Effects of the Greek Financial Crisis on Access to Healthcare

On June 30, 2015, Greece was due to repay €1.5 billion (around $1.6 billion) in debt to the International Monetary Fund. As it became apparent that Greece would not be able to make the payment without financial assistance, Greek authorities negotiated the terms of a bailout extension with its European creditors throughout June. On June 27, 2015, Greek Prime Minister Alexis Tsipras called a referendum on the acceptance of final conditions proposed by the creditors on the 25th of that month. With a financial system in danger of collapsing, strict capital controls were imposed, including cash withdrawal limits and foreign money transfer restrictions. On July 5, 2015, over 60% of Greeks rejected the bailout conditions, opening a final round of negotiations with creditors. A week after, the Eurogroup agreed to offer Greece a third bailout. In return for the €86 billion ($94 billion) bailout, Greece agreed to implement the strict measures imposed by the creditors, considerably harsher than those rejected in the referendum.

As the Eurogroup negotiates the specific terms of the new bailout, the acute financial crisis has already threatened access to health services in Greece. First, with a debt of over €4 billion ($4.4 billion), the main healthcare provider in Greece, EOPYY, is failing to meet its financial obligations towards suppliers, jeopardizing the supply of medical devices and drugs. In fact, some doctors have already reported a shortage of drugs in hospitals. A similar undersupply of medicines occurred during 2012 and 2013, when over 50 pharmaceutical companies slashed drug supply to Greece by 90% and hospitals required patients to provide their own medicines. Second, as capital controls continue, many patients are unable to afford out-of-pocket payments for health services subject to co-payment, such as prescription drugs or out-patient visits. Furthermore, there is a possibility that some commercial pharmacies may stop accepting EOPYY coverage as they did in 2012, and patients may be solely responsible for payment. This problem is further aggravated by the fact that retirees, who use more prescription drugs, is the group most affected by the capital controls imposed. This is because a large proportion of the Greek pensioners do not have credit cards and without them, each individual is only allowed to withdraw €120 (around $132) cash per week, as opposed to the €60 ($65) per day cash withdrawal limit for those with credit cards.

The midterm consequences of the financial crisis will be triggered following implementation of the pack of austerity measures required by the creditors to offer a third bailout, and in particular, by the pension system reform. In addition to moving the retirement age to 67 years, the contributions of pensioners towards healthcare will be raised from 4% to 6%. To raise this contribution, the Greek authorities may increase cost sharing for health services as it did in 2011, when co-payments for outpatient visits increased from €3 ($3.3) to €5 ($5.5) and prescription drug cost sharing increased by 10%.

Even if the pension system reform imposes greater financial burden on pensioners with respect to healthcare access, a new bailout is arguably a better scenario from the healthcare perspective than a potential exit from the Eurozone. If Greece was forced to exit the euro and introduce its former currency drachma, it would suffer a major devaluation, which would decrease the purchasing power of the EOPYY to import health technologies and treatments. In fact, the European Federation of Pharmaceutical Industries and Associations warned that with the EOPYY owing over €1.1 billion ($1.21 billion) to international drug companies, Greece´s exit from the euro could lead to severe shortages of medicines, which could trigger a public healthcare crisis.

In summary, the recent events in the Greek crisis are jeopardizing access to some health services, especially prescription drugs. Even if the pension system reform imposed by the Eurogroup reduces healthcare affordability for seniors in Greece, a third bailout is better for healthcare overall than a potential exit from the Eurozone.