By George Constantelis
The Greek economy, which is now experiencing the repercussions of an extraordinary global financial crisis but also fighting its own systemic demons, is at the centre of political debate. The focus is on severe budget constraints and the simultaneous need for economic growth, with everyone hoping that Greece will soon come out of the woods. Mainly due to insufficient controls over hospital and other spending, the overall healthcare sector has been part of the problem across time. However, it must be seen as part of the solution for a growing economy and a prosperous society.The Greek healthcare system has been founded on the principle of unrestricted access – and rightfully so. All patients, regardless of financial stature, are able to receive innovative medicines with minimal administrative, logistical or other barriers. How many other countries in the world can state the same? Health economists make the link between access and average life-expectancy and Greece does follow this rule, as we live longer than the European average.
Unfortunately and misleadingly, the principle of unrestricted access is being linked to the increasing healthcare expenditures. Numbers, however, speak loud and clear and should not be questioned. On the one hand, new medicines contribute to improved healthcare, adding years to life and life to years but also diminishing overall costs, such as hospital stays. In other words, it is obvious that health does equal wealth. On the other hand, the expenditure for medicines accounts for only 20 percent of the overall healthcare spending. In fact, aiming at cost containment, the state defines the prices of medicines as the three lowest of the Eurozone, which is not the case for any other product in Greece.
Then where does the other 80% go and what has derailed the overall healthcare expenditures? In absence of any type of IT either at the hospital or sick funds level, there is wasteful, unmonitored spending and, in some cases, even unlawful practices at different parts of the healthcare chain, which have led to the overall healthcare spending dangerously ballooning over the last decades. Clearly, the issue is clearly one of mismanagement and not one of expensive drug prices. In fact, this is exactly the reason why the introduction of electronic systems and controls, which has been advocated for by the pharmaceutical industry, is an imperative need for overall cost containment.
With the focus being on the economy, one should not disregard the important macro-economic role of the pharmaceutical industry, which employs more than 15,000 highly-educated people. Most importantly, it has maintained a steady growth in employment over the years. However, in order to capitalize on this growth, a lot remains to be done in terms of the state providing tangible motives for growth in both R&D, which would invite foreign direct investment, and local manufacturing that is directly linked to the creation of jobs. In other words, a favorable and predictable regulatory environment needs to be established. Otherwise, why should a multinational company invest today in Greece when the tax laws are constantly changing?
As we are all uniting to conquer the current challenging economic situation of Greece, we need to be mindful of the true underlining causes and systemic problems of the economy. Most important, we need to have a clear vision and work to realize that vision. So, for the healthcare sector, a fundamental question that we need to answer is what type of a healthcare system we want: one where patients can be treated with all appropriate medicines or one that restricts access to innovative therapies? Once we make that choice, we will stop reacting on an ad hoc basis and implement an integrated healthcare strategy. In the meantime, let’s keep our fingers crossed that the choice that we make is the right one.
