The health care system in Greece is a complex and multifaceted system that consists of a universal health care system provided through national health insurance, as well as a private health care sector. In the modern Greek state, the National Healthcare Service (ESY, Ethniko Systima Ygeias) was established to provide healthcare.
Health care in Greece has evolved over time to ensure that all residents have access to necessary medical care. The universal health care system provided through national health insurance forms the backbone of the healthcare system, offering comprehensive coverage to the population. This includes primary care services, such as general practitioner visits and preventive care, as well as specialized care, including hospital stays and surgeries.
In addition to the universal health care system, Greece also has a private health care sector that operates alongside the public system. Private healthcare services are accessible to those who have private health insurance or are willing to pay out-of-pocket for their medical expenses.This sector has seen significant growth in recent years and now accounts for more than half of healthcare expenditure in Greece.
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Structure and Organization of Healthcare Services
The system encompasses a National Health System (NHS), compulsory social insurance, and a voluntary private healthcare system. The NHS provides universal coverage to all residents, while social insurance funds and voluntary health insurance also contribute to healthcare funding. The system includes general and specialized hospitals, primary care health centers, and rural medical surgeries.
The public healthcare system is managed by seven (7) Regional Health Authorities, which report to the Ministry of Health and Social Solidarity (link, in greek only). Social insurance funds purchase healthcare services from the NHS and private providers, covering different occupational groups.
One example of the structure and organization of healthcare services in Greece is the role of primary care health centers. These centers serve as the first point of contact for individuals seeking medical care and provide a wide range of services, including preventive care, diagnosis, and treatment of common illnesses. Primary care health centers play a crucial role in promoting community health and well-being, as well as in coordinating and managing the healthcare needs of the population.
The regional authorities in Greece are expected to play a larger role in coordinating primary care in the future. This decentralization of healthcare management aims to bring healthcare services closer to the communities and ensure that the specific needs of each region are addressed. By empowering regional authorities, the healthcare system can be more responsive to the unique challenges and demands of different areas in Greece.
Access to Healthcare in Greece
Access to healthcare services in Greece is generally available and accessible to the population. Efforts are being made to further improve access by developing primary care services and enhancing the role of general practitioners (GPs). The goal is for GPs to become the first point of contact for all residents, providing comprehensive and coordinated care. While referral to a specialist is not yet mandatory, it will eventually be phased out.
To ensure that individuals have access to necessary healthcare services, Greece has been working towards developing a robust primary care system. This involves strengthening the role of GPs as the main providers of primary care and the first point of contact for individuals seeking medical assistance. By expanding the availability of primary care facilities and enhancing the skills and capabilities of GPs, the healthcare system aims to provide more efficient and coordinated care.
The development of primary care services is crucial to improving access to healthcare in Greece, especially in rural and underserved areas. By ensuring that individuals have access to primary care close to their communities, unnecessary hospitalizations and visits to specialists can be reduced, leading to better overall health outcomes and more efficient use of healthcare resources.
What health care services are available to uninsured people in Greece?
- Exactly what the insured are entitled to from public health facilities.
- Free and unrestricted access to primary and secondary public health care facilities, mental health care facilities, rehabilitation facilities and university hospitals.
- All hospital and diagnostic procedures free of charge
- Scheduled operations free of charge
- Free health prevention and promotion (e.g. vaccinations)
- Free dental care
- Free obstetric care and birth planning in public hospitals
- Medication administration through private and public pharmacies. A significant proportion of the uninsured population is eligible for free medicines.
- Elimination of the €1 per prescription for the uninsured population eligible for zero drug coverage.
- Physical therapy, speech therapy, occupational therapy, psychotherapy and special treatment.
- Provision of medical equipment and supplies
Public Healthcare in Greece
The Ministry of Health regulates the entire healthcare system in Greece. The NHS, as part of the public healthcare system, provides universal coverage to the population. It consists of:
- general and specialized hospitals
- primary care health centers
- rural medical surgeries
Public healthcare plays a critical role in ensuring that all individuals in Greece have access to necessary medical care. The NHS, which forms a significant part of the public healthcare system, provides comprehensive coverage, including primary and specialized care services.
Financing for the public healthcare system in Greece comes from a mixed system of public sources and out-of-pocket payments. Taxes account for 70% of NHS financing, while the remaining funds come from social security contributions and out-of-pocket payments. This mixed financing model aims to ensure the sustainability of the healthcare system while also providing affordable care to the population.
However, the public healthcare system in Greece faces challenges, particularly related to the oversupply of doctors and the shortage of nurses. The imbalance between doctors and nurses can result in operational and service distortions, impacting the quality and efficiency of care provided to patients. Addressing these challenges requires optimizing the allocation of healthcare resources and finding ways to attract and retain healthcare professionals in the workforce.
