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Country profiles of health system responses to the crisis | Greece 391 % Greece: Fig. 1 Economic and fiscal indicators 2000–2007 and 2008–2011 60 55 50 45 40 35 30 25 20 15 10 5 0 −5 −10 −15 −20 −25 −30 _ _ _ _ ● ● _ _ ● ● _ _ _ ● _ Real GDP per capita growth _ _ _ _ _ ● ● _ _ ● ● ● _ _ _ Deficit/surplus (% GDP) _ _ _ _ _ _ _ _ _ _ ● ● _ _ _ ● _ ● _ ● _ _ _ _ _ Government spending (% GDP) _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Government health spending (% total government spending) _ _ _ _ _ _ ● _ ● ● ● ● _ _ _ 10−year bond rates _ _ _ _ _ _ _ ● ● ● ● ● _ _ _ _ _ Unemployment rate Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators: WHO Health for All. Year 2000−2007 2008 2009 2010 2011 Greece: Fig. 2 Trends in per capita spending on health, 2000–2011 2000 Public spending per capita OOP spending per capita Non−OOP private spending per capita Per capita spending $, PPP 1500 1000 500 0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 20 Growth % 0 −20 −40 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Public spending per capita growth OOP spending per capita growth Note: Spending calculated from WHO Health for All. Non−OOP private spending per capita growth

392 Economic crisis, health systems and health in Europe: country experience Changes to health coverage Population (entitlement) • People with a low income or who are uninsured will have free access to treatment in designated public hospitals and to generic outpatient prescription drugs from 2014 (2011). The benefits package • Reimbursement claims for hospital care must be submitted within two months (2010). • A national benefits package was established (2011). • A positive list of drugs was reintroduced (abolished in 2006), with a focus on generic drugs (2011). • Some previously covered services were excluded (e.g. polymerase chain reaction and thrombophilia tests) and cover restricted for others (childbirth, air therapy, balneotherapy, thalassaemia, logotherapy and nephropathy) mainly on the basis of their high cost (MoU 2012). • A new negative list of medicines was created based on similar lists in Spain and Italy; the list should be updated twice a year, shifting many medicines to over-the-counter status (2012). User charges • Introduction of an exemption from user charges in public facilities for people in vulnerable groups and the addition of people with diabetes and people requiring organ transplants to the list of vulnerable groups (2011). • User charges for outpatient visits in public hospitals and health centres increased from €3 to €5 (2011). • Introduction of a new co-payment of €25 per admission to a public hospital (revoked in 2014) and an additional €1 per NHS prescription in outpatient and inpatient settings from 2014 (2012). • User charges for diagnostic tests in public hospitals abolished (2012). • Co-insurance rates for drugs for specific diseases increased from 10% to 25% (rheumatoid arthritis, psoriatic arthritis, lupus, vasculitis, spondyloarthritis, scleroderma, chronic obstructive pulmonary disease, pituitary adenomas, osteoporosis, Paget's disease, Crohn's disease, cirrhosis), from 0% to 10% (Alzheimer's disease, dementia, epilepsy, angiopathy) and from 0% to 25% (pulmonary hypertension); patients requiring haemodialysis will no longer be exempt from all prescription drug user charges, just from those related to their condition (2012).

Country profiles of <strong>health</strong> system responses to the <strong>crisis</strong> | Greece<br />

391<br />

%<br />

Greece: Fig. 1 Economic <strong>and</strong> fiscal indicators 2000–2007 <strong>and</strong> 2008–2011<br />

60<br />

55<br />

50<br />

45<br />

40<br />

35<br />

30<br />

25<br />

20<br />

15<br />

10<br />

5<br />

0<br />

−5<br />

−10<br />

−15<br />

−20<br />

−25<br />

−30<br />

_ _<br />

_ _<br />

● ●<br />

_ _<br />

●<br />

●<br />

_ _<br />

_<br />

●<br />

_<br />

Real GDP<br />

per capita growth<br />

_ _<br />

_ _ _<br />

● ●<br />

_ _<br />

●<br />

● ●<br />

_ _ _<br />

Deficit/surplus<br />

(% GDP)<br />

_ _ _ _ _ _ _ _<br />

_ _<br />

●<br />

●<br />

_ _<br />

_<br />

● _ ●<br />

_<br />

●<br />

_ _ _ _ _<br />

Government<br />

spending<br />

(% GDP)<br />

_ _ _ _ _<br />

● ● ● ● ●<br />

_ _ _ _ _<br />

Government<br />

<strong>health</strong> spending<br />

(% total government<br />

spending)<br />

_ _ _ _ _<br />

_ ● _ ●<br />

●<br />

●<br />

●<br />

_ _ _<br />

10−year<br />

bond rates<br />

_ _ _ _ _<br />

_ _<br />

●<br />

●<br />

●<br />

●<br />

●<br />

_ _ _ _ _<br />

Unemployment<br />

rate<br />

Notes: Deficit/surplus: Eurostat; 10-year bond rates: European Central Bank; Other indicators:<br />

WHO Health for All.<br />

Year<br />

2000−2007 2008 2009 2010 2011<br />

Greece: Fig. 2 Trends in per capita spending on <strong>health</strong>, 2000–2011<br />

2000<br />

Public spending per capita OOP spending per capita Non−OOP private spending per capita<br />

Per capita spending $, PPP<br />

1500<br />

1000<br />

500<br />

0<br />

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />

20<br />

Growth %<br />

0<br />

−20<br />

−40<br />

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011<br />

Public spending<br />

per capita growth<br />

OOP spending<br />

per capita growth<br />

Note: Spending calculated from WHO Health for All.<br />

Non−OOP private spending<br />

per capita growth

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