Healthcare In Greece: A Guide For Expats

Flag Of Greece With Healthcare Professional

Are you considering a move to the sun-kissed lands of Greece? One of the most critical aspects to figure out is the healthcare system.  This guide digs deep into the structure of the healthcare system in Greece, and its unique mix of public and private sectors. It also walks you through access to healthcare services for expats living in Greece and the common health concerns in the region.

Understand the role of pharmacies in healthcare delivery and learn about the future of healthcare in Greece. Get the information you need to make informed decisions about your health in Greece.

Overview of Healthcare in Greece

If you’re an expat living in Greece, you’ll find that the Greek healthcare system mixes a National Health System (NHS), compulsory social insurance, and a solid voluntary private healthcare system. This system’s goal is to provide universal coverage to public health and cover all residents, including expats like us, who contribute to the general insurance company, the Social Insurance Institute (IKA).

Structure of the Greek Healthcare System

The Greek NHS consists of about 130 general and specialized hospitals, funded by the state budget and social insurance funds. Military and university hospitals are also managed and sponsored by the Ministries of Defense and Education. The public healthcare system includes primary care, several rural health centres, and medical surgeries funded by the state budget.

The public healthcare system’s financing is mixed, with salaries covered by the state budget and the rest of the expenses covered by service charges to insurance funds and patients.

Taxes comprise 70% of the NHS financing; the rest comes from social security and out-of-pocket payments.

Even though Greece has more physicians per capita than any other OECD country, it needs more nurses. The number of hospital beds per capita has decreased over time, coinciding with a reduction in average length-of-stay in hospitals and an increase in same-day surgical procedures.

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Roles of Public and Private Sectors

The various public insurance funds and private sectors play significant roles in the Greek healthcare system. Around 30 social insurance funds purchase healthcare services from the NHS and private providers for their covered population. The private sector, including physicians, practices, diagnostic centres, laboratories, and hospitals, has grown significantly over the past decade and a half.

As an expat, you can access free or low-cost public healthcare if you contribute to the IKA. in Other countries, European Union nationals can avail of free healthcare benefits with the European Health Insurance Card (EHIC). Private healthcare is also available but isn’t covered by IKA and can be pricey.

Common Health Concerns in Greece

Living in Greece, you’ll likely notice that the public’s perception of health risks prioritizes road accidents, cancer, and air pollution. Mental health disorders, including depression, have increased due to socioeconomic factors caused by the economic crisis in Greece. Air pollution and natural disasters, such as wildfires and earthquakes, are significant environmental factors affecting public health in Greece.

Vaccination coverage in Greece is high for children but lower for adults. The importance of diet and obesity, exercise, and smoking varied depending on smoking status, with non-smokers and men considering these factors more important.

Role of Pharmacies in Healthcare Delivery

Pharmacies in Greece play a key role in healthcare delivery. They’re plentiful and well-stocked, and pharmacists are knowledgeable. Patients trust their pharmacist as a health professional and value the accessibility and immediate service pharmacies provide.

Pharmacies can provide primary care services, such as blood pressure measurement and intramuscular injections. They also play a key role in mental healthcare, providing medication, primary care, monitoring, and referring patients to other health professionals.

Accessibility of Healthcare in Greece

Despite Greece’s financial challenges, the healthcare standards remain robust, ensuring citizens and expats have easy access to healthcare services.

Healthcare Professionals

Geographical Distributions of Healthcare Resources

Healthcare resources in Greece are widely distributed. The ESY provides a wide range of services, such as public health surveillance, infectious disease control, environmental health control, health promotion, general and specialist health care services, hospitalization, laboratory services, discounted drugs and medicines, maternity care, medical appliances, and transportation.

Private hospital facilities maintain excellent standards in metropolitan areas, and even in rural areas, smaller outpatient clinics attached to larger public hospitals are available. These facilities provide faster emergency treatment than larger public hospitals.

Access to Healthcare Services for Residents

For expat residents, access to healthcare services in Greece is relatively straightforward. Suppose you’re an expat working in Greece with a social security number. In that case, you can access free or subsidized healthcare benefits by paying public or private health insurance coverage contributions. Self-employed expats can benefit from the social security fund called OAEE.

Health Services Accessibility for Tourists and Expats

For tourists and expats, Greece’s healthcare and emergency care services are also quite accessible. Citizens of EU member states can use their EHIC for healthcare free medical care services in Greece. However, this card doesn’t cover private care costs. Individuals with an EHIC card can freely consult a doctor in a PEDY unit and benefit from some dental treatments in a PEDY clinic.

For non-EU expats, private health insurance is a must. Private healthcare and private medical facilities in Greece have newer equipment than public facilities, and the medical staff in private hospitals are more likely to speak English. Private insurance can cover what general insurance doesn’t; in some cases, it may even cover all medical expenses.

