by Maria Spiliopoulou
ATHENS, Oct. 11 (Xinhua) -- Greek society is suffering grave and potentially catastrophical consequences on health and social care from a two-year debt crisis.
The crisis exposed a problematic welfare state already sick and unfit to help vulnerable groups cope with the emergency, Greek and foreign experts warned in a string of recent surveys.
In an interview with Xinhua, Panagiotis Behrakis, Associate Professor at the Medical School of the University of Athens and Harvard School of Public Health, suggested a radical shake-up of the system through reforms to secure that Greeks will survive the crisis in one piece. Many local and foreign scientists support the need for a "reform pill".
University of Cambridge published a study this week in the medical journal Lancet, showing that due to rising unemployment that hit a record high 16.5 percent this year and austerity budget cuts to slash deficits and escape default, the most vulnerable social groups lose access to health care. As a consequence, heroin addiction rose by 20 percent in a year and HIV infections doubled in 2010, as special support programs were reduced.
Addressing the parliament a few weeks ago, Greek Health Minister Andreas Loverdos acknowledged a 40 percent rise in suicides up from last year. According to figures from Greek authorities, the number of people who received sickness benefits was reduced by the same percentage in the same period, as social security funds have 4.5 billion euro (6.1 billion U.S. dollars) debts.
Public hospitals reported shortages in essential medicines last year due to a debate between the government and pharmaceutical companies over overdue bills, as state-run hospitals are burdened with 6.5 billion euro (8.8 billion U.S. dollars) debts. All of a sudden, cancer patients such as Rina, a middle-aged mother of two children, were asked to pay for their own medication that costs more than the average monthly salary in Greece.
"I had to borrow money from relatives and friends, since we cannot resort to banks anymore. We have already spent a fortune for my treatment over the past few years in private hospitals and doctors, because I could not wait in a queue for months to undergo an operation or be treated in public hospitals," Rina told Xinhua.
Up to 2010, Greek households spent on an annual basis two billion euros on supplementary private insurance. Amidst a wave of salary cuts, tax hikes, mounting unemployment and recession, they have to rely on shrinking public services.
"I would not say that the welfare system in Greece collapses, but for certain is being shrunk. Education, Health, social benefits are being reduced in a phase in our history when we face financial woes. It is not worldwide unprecedented," noted Professor Behrakis, adding that Greek people must accept that in difficult times there are losses.
"We must be realists and try to reduce the impact," he stressed, attributing today's problems in social welfare to chronic malfunctions, such as waste of funds and corruption.
"The welfare state in Greece was among the causes of the crisis, while it is also being affected by it. At the same time, a reformed welfare state is urgently needed to prevent the crisis from turning into a catastrophe," Manos Matsaganis, Assistant Professor at the Athens University of Economics and Business, argued in a paper on the subject published this year.
Matsaganis explained that the welfare system contributed to the fiscal crisis due to huge deficits in key programmes such as pensions linked to mismanagement.
Spending on welfare is not marginal in Greece. About 26 percent of the national income is invested to welfare and poverty reduction, while the European average is about 27.3 percent. But at least 90 percent of these funds are spent on paying pensions. Family, sickness, housing, unemployment and social assistance benefits on the other hand account for a mere 3.2 percent of average household income.
In spite of rising expenditure, poverty in old age remains above the European average (22 percent vs. 19 percent), as the system favours privileged categories, such as self-employed over wage earners and public over private sector employees, Matsaganis pointed out.
"Historically, the Greek welfare state has been rather good at handing out pensions to well-paid workers in their early 50s (or earlier), but much worse at protecting low income families or helping young people get a job or move out of the parental home," he said.
The current crisis and the measures to counter it deprived this problematic welfare state of resources. As a result, social safety net benefits were slashed. For instance, the Workers' Housing Organisation was forced to suspend payment of "rent subsidies" in 2010, while disabled people face reduction on allowances.
Private sector employees on a temporary basis with limited job protection and less generous pay and benefits compared to civil servants, long-term unemployed lacking access to benefits, families who live in poverty with one or two children and are not qualified for child benefits that are handed out to larger families, are under enormous pressure.
"On paper, things might seem ok. When you lose your job you can claim an unemployment monthly benefit of 450 euros (612.45 U.S. dollars) on average based on unemployment insurance contributions for up to a year. But if you were forced to work in the shadow economy, so that your employers would not pay taxes, you are left with no support at all," Yannis Sinanidis, a 32-year old married private sector employee who is jobless for almost tewo years, told Xinhua.
Sinanidis depends on his family to make ends meet. Families in Greece always worked as an informal welfare state, absorbing social shocks. This time, as the average Greek household has seen its income reduced by some 30 percent in a year, he can not expect much help from his pensioner father.
"Despite current difficulties, I believe that through drastic deficit cuts and a strong shock for Greek society, through bold structural reforms, we can overcome the crisis," Professor Behrakis said.
"I cannot make predictions on whether we will witness social upheaval. In Medicine the most difficult part is to make a prognosis. The same applies for society. But there is a saying for politics that I believe is a diachronic truth- that there is a solution to every crisis in a democracy through dialogue. After all, we taught democracy to the world," he added, arguing that still the Greek system is better than the one in the United States.
"I have no doubt. The American health care system is based on private insurance and the economic situation of each person. The gap is enormous between rich and poor. On average in Greece a poor person enjoys in comparison better services," he said, explaining that in Athens, if an ambulance takes you to a hospital, nobody will ask for identity card or insurance. They will provide you with first aid.
"Up to now we treated in Greek hospitals even citizens of neighbour countries free of charge," Behrakis stressed.
Matsaganis agrees that bolstering social protection through reforms in the pension, health, welfare system to reallocate spending on the most vulnerable groups, is an emergency. "Failing to soften the impact of the crisis is likely to prove costlier in terms of social unrest and rising crime," he warned.