contributions and general taxation, the system provides coverage to all citizens and legal residents, though it has faced significant challenges due to the Greek government-debt crisis and subsequent austerity measures. Recent reforms, such as those initiated under the bailout programs and the establishment of the National Organization for Healthcare Services Provision (EOPYY), aim to improve efficiency and financial sustainability.

History

The foundations of modern Greek healthcare were laid in the early 20th century with the creation of various social insurance funds, most notably the Social Insurance Institute (IKA), established in 1934. The pivotal moment came with the passage of Law 1397/1983 under the government of Andreas Papandreou, which created the universal National Healthcare System (ESY). This reform aimed to replace the fragmented insurance system with a Beveridge model-inspired service. Subsequent decades saw incremental changes, but the system was profoundly tested by the Greek government-debt crisis beginning in 2009, leading to deep budget cuts and a wave of reforms mandated by international creditors like the International Monetary Fund and the European Commission.

Healthcare system structure

The structure is characterized by a complex mix of public and private entities. The Ministry of Health oversees the public system, which is delivered through the ESY and seven decentralized Health Regions. The key purchaser and insurer is the unified National Organization for Healthcare Services Provision (EOPYY), created in 2011 to consolidate numerous previous funds. Alongside this public structure exists a extensive private healthcare sector, including private hospitals, diagnostic centers, and physician practices. Regulatory bodies such as the National Organization for Medicines (EOF) and the Hellenic Food Authority (EFET) oversee drug safety and public health standards.

Healthcare financing

Healthcare is financed through a combination of mandatory social insurance contributions, general taxation, and significant out-of-pocket payments. The primary source is payroll contributions shared between employers and employees, collected by entities like the Unified Social Security Fund (EFKA). The government also provides substantial funding from the state budget to support the ESY. Despite universal coverage, high rates of informal out-of-pocket payments for services and pharmaceuticals have been a persistent issue. The system's financing was severely constrained during the memoranda period, leading to increased cost-sharing for patients.

Healthcare providers and facilities

Public providers include a network of regional and university hospitals, such as the major Attikon University Hospital in Athens and the Papageorgiou Hospital in Thessaloniki, alongside rural health centers. The physician workforce includes a mix of salaried public hospital doctors and private practitioners, with many holding dual practice. The private sector is robust, featuring well-equipped clinics and hospitals like the Hygeia Hospital in Marousi and the Metropolitan Hospital in Piraeus. Primary care is provided by both public health center doctors and private GPs, though the system has historically been hospital-centric.

Health status and outcomes

The population enjoys a relatively high life expectancy, which was 81.1 years in 2019 according to the World Health Organization. Major causes of mortality align with European patterns, dominated by Cardiovascular disease and Cancer. Greece historically reported very favorable outcomes on indicators like Infant mortality, though economic hardship impacted some public health metrics. The country also faces a high prevalence of risk factors such as smoking and obesity. The COVID-19 pandemic in Greece tested the system's capacity, with response measures coordinated by the Ministry of Health and experts like Sotiris Tsiodras.

Challenges and reforms

The system faces enduring challenges including geographical inequalities, long waiting times, and the legacy of fragmentation. The austerity measures imposed after the Greek government-debt crisis led to reduced health spending, staff shortages, and reported shortages of medical supplies. Major reform efforts have focused on centralizing procurement through EOPYY, implementing DRG hospital financing, and attempting to strengthen primary care to reduce hospital overcrowding. Ongoing debates concern the sustainable financing of the ESY, the integration of digital health tools, and improving access in remote areas and islands.

Category:Healthcare in Greece Category:Health by country