Greece: State provision for diabetes just started collapsing
Greek crisis is turning 8 this year and its impact affects now pretty much everything in the country. Hundreds of thousands of jobs lost, incomes reduced, taxes reaching record - breaking high levels and huge debts desperately awaiting to be managed. The society is violently divided and the state is losing the last pieces of its shattered prestige. But now, healthcare is the next big thing to be "adjusted" to our modern reality. This is well translated into brand new cuts of expenses, benefits and social security provisions for those in need. Especially when it comes to people with diabetes, things are just about to get wild.
30 MILLIONS LESS ON DIABETES SUPPLIES BUDGET
Private health insurance in Greece is a rare phenomenon. Citizens curently rely on social security services, most of them now operated by a main provider. This provider is responsible for reimbursing to beneficiaries (who pay of course an amount of contributions to the services provider) all products related to diabetes care, such as equipment, supplies and medicines. In general terms, this means that people only need to place an order based on a medical prescription to their local pharmacy and get their "life savers" for free. Then pharmacists get reimbursed by the state (the social security provider) according to mutual contractual agreements that particularize the amount of reimbursement for certain types of products. So, what's the case? Recently, the s.s. services provider has decided to spend less on diabetes care supplies by reducing expenses up to 30 million euros (35%). That situation led to a revised but unfair contractual agreement with pharmacies which are now obligated to accept product reimbursements far lower than even wholesale prices! The state forces pharmacists to buy at a higher price (wholesale price) but get less money back through the reimbursement process, since reimbursement prices will be much lower from now on. As a result, no profit is left for pharmacies.
That situation led to a revised but unfair
contractual agreement with pharmacies which
are now obligated to accept product
reimbursements far lower than
even wholesale prices!
Bad news don't stop here. The national social security health services provider is following an other annoying practice: State payments to pharmacicts following the execution of medical prescriptions tend to be really late. In fact, pharmacies have not been paid since January (!) for diabetes supplies distributions made through valid prescriptions. It's been half a year or so without any news, resulting in pure loss for businesses which are both obliged to execute orders and credit untrustworthy state institutions. This is why pharmaceutical unions are now thinking of breaking the contract with the state, making patients pay for all their supplies and then request their money back directly from the social security provider. Well, not every single person with diabetes can afford paying up to 200 euros at once and then wait for the state to cover up his expenses!
NO RIGHT TO NEW TECHNOLOGIES
With all this strategy implemented by the state, there is no space -of course- for the introduction of new cutting edge products, which thrive on global health markets and make life with the condition a lot more manageable. Official requests for future reimbursements of new pump models and glucose monitoring systems seem impossible to be met. On the other hand, due to the expenses reductions, more out-of-date and inaccurate systems are about to return back as the only ones to be fully covered by the health insurance mechanism. Quality is no priority anymore.
On the other hand, due to
the expenses reductions,
more out-of-date and inaccurate systems
are about to return back
as the only ones to be covered
fully by the health insurance mechanism.
Recently, the president of the main s.s. health services provider, Mr Bersimis, has reassured patients that there will be no changes regarding the access to and quality of their healthcare products. He appeared willing to simplify the process of integration and reimbursement of new diabetes technologies, as well as to renegotiate the reimbursement process contract between the state and pharmacies nationwide. Promises are always made to be broken, this is something Greeks know for sure. But let's wait (once again) and see...
THE CURSE OF BEING UNINSURED
Almost 2.5 million people are reported to live without some kind of health insurance. The state has now issued new legislation, making it easier for those in need to access basic healthcare without paying out of their pocket. This special provision is implemented through public hospitals which owe the duty of providing for free diabetes supplies to those meeting the legal criteria (e.g. low income). However, these revolutionary policies are only partially put into action, since no extra state money are being invested to cover the funding needs of the project. This, consequently, leeds to poor peer support from the healthcare system, adding to the huge deficits of the whole social security structure. Indeed, many of our fellow citizens are only granted a couple of behindhand test strips from hospitals' pharmacies to cope with their monthly needs. No free insulin, no lancets, no needles. Luckily, there are some Facebook groups tracking down requests from patients and therefore making smaller or bigger donations in diabetes medical supplies to help them survive. That's the only way to live with dignity and hope. The system is not working, at all.
Indeed, many of our fellow citizens
are only granted a couple of
behindhand test strips
from hospitals' pharmacies to cope with
their monthly needs.
No free insulin, no lancets, no needles.
This great problem gives us a new opportunity to re-open the talk about healthcare crisis in both national and international level. Access to lifesaving medicines is getting more restricted, denying people from a chance to a better and prosperous life. Destroying one's own dream of a future where diabetes can do no harm is purely devastating. Today, we all need to take a stand against degradation, we should all act now to change tomorrow.
Dimitris Kaperdanakis
sweetstoriesGR: The T1D Forum
Alexandroupolis Regional Diabetes Union (@diabetesAXD)
IDF Young Leader in Diabetes
