Sustainability of Healthcare Financing in Greece: A Relation Between Public and Social Insurance Contributions and Delivery Expenditures

Abstract

The economic crisis in Greece, which began in 2010 and lasted for 10 years, highlighted the serious problems and challenges of the Greek Social Health Insurance system. The reforms that mainly took place during the crisis provided a temporary solution. They focused on establishing a new National Organization for Healthcare Services (named EOPYY) and merging all the old insurance funds. This paper aims to examine whether this social health insurance fund has been sustainable in the long run. An actuarial model was created to project future expenses and revenues. Demographic and economic trends were considered, while it was assumed that medical technology remains unaltered. The assessment of the system solvency was based on the ratio (Revenue/Liabilities) calculated for each year, from 2020 to 2050. The results led to deficits, the amount and the time point in which they appear depends on how optimistic or pessimistic demographic and economic assumptions were. A new financial flow model was proposed to address the deficits. The results show that under the new model, the system remains solvent until 2050. The state subsidy amount on the employees’ health insurance premium was estimated as a percentage of the employees’ wage.

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“…Therefore, the assessment model of fiscal burden on the income side (URRBMI only) is expressed as formula (7):…”

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Stakeholder perceptions and public health system performance evaluation: Evidence from Greece during the COVID-19 pandemic

“…Among stakeholders of the policy community, fiscal resources are recognized as the most essential, being selected in the relevant question by 74.33% of the sample (Figure 7). Given Greece's recent exit from a 10-year economic depression, long-term underfunding has made fiscal resources particularly scarce (Mavridoglou and Polyzos, 2022). Furthermore, in the distribution of spending, 44% of the 2021 health budget was devoted to impatient care while only 1.4% was used for preventive services, among the lowest between EU countries (OECD/European Observatory on Health Systems Policies, 2021).…”