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11-30-2016

The public health crisis in and its ties to a failing economy

Anna M. Carleen Thomas Jefferson University, [email protected]

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Recommended Citation Carleen, Anna M., "The public health crisis in Greece and its ties to a failing economy" (2016). CWIC Posters. 28. https://jdc.jefferson.edu/cwicposters/28

This Article is brought to you for free and open access by the Jefferson Digital Commons. The Jefferson Digital Commons is a service of Thomas Jefferson University's Center for Teaching and Learning (CTL). The Commons is a showcase for Jefferson books and journals, peer-reviewed scholarly publications, unique historical collections from the University archives, and teaching tools. The Jefferson Digital Commons allows researchers and interested readers anywhere in the world to learn about and keep up to date with Jefferson scholarship. This article has been accepted for inclusion in CWIC Posters by an authorized administrator of the Jefferson Digital Commons. For more information, please contact: [email protected]. The public health crisis in Greece and its ties to a failing economy Anna M. Carleen Sidney Kimmel Medical College of Thomas Jefferson University, Population Health College within a College 2016

Healthcare in Greece Economic Crisis Austerity measures affecting healthcare system

Between February 2010 and May 2016, thirteen austerity packages have been passed by the Greek In 2009 the Greek government admitted that the numbers it had been reporting to the European government. Several of those which have particularly targeted the healthcare system are listed here: Union about its national budget deficit were artificially small. The deficit was actually huge, way larger  Cutting public health insurance for individuals who have been unemployed for over a year than what the EU requires of member countries if they want to reap the benefits of being in this  Reduction in budgets (despite increased public hospital admissions) up to 50% financial network. A benefit of being in the EU is that it makes it much easier for governments to take  Salary freezes and salary cuts for both public and private employees out large loans, because lenders trust that a member country will make good on its debts due to the  Hiring freezes followed by layoffs in the public sector security it has from being part of the union. This admission by the Greek government came at the tail  Increased health contributions paid by pensioners end of, and was very much linked to, the global financial crisis felt here in the United States in 2008. As a result, lenders started enacting stricter borrowing rules, and Greece had to take out even more  Cuts to the Ministry of Health loans. By spring of 2010 it was veering towards bankruptcy, and in May of 2010 the first  Implementation of drug rationing programs of three bailout agreements with the troika (International Monetary Fund, European *see graph below for an illustration of decreased health expenditures  Compulsory insurance Central Bank, and the European Commission) was reached. This bailout came with through National Health conditions, or austerity terms, that the Greek government had to agree to. These included deep budget System, established in 1981 Examples of specific impacts of austerity measures cuts, steep tax increases, and promises to implement anti-corruption strategies and cut down on tax  Voluntary private healthcare system (about 15% of evasion. population participates)  and doctors offices are without basic medical supplies such as gauze, band-aids, and  130 public hospitals, 13 syringes, and are turning to cheaper equipment in order to cut down costs The second bailout came in 2012 after the recession continued to worsen. The third bailout came in military hospitals, 2  Cancer screening programs have been drastically reduced summer of 2015 after a series of failed negotiations between Greece’s newly in power Syriza party and university hospitals the troika, Greece defaulting on its loans, and a popular vote by the Greek people to reject the latest  200 Primary Care Health  HIV and tuberculosis rates are rising* proposed bailout conditions. Centers  Rates of depression and suicide are increasing  NHS is paid for mostly by taxes  Malaria is making a comeback due to government’s inability to afford the appropriate pesticides  Public hospitals are being overloaded, partly because people can no longer afford primary care  Months-long wait time for appointments and procedures Testimonials from clinicians and patients  Drug shortages and increased drug costs  Some pharmacists and hospitals are asking for cash payments for fear of not being reimbursed These quotes come from individuals interviewed by a Greek film maker Aris Chatzistefanou in a short documentary for The Guardian. These people promptly by insurance companies either work for or are patients at Nikaia hospital, located roughly where the purple star is on the map above. All images are taken from the documentary, which is cited in the references. Quotes are written on the image of the person who said them.  Patient fees have been instituted at many public clinics and hospitals  Hospitals are understaffed and clinicians are overworked “I came back to Greece two years ago. They are now so *see graph below vulgar that they give state “Yesterday morning the deputy benefits only when the levels governor of the hospital released an of CD4 drop below 200. That Two manifestations of public health changes: cut costs official document. He instructed a halt is when you are in the final to regular surgeries, as of today, stage. Otherwise, you don’t Wednesday the 13th of June. Recently and increased HIV rates we also had alarming signs of danger, get the benefit. Some friends signs of financial asphyxiation, from told me ‘I will stop my other large and smaller hospitals across medicine in order to drop the country. Doctors and nurses are below 200.’ We have to do it buying band aids themselves, to have Per-person health spending HIV infections one available in their pocket.” in order to survive, to have something to eat.” Graffiti on building in Patras, Greece, in response to the austerity measures imposed in 2010 and made harsher since. Translated to English: No pain is enough.

“I didn’t think these things would ”Most people in the waiting room should happen in a developed European have been treated in primary care. Since this is not available, they come to country with a developed public the hospital, where it is also cheaper… health system. In general, Currently there is a lack of various diseases are now increasing and materials. Some days there are no getting more serious. This is due syringes. The next day there are to the rise of social inequalities syringes but there are no gloves. You References and the rise of poverty.” start to work without knowing what you have and what you don’t have.”

1. Alfred, Charlotte. "The Deadly Cost Of Austerity On Greece's System." The Huffington Post. TheHuffingtonPost.com, 3 July 2015. Web. 2. HealthManagement.org. "An Overview of the Healthcare System in Greece." HealthManagement. N.p., 10 Oct. 2010. Web. 3. Aldhous, Peter. "These 6 Charts Show What Austerity Did To ' Health." BuzzFeed. N.p., 6 July 2015. Web. 4. Chatzistefanou, Aris. "Greece's Biggest Hospital Struggles as Austerity Cuts Bite - Video." The Guardian. Guardian News and Media, 15 June 2012. Web.