Greece: Ex Post Evaluation of Exceptional Access Under the 2010 Stand-By Arrangement

The New Political Economy of Health Care in the European Union

“…46,47 Countries in the Excessive Deficit, Balance of Payments, or Troika procedures, and in fact most others, have increased copayments, limited services and access to services for segments of the population, and cut workforce, pensions, or public-sector pay and benefits. 34,[48][49][50] The result, unsurprisingly, has been an increasing percentage of people in countries subject to E.U. austerity programs who report lack of access to health care due to inability to pay.…”

“…32 The IMF's own review of the Greek lending program seems to show these results, 33 though the Troika has forced changes in the organization of health care in Greece and the other peripheral states. 34 Meanwhile, the states under the Troika have mostly fulfilled the core economic targets of reduced deficits, though shrinking or stagnant economies mean that their debt-to-GDP ratios are still generally getting higher. Fulfilling these targets does not occur through the relatively nuanced policies in the EAPs, such as generic substitution or ministerial reorganization, so much as through major changes in the public finances, such as budget cuts, reductions in the list of covered services, pension cuts, staff cuts, claw-backs, or revenue measures such as higher taxes or user fees.…”

“…It has now been entrenched in the fiscal governance of the European Union, discussed in the next two sections and elsewhere. 34,35 On Paper: The Architecture of Fiscal Governance Given that the origins of fiscal governance lie in the Eurozone financial crisis, it is not surprising that the focus and justification of E.U. fiscal governance is the policy objective of 3% deficits and a 60% debt: GDP ratio.…”

“…effect on health care systems was framed almost uniquely as an application of its general economic legislation to health care. 34,37 While the OMC, BEPG, and lesser forms of international exchange all aspired to influence member state health policies, they were very soft forms of law that worked only when they had allies within the member states who were able to use them in domestic politics. 38 The European Semester of economic policy coordination refers to an ongoing cycle of reviews and recommendations that brings together all the elements of the fiscal and macroeconomic governance architecture discussed in the previous section.…”

On The Odiousness of Greek Debt

“…The restructuring of the debt recommended by the IMF in 2010 would have reduced it by 80% and would have, according to the IMF, contributed to a speedy and feasible recovery. 67 On the contrary, the plans favoured by the French and German governments, based on the pretention that Greece could fulfil the programme and pay back the debt in full were bound to fail. As is well known, the IMF, despite the vocal disagreement of its staff and of some Member States, ended up following the French and Greek line (something that required an 'express' reform of the IMF Articles of Agreement, as the level of credit granted nominally to the Greek state exceeded several times the maximum amount it could have lent to Greece).…”