Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state

Detalhes bibliográficos
Autor(a) principal: Economou, Charalampos
Data de Publicação: 2018
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25761/anaisihmt.246
Resumo: The present paper discusses the impact of restrictive policies dictated by Troika on Greece’s health care system. The majority of the measures introduced during the first wave of reforms (2010-2014), were fiscal consolidation measures resulting in increasing barriers to access to health services and a deterioration of the health of the population. Policies likely to promote health care system goals such as universal coverage, strategic purchasing, Health Technology Assessment, public health measures, shifting from inpatient to ambulatory care, and integration and coordination of primary and secondary care, were neglected, while some other, e.g. the National Organization for the Provision of Health Services, the National Primary Health Care Network and Diagnosis Related Group-Greek Version, were not well planned and implemented, due to extremely strict reform targets and schedules imposed by the Memoranda. Although after 2015 these neglected issues came to the forefront of the health policy agenda, issues for further consideration remain in relation to the scope and depth of social health insurance, the adequacy of public health funding, the development of a resource allocation mechanism, the reorganization of the hospital sector, the development of physical rehabilitation, long-term and palliative care and the strengthening of public health services. Using the health system as a case study, we argue that “hard” Europeanization mechanisms characterized by fiscal austerity and internal devaluation resulted to the retrenchment of the Greek welfare state.
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spelling Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare stateO sistema de saúde grego e a crise: um estudo de caso na luta pela capacidade do Estado SocialThe present paper discusses the impact of restrictive policies dictated by Troika on Greece’s health care system. The majority of the measures introduced during the first wave of reforms (2010-2014), were fiscal consolidation measures resulting in increasing barriers to access to health services and a deterioration of the health of the population. Policies likely to promote health care system goals such as universal coverage, strategic purchasing, Health Technology Assessment, public health measures, shifting from inpatient to ambulatory care, and integration and coordination of primary and secondary care, were neglected, while some other, e.g. the National Organization for the Provision of Health Services, the National Primary Health Care Network and Diagnosis Related Group-Greek Version, were not well planned and implemented, due to extremely strict reform targets and schedules imposed by the Memoranda. Although after 2015 these neglected issues came to the forefront of the health policy agenda, issues for further consideration remain in relation to the scope and depth of social health insurance, the adequacy of public health funding, the development of a resource allocation mechanism, the reorganization of the hospital sector, the development of physical rehabilitation, long-term and palliative care and the strengthening of public health services. Using the health system as a case study, we argue that “hard” Europeanization mechanisms characterized by fiscal austerity and internal devaluation resulted to the retrenchment of the Greek welfare state.Este artigo analisa o impacto das políticas restritivas ditadas pela Troika no sistema de saúde grego. A maioria das medidas introduzidas durante a primeira fase das reformas (2010-2014) foram medidas de consolidação fiscal resultantes do aumento das barreiras ao acesso aos serviços de saúde e uma deterioração da saúde da população. Políticas que tendencialmente promoveriam as metas do sistema de saúde tais como cobertura universal, aquisição estratégica, avaliação da inovação tecnológica, medidas de saúde pública, mudança de internamento para cuidados em ambulatório, integração e coordenação de cuidados de saúde primários e secundários foram negligenciadas, enquanto que outras, por exemplo, a Organização Nacional para a Prestação dos Serviços de Saúde, a Rede Nacional de Cuidados Primários de Saúde e grupos de diagnóstico homogéneos (GDH) na versão grega, não foram bem planeadas nem implementadas devido aos exigentes objetivos reformistas e aos prazos impostos pelos memorandos. Embora depois de 2015 estes assuntos negligenciados tenham passado a constar como prioridades da agenda da política de saúde, outros continuam a necessitar de uma melhor abordagem em relação à abrangência do seguro social de saúde, a adequação do financiamento público da saúde, o desenvolvimento de um mecanismo de alocação de recursos, a reorganização do setor hospitalar, o desenvolvimento da medicina física e de reabilitação, os cuidados continuados e paliativos e o reforço dos serviços públicos de saúde. Usando o sistema de saúde como um estudo de caso, defendemos que “fortes” mecanismos de europeização caracterizados por austeridade fiscal e desvalorização interna resultam na retração do sistema público de saúde grego. Universidade Nova de Lisboa2018-12-15T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.25761/anaisihmt.246oai:ojs.anaisihmt.com:article/246Anais do Instituto de Higiene e Medicina Tropical; Vol 17 No 1 (2018): Suplemento Nº1; 7-26Anais do Instituto de Higiene e Medicina Tropical; v. 17 n. 1 (2018): Suplemento Nº1; 7-262184-23100303-7762reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://anaisihmt.com/index.php/ihmt/article/view/246https://doi.org/10.25761/anaisihmt.246http://anaisihmt.com/index.php/ihmt/article/view/246/206http://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessEconomou, Charalampos2022-09-23T15:30:24Zoai:ojs.anaisihmt.com:article/246Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:03:58.628395Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
O sistema de saúde grego e a crise: um estudo de caso na luta pela capacidade do Estado Social
title Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
spellingShingle Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
Economou, Charalampos
title_short Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
title_full Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
title_fullStr Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
title_full_unstemmed Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
title_sort Greece’s healthcare system and the crisis: a case study in the struggle for a capable welfare state
author Economou, Charalampos
author_facet Economou, Charalampos
author_role author
dc.contributor.author.fl_str_mv Economou, Charalampos
description The present paper discusses the impact of restrictive policies dictated by Troika on Greece’s health care system. The majority of the measures introduced during the first wave of reforms (2010-2014), were fiscal consolidation measures resulting in increasing barriers to access to health services and a deterioration of the health of the population. Policies likely to promote health care system goals such as universal coverage, strategic purchasing, Health Technology Assessment, public health measures, shifting from inpatient to ambulatory care, and integration and coordination of primary and secondary care, were neglected, while some other, e.g. the National Organization for the Provision of Health Services, the National Primary Health Care Network and Diagnosis Related Group-Greek Version, were not well planned and implemented, due to extremely strict reform targets and schedules imposed by the Memoranda. Although after 2015 these neglected issues came to the forefront of the health policy agenda, issues for further consideration remain in relation to the scope and depth of social health insurance, the adequacy of public health funding, the development of a resource allocation mechanism, the reorganization of the hospital sector, the development of physical rehabilitation, long-term and palliative care and the strengthening of public health services. Using the health system as a case study, we argue that “hard” Europeanization mechanisms characterized by fiscal austerity and internal devaluation resulted to the retrenchment of the Greek welfare state.
publishDate 2018
dc.date.none.fl_str_mv 2018-12-15T00:00:00Z
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dc.publisher.none.fl_str_mv Universidade Nova de Lisboa
publisher.none.fl_str_mv Universidade Nova de Lisboa
dc.source.none.fl_str_mv Anais do Instituto de Higiene e Medicina Tropical; Vol 17 No 1 (2018): Suplemento Nº1; 7-26
Anais do Instituto de Higiene e Medicina Tropical; v. 17 n. 1 (2018): Suplemento Nº1; 7-26
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