Greece’s rundown state hospitals are cutting off vital drugs, limiting non-urgent operations and rationing even basic medical materials for exhausted doctors as a combination of economic crisis and political stalemate strangle health funding. With Greece now in its fifth year of deep recession, trapped under Europe’s biggest public debt burden and dependent on international help to keep paying its bills, the effects are starting to bite deeply into vital services. “It’s a matter of life and death for us,” said Persefoni Mitta, head of the Cancer Patients’ Association, recounting the dozens of calls she gets a day from Greeks needing pricey, hard-to-find cancer drugs. “Why are they depriving us of life?”
Dear friends of single-payer health care: do keep reading. And then please write and tell us all how you are going to avoid this happening here in America once you have had it your way and the federal government runs our entire health care system.
In fact, the Greek system is not even fully socialized. As is the case in most European countries, the government has stopped paying for all health care a long time ago – it was making more spending promises than it could keep – which has foeced patients in the Greek health care system to pony up some cash of their own for medicines. Government provides “subsidies”, but as the Reuters story explains, even those are too much for this high-taxed country to pay for:
Greece, a member of the euro zone that groups some of the richest nations on earth, has descended so far that drugmakers are even working on emergency plans to keep medicines flowing into the country should it crash out of the currency bloc. The emergency has grown out of a tangle of unpaid bills, with pharmacists and doctors complaining of being unable to pay suppliers until competing health insurers clear a growing backlog of unfilled state payments.
Imagine if the government had a complete monopoly so that not even private payments and shipments of medical drugs were possible.
Long queues have been forming outside a handful of pharmacies that still provide medication on credit – the rest are demanding cash upfront until the government pays up a subsidy backlog of 762 million euros, or nearly $1 billion. “We’re not talking about painkillers here – we’ve learned to live with physical pain – we need drugs to keep us alive,” Mitta, a petite former marathon runner and herself a cancer survivor, said in a voice shaky with emotion.
She is not in line for food, though. She is in line for a product that is heavily subsidized and regulated by government.
Greeks have long had to give medical staff cash “gifts” to ensure good treatment. Nevertheless the health system was considered “relatively efficient” before the crisis despite a variety of problems including a fragmented organization and excess bureaucracy, according to a 2009 report for the Organisation for Economic Cooperation and Development. But it has been unable to respond to the growing crisis. The European Union and International Monetary Fund, which provided a 130 billion euro lifeline to Greece in March, have demanded big cuts to the system as part of a wider package of austerity measures.
Sweden is another country that has gone through austerity measures of this kind. In fact, they are still being enforced, with very deadly results.
As the Reuters story continues, we learn more about what it is like to live under a government-run health care system:
Outside one of the 133 state hospitals – whose managers have sometimes been appointed as supporters of whichever political party was in power at the time – a banner put up by protesting staff reads “Hospitals Belong to the People”.
They already belong to the people. They are owned, operated and funded by the government.
A doctor at the university hospital in the northwestern Athens suburb of Chaidari cites a lack of basic examining room supplies in her own department, such as cotton wool, catheters, gloves and paper used to cover the examining table. The shortage of paper, which is thrown out after each patient has used it, means corners have to be cut on hygiene. “Sometimes we take a bed sheet instead and use it for several patients,” said Kiki Kiale, a radiologist specializing in cancer screening. “It’s tragic but there’s no other solution.”
In my book Remaking America: Welcome to the Dark Side of the Welfare State I tell a story from a government-run university hospital in southern Sweden where they use a cafeteria as an overflow room for patients with very contageous bacterial infections. When it is time to serve lunch the staff remove the patients and – if they have time – wipe down as much of the room as they can before lunch is served. I also report of the extreme shortage of mammography specialists and equipment.
Apparently, things are about as bad in Greece:
Kiale, 52, said staff cutbacks and a lack of crucial equipment – including a digital mammography machine – meant some doctors were seeing 40 patients during a shift but many patients were still unable to get treatment. In the chaos, patients can slip through the cracks or turn up for treatment again only when their illness has progressed too far for them to be saved. … Pharmaceutical industry sources say drugmakers have already discussed with European authorities how to keep Greece supplied with medicines should it have only new, radically devalued drachmas to pay for them. They have been looking closely at the experience of Argentina’s collapse in 2002, when some firms agreed to continue to supply medicines without payment for a while.
Sure, it is relevant to compare to Argentina. But keep in mind that Argentina, like Greece, fell into a hole because of a morbidly obese welfare state. Furthermore, my comparison to Sweden is important: it illustrates that the crisis in the Greek system is only partly due to the country’s overall bad economy. My good friend Dan Mitchell over at the Cato Institute has more evidence that the crumbling Greek health care is a systemic problem: his analysis of British health care is well worth reading.
In fact, the entire mess in Greece is, as I have explained on numerous occasions, caused by the welfare state. The same thing happened in Sweden during the ’90s (and the only part of their economy that has recovered is the export industry – the rest is a mess) and America is in for a similar ride once our recklessly spending government has run out of credit. Therefore, we should all pay close attention to the rest of the Reuters story on Greece, and consider how far we are willing to push our country before we join Greece down in the dungeons of panic-driven austerity – especially if we continue down the path of socializing our health care system.
In fact, here is a point to consider for all you health care socialists out there who want to reduce the share of GDP that we here in America spend on health care:
The IMF has said Greece needs to keep public health spending below 6 percent of GDP, down from around 10 percent at present and must sharply cut spending on pharmaceuticals which has surged over the past decade. It says Athens must cut such spending by at least 2 billion euros from 2010 levels, a step that would bring the average public expenditure on outpatient pharmaceuticals to 1 percent of GDP by the end of this year. What effect such cuts will have on patient care is likely to be dramatic, especially without a wider reform of healthcare. Even before the crisis, public hospitals were under strain and the notorious cash-filled “fakelaki” or “little envelope” which patients have had to hand over to get good treatment have become a byword for the corruption in the system.
The bribes and the corruption resulted from the fact that government was rationing health care, thus pushing patients to the point of desperation.
We can learn a lot from the Greek crisis. The lesson from their starved health care system is perhaps the most ominous one. And, again, let’s note that what the Greeks fear dying of is not starvation. Unlike health care, their food is still produced and funded on the principles of a private, free economy.