Private Healthcare in Greece
Private healthcare in Greece operates alongside the public healthcare system, providing additional options and choices for individuals seeking medical care. Private providers are contracted by the National Organization for Healthcare Provision (EOPYY) for primary care and outpatient services.
The private healthcare sector in Greece has experienced significant growth in recent years and now accounts for more than half of healthcare expenditure.This sector includes:
- profit-making hospitals
- diagnostic centers
- independent practices
Private healthcare services are accessible to those who have private health insurance or are willing to pay out-of-pocket for their medical expenses. Private healthcare is financed through insurance funds and direct payments by patients.
One example of private healthcare in Greece is the availability of private hospitals. These hospitals offer a range of specialized services and treatments, often with shorter waiting times compared to public hospitals. Individuals who have private health insurance or can afford to pay out-of-pocket can choose to receive medical care at private hospitals, enjoying the benefits of more personalized care and the use of advanced medical technologies.
Private healthcare services in Greece are also accessible through diagnostic centers and independent practices. These facilities provide specialized diagnostic tests, such as imaging scans and laboratory tests, as well as outpatient procedures and consultations with specialists. Individuals who opt for private healthcare can benefit from more flexible appointment scheduling and shorter waiting times for consultations and procedures.
Healthcare Insurance in Greece
The healthcare insurance model in Greece consists of a national health service and a social health insurance model. Health coverage was extended to uninsured people registered as unemployed and refugees in 2016. This extension aimed to ensure that these individuals have access to necessary healthcare services, regardless of their financial situation.
In the private healthcare sector, individuals who choose to receive private healthcare services or undergo tests and procedures not covered by the publicly funded system are responsible for covering the cost themselves. This includes the cost of private healthcare services and tests, which can vary depending on the provider and the specific services required.
Efforts have also been made to increase the use of generic drugs in Greece. This is part of an ongoing effort to reduce healthcare costs and make medications more affordable and accessible to the population.
What health care services are available to uninsured people in Greece?
- Exactly what the insured are entitled to from public health facilities.
- Free and unrestricted access to primary and secondary public health care facilities, mental health care facilities, rehabilitation facilities and university hospitals.
- All hospital and diagnostic procedures free of charge
- Scheduled operations free of charge
- Free health prevention and promotion (e.g. vaccinations)
- Free dental care
- Free obstetric care and birth planning in public hospitals
- Medication administration through private and public pharmacies. A significant proportion of the uninsured population is eligible for free medicines.
- Elimination of the €1 per prescription for the uninsured population eligible for zero drug coverage.
- Physical therapy, speech therapy, occupational therapy, psychotherapy and special treatment.
- Provision of medical equipment and supplies
Challenges and Improvements in the Greek Health Care System
The Greek healthcare system faces numerous challenges, including economic austerity measures and an influx of third-country nationals. Barriers to healthcare access for third-country nationals include legal, communication/language, cultural, and bureaucratic issues. The Covid-19 pandemic has further impacted access to healthcare, particularly for migrants and refugees living in precarious situations. Improvements in the healthcare system include the development of primary care and the implementation of an integrated care system. The goal is to improve efficiency, access, and quality of healthcare services in Greece.
In response to these challenges, improvements have been made and continue to be implemented in the Greek healthcare system. The development of primary care services aims to enhance the efficiency and accessibility of healthcare services, ensuring that individuals can receive appropriate care in a timely manner. By strengthening the role of GPs and expanding the availability of primary care facilities, the healthcare system can better meet the needs of the population.
The implementation of an integrated care system is another improvement being pursued in Greece. This system aims to improve coordination and communication among healthcare providers, ensuring that individuals receive comprehensive and coordinated care across different healthcare settings. By integrating various aspects of care, such as primary care, specialized care, and social services, the healthcare system can better address the complex needs of patients and provide more efficient and effective care.
Landscape of Health Care in Greece: From Doctors to Hospital Beds
Greece has a relatively high number of doctors per capita (6.5 doctors per 1000 citizens in 2016), ensuring that there is a sufficient workforce to provide medical care to the population. This high number of doctors per capita is in part due to the historical emphasis on medical education and the availability of medical training programs.
However, there is a shortage of nurses in the healthcare system. The shortage of nurses can impact the delivery of care and the overall efficiency of the healthcare system. While the Greek health system needs at least 2-3 nurses per doctor, it currently has about 1.5.
Efforts are needed to optimize the allocation of healthcare resources and improve the balance between doctors and nurses in the Greek healthcare system. This includes attracting and retaining nurses in the healthcare workforce, as well as implementing strategies to ensure that healthcare professionals are distributed evenly across different regions in Greece.
In recent years, there has been a shift in the Greek healthcare system towards same-day procedures, resulting in a decrease in the number of hospital beds per capita. This change is aimed at promoting more efficient use of healthcare resources and reducing the length of hospital stays. However, it also means that there is a need to ensure that there are adequate facilities and resources available for same-day procedures.
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