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© 2021 International Monetary Fund
WP/21/189
IMF Working Paper
European Department
Healthcare Reform in Greece: Progress and Reform Priorities
Prepared by Niki Kalavrezou and Hui Jin1
Authorized for distribution by Dennis Botman
July 2021
IMF Working Papers describe research in progress by the author(s) and are published to elicit comments and to encourage debate. The views expressed in IMF Working Papers are those of the author(s) and do not necessarily represent the views of the IMF, its Executive Board, or IMF management.
Abstract
We review Greek public sector healthcare policies and health-related outcomes since 2010. We find that excess spending was successfully curtailed, elements of the institutional framework were modernized, and health outcomes have been relatively favorable. However, especially prior to Covid-19, public healthcare spending had been compressed to potentially unsustainable levels, with widening inequalities and large unmet needs, especially among the poor. Higher public spending and advancing structural healthcare reforms are needed to improve the efficiency and equity of the Greek healthcare system, including strengthening primary healthcare, reducing out-of-pocket payments, and eliminating remaining insurance gaps.
Keywords: healthcare, health policy, structural reforms, health insurance
JEL Classification Numbers: H51, I18
Authors’ E-Mail Addresses: nkalavrezou@imf.org; hjin@imf.org
Contents
ABSTRACT
I. INTRODUCTION
II. GREECE’S HEALTHCARE SYSTEM BEFORE THE CRISIS
III. NARRATIVE APPROACH: DETAILS OF THE HEALTHCARE REFORM IN GREECE
A. OVERVIEW OF THE HEALTHCARE REFORM
B. AN ASSESSMENT OF MACRO HEALTHPOLICY REFORMS
C. ASSESSMENT OF STRUCTURAL HEALTH POLICY REFORMS
IV. SPENDING COMPRESSION, RISING UNMET NEEDS, AND REFORM PRIORITIES
V. CONCLUSION
REFERENCES
The authors would like to express sincere gratitude to Maura Francese, Peter Dohlman, and Ivohasina Razafimahefa for their excellent comments. This paper was prepared prior to the outbreak of the Covid-19 pandemic and does not provide a comprehensive assessment of its impact on the healthcare sector in Greece.