Out-of-pocket Expenditure and Insurance Coverage

While most medical care in Greece is free, all working citizens must contribute to social insurance, and about 15% of Greeks also purchase private health insurance. Private insurance costs depend on age, gender, nationality, payment frequency, coverage area, and more.

Private health insurance is beneficial as it can reduce waiting times and cover what public insurance doesn’t. However, it’s important to note that the cost of private health insurance can vary depending on various factors such as age, area of coverage, choice of product, deductibles, co-insurance, payment frequency, gender, nationality, and country of residence.

Understanding the Healthcare System in Greece

The quality of health care here in Greece is generally high, despite public hospitals often being older and more run-down compared to private clinics. The state healthcare system is free or cheap, and you don’t need a referral from your GP to see a specialist.

However, it’s important to note that while medical care by IKA-approved practitioners in private practice is usually free, patients must pay for prescribed medicines.

Accessing Healthcare as an Expat

Golden Visa holders in Greece don’t automatically get healthcare and may need to obtain private health insurance. It’s also worth noting that many expats use international Private Medical Insurance (PMI) to ensure access to care and reduce waiting times.

Private Healthcare in Greece

“Private healthcare insurance in Greece can offer on-demand access to a network of private hospitals, shorter waiting times, better facilities, and more up-to-date equipment. Private health insurance is an excellent way for expats with ongoing health issues to cover costs not included in the public or state health benefits scheme.

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Emergency Services and Pharmacies

Emergency medical services in Greece are free, and public ambulances are available in larger cities. However, access to public ambulance services may be restricted in more remote areas, but private alternatives are available.

Pharmacies in Greece are widely available, and many pharmacists speak English. They’re usually marked by a green cross against a white background and generally open from 8 am to 1 pm and 5 pm to 8:30 pm.

Mental Health Services

Mental health services in Greece have been increasing, and expats with international health insurance have access to more advanced medical professionals and services. However, there still needs to be more staff and services in some areas.

Informal Payments and Out-of-Pocket Costs

There’s a tradition in Greece of leaving an envelope of money for doctors, known as “fakelaki,” but it’s not a legal practice and varies from doctor to doctor. Informal or undocumented payments aren’t unique to Greece and have been well-documented in many other European countries with similar publicly financed healthcare systems. These payments jeopardize efforts to improve quality and access to care and exacerbate healthcare disparities and inequalities.

The Greek healthcare system relies heavily on private funding, and out-of-pocket healthcare spending accounts for over one-third of the country’s healthcare expenditures. The Greek state has reduced funding for health, resulting in substantial out-of-pocket payments to the Greek population. This has led to a positive relationship between out-of-pocket expenses for inpatient care in private hospitals and SHI funding in specialized hospitals.

The Future of Healthcare in Greece

Efforts to reform the public healthcare insurance system have been ongoing, focusing on improving primary care, reducing pharmaceutical expenditure, and standardizing benefits. The Greek health policymakers should consider supplementing the SHI system with the Private Health Insurance (PHI) sector. More than introducing official fees might be required to limit informal payments and stricter regulatory policies are needed.

Challenges and Controversies in Greece’s Healthcare

The healthcare system in Greece has been grappling with many issues, which the country’s economic downturn has exacerbated. These issues have necessitated reforms primarily focusing on operational, financial, and managerial aspects.

Impact of Economic Crisis on Greek Healthcare

The economic downturn 2009 led to the most significant international bailout ever agreed upon. This crisis deeply affected the country’s healthcare system, which was already grappling with inefficiencies like a high degree of centralization in decision-making, suboptimal managerial structures, and unequal and inefficient distribution of resources. The crisis led to a surge in health spending, with total expenditure on health jumping from 8.6% of GDP in 2003 to 9.9% in 2009. This increase was mainly driven by high levels of private health spending, primarily in out-of-pocket payments.

Healthcare Inequality Issues in Greece

The financing of the Greek healthcare system is significantly unfair, with public funding putting a disproportionate burden on lower socioeconomic groups. The economic crisis has exacerbated these inequalities, with cuts in public spending and household income negatively affecting access to healthcare services. User charges, private physician consultations, and increases in medication co-payments have placed additional burdens on the population, especially the poorer segments of society.

Controversial Cases and Legal Battles in Greek Healthcare

The Greek healthcare system has been embroiled in a number of controversial cases and legal battles in recent years. These have primarily been driven by the impact of the economic crisis and the subsequent austerity measures, which have led to reductions in resources, increased user charges, and decreased access to care. These issues have been particularly challenging for expats in Greece, who may face additional barriers in accessing healthcare due to language differences and unfamiliarity with the system.

The Effects of Austerity Measures on Healthcare

The austerity measures introduced in response to the economic crisis have significantly impacted the Greek healthcare system. These measures have included salary cuts for all public healthcare staff, reductions in hospital beds and the consolidation of departments, and measures to reduce input costs, including the cost of hospital supplies. While necessary to control spending, these measures have significantly impacted the quality and accessibility of healthcare services in Greece.

The Greek Healthcare System

If you’re an expat in Greece, getting to know the healthcare system is important. The Greek National Health System (ESY) was established in 1983 to replace the existing primary healthcare infrastructure and unify social health insurance schemes. However, the system needed to be fully implemented, and weaknesses persisted. The primary healthcare system in Greece is fragmented and based on a complex public/private mix of the ESY, social health and national social security insurance, and the mostly private healthcare sector.

Corruption in the Greek Healthcare System

Corruption in Greece’s public health insurance sector is a serious issue, with a high-risk sector according to the national strategic plan for the fight against corruption. The general perception of corruption in Greece’s national health insurance system is high, with 91% of Greek respondents believing that bribery and abuse of power for personal gain are widespread.

The Need for Reforms in the Greek Healthcare System

The Greek healthcare system needs reforms to address corruption, improve funding, and ensure equal access to healthcare services for all, including expats. The current healthcare system in Greece requires corrective amendments, as it relies heavily on outlier payments and doesn’t consider actual costs and clinical protocols.

The reforms in the Greek healthcare system have focused on operational, financial, and managerial aspects but still need to address patient-centred care or resource allocation adequately. The emphasis on cost-containment measures has resulted in horizontal cuts rather than strategic resource allocation.

As an expat, staying updated on any changes affecting your access to healthcare services is essential. You can receive quality medical care in Greece with proper preparation and understanding of the healthcare system.

Healthcare Professional With Clipboard

Future Projections and Prospects of Healthcare in Greece

For expats residing in Greece, understanding the future projections and prospects of the national healthcare service is crucial.

The country’s healthcare system has undergone extensive reforms since 2010, enhancing publicly provided primary care services and digital transformation.

However, challenges persist, such as the need for increased health budget spending and bolstering medical and nursing staff.

Innovations & Developments in the Greek Healthcare System

Innovation is a key driver of change in the Greek healthcare system. Despite its ranking in the World Index of Healthcare Innovation, Greek healthcare entrepreneurs are eager to develop innovative projects. These initiatives have yielded positive results, enhancing patient service, enterprise structures, facilities and technology, and the clinical environment. However, hurdles such as stringent operating protocols, lack of funding, and slow digital transformation impede the implementation of innovative ideas.

The Greek government is actively shaping the innovative health tech market through new partnerships. The 2023 Future of Healthcare in Greece Conference aims to spotlight new developments that will influence the healthcare sector over the next decade. These developments encompass digital health, growing consumerism, and mounting financial constraints world health organization.

Role of AI and Digitalization in Improving Patient Care

Artificial Intelligence (AI) and digitalization are playing a significant role in enhancing patient care in Greece. AI can swiftly and accurately analyze large amounts of data, leading to earlier detection and treatment of diseases and personalized treatment plans for patients. It’s also being used to develop new drugs and treatments and improve the healthcare system’s efficiency by automating routine tasks.

Greece has established the EDIH Health Hub to support the digital transformation of the health and pharma sector. The Health Hub uses AI and emerging technologies to provide services such as testing before investment, knowledge and innovation transfer, support to find assets, and innovation ecosystem and networking.

Government Policies for Healthcare Reform

The Greek government has implemented various initiatives to enhance primary healthcare, including establishing primary healthcare centres and recruiting primary care physicians. The goal is to provide comprehensive and coordinated patient care, improve health outcomes, and reduce healthcare costs. However, the immediate healthcare reforms in Greece have yet to significantly improve population coverage, service coverage, and financial protection. There’s a need to rationalise and consolidate the fragmented primary healthcare system here.

The EU National Recovery and Resilience Plan “Greece 2.0” includes a framework to promote and reform the health system in Greece, focusing on digitalising public health services and using information technology applications.

Potential Impact of Global Health Trends on Greek Healthcare

Global health trends are likely to impact Greek and private healthcare systems significantly. The Covid-19 pandemic has necessitated and accelerated significant transformations in health systems worldwide, including Greece. The next decade will see a considerable change in how health systems are designed, propelled by opportunities such as digital health, growing consumerism, and mounting financial constraints.

Greece’s medical tourism sector has gained prominence, attracting patients worldwide seeking high-quality, cost-effective treatments. This trend is likely to continue, with Greek medical professionals excelling in various fields of medicine.

Final Thoughts on Healthcare in Greece for Expats

Navigating the Greek healthcare system as an expat comes with its unique challenges. From understanding the structure of the NHS to finding suitable insurance options, it requires patience and research. The standard of healthcare in Greece is commendable, and the choice between public and private providers offers flexibility.

While ongoing reforms aim to improve primary care and achieve Universal Health Coverage, expats should consider private insurance to bridge any gaps. Also, staying informed about your healthcare rights and proactively exploring different options can significantly enhance your experience as an expat in Greece. Remember, your health is worth it!



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Rihab Saad

Managing Director
Next Generation Equity

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