Metropolitan Community Clinic at Helliniko: July 2014

Sunday, July 27, 2014

Put a Stop to Our Inhuman Policies

Press Release

Put a Stop to Our Inhuman Policies

Even the most skeptical now accept that the economic crisis in

Greece

has seriously hindered the Greek Public Health System. Quality of service has declined while cost, for the insured has increased month after month. The uninsured have paid a higher cost – sometimes with their lives, lost due to the callous implementation of policies in the public health sector since 2010.

In the last few months we have seen a flood of circulars from the Greek Ministry of Health hailing tremendous changes in the public health system since the beginning of 2014. These changes aim to “reform” the system but they raise doubt as to their purpose and even their objective. Of course there have been some good reforms made as well, but these cannot be implemented because of systematic and criminal underfunding of the Greek public health system.

We will, as we always do, document and give evidence to the tragic effects of these policies in public health. Many are deadly and criminal policies, dressed up to seem humanitarian reforms.

More specifically:

Found on the web page of HDIKA (E-Government Social Insurance S.A.) (https://www.e-syntagografisi.gr/e-pre/faces/Login?_afrLoop=591787041964811&Adf-Window-Id=w0&_afrWindowMode=0&_adf.ctrl-state=p8bdtfbzl_3&_afrRedirect=591787151771022)

“We inform you that, in agreement with the government decision no. Y9/oik 53768 (Government Gazette B 1796/1-7-14) that from today 9/7/2014 each prescribing physician must control monthly minimum limits of prescriptions of the active substances of drugs which are not under protection status and it is not permissible to prescribe under a specific minimum percentage. Also, per the decision of EOPYY (Greek National Organization of Health Service Providers) restrictions have been placed on the (SPC) age at diagnosis and prescribing specific medications, as per notifications.”

What?? (The quote above comes out “gobbledygook” in both Greek and English) Could the Ministry of Health please explain what is meant by that? In other words, a doctor has to choose what to prescribe using the criteria of the age of the patient because EOPYY says so?

The Greek Ministry of Health and EOPYY following minimum limits on prescribing generic medications put a cap on expenses on prescribed medicine, per doctor by specialty and location. The risks associated with this policy could potentially be disastrous, especially for those with chronic diseases requiring monthly treatment. It’s a policy that can put lives in danger. See more in the article “Risks from the Prescription Ceiling” http://www.efsyn.gr/?p=217204 - (in Greek) and the article “Reactions AmeA to the Prescription Ceiling” (http://www.newsbeast.gr/greece/arthro/705713/addraseis-amea-gia-to-plafon-sti-sudagografisi) (in Greek)

3. Vaccinations against meningitis B has not been approved by the National Committee for Vaccinations despite the medication being approved by the National Organization for Medicines (EOF). Why? Because the president of this board has not yet been appointed. The result? A 50 year old woman in Ioanina has already died. Read more in the article “The National Committee for Vaccinations Frozen” http://www.imerisia.gr/article.asp?catid=27201&subid=2&pubid=113308852: (in Greek)

4. The Greek government is leaving the 400,000 who are insured under OAEE (the public insurance carrier for independent workers, such as free-lance teachers, consultants, writers, visiting home service providers, etc), but who owe money to the insurer without medical coverage if their yearly income was 12,000 euro or more over the last three years. That cut off is way too low. In other words, the government reckons that a cancer patient, who owes payments to OAEE should be able to afford hyper-expensive cancer therapy, because his income has averaged 12,00 euro per year. Read more in the article “400,000 insured left without medical cover” http://www.enet.gr/?i=news.el.article&id=436332 -(in Greek)

5. The government has taken a few positive steps, up to a point. They have allowed uninsured citizens access to primary health care through public health clinics (PEDY), they have access to medication (with the same co-pay as insured patients) and, as far as secondary health care goes, cost-free access to public hospitals. But even these positive steps are not as positive as they seem. A huge wall of bureaucracy is the main hurdle. Public hospitals have fewer people working and the Greek Public Health System is woefully underfunded. When you take a second look at it nothing has really changed; the insured as well as the uninsured often go without the treatments the need because they cannot pay for their medicines. The appropriate doctors they need are not to be found in PEDY because 50% of the doctors in the system have been fired. Patients are also still excluded from the public hospitals, because the hospitals don’t have the funds. For instance, KAT hospital had to stop surgery altogether. At Areteo Hospital, which treats 1,000 cancer patients a year, the oncology department has only one employee while they are required by law to have at least three.

The Doctors’ Association of Athens recently announced results of their research, concluding that one in three citizens have no access to either doctors or medication. Also, many pharmaceutical associations in Greece report that more and more citizens are unable to get the needed medications to continue their therapies.

Read more in the following articles – all in Greek:

“The Odyssey of the uninsured in hospitals”

http://www.tovima.gr/society/article/?aid=614832 (in Greek)

“Surgery in Suspension at KAT Hospital”

http://www.kathimerini.gr/774518/article/epikairothta/ellada/prowrh-anastolh–xeiroyrgeiwn-sto-kat (in Greek)

“People of Ko in the streets because of shortages in the Hospital of Kos”

http://tvkosmos.gr/article.asp?newsid=2340809

“Doctors’ Association of Athens ‘One in three patients have limited access to doctors and medications’”

http://www.kathimerini.gr/775700/article/epikairothta/ellada/isa-enas-stoys-treis-as8eneis-exei-provlhma-prosvashs-se-giatroys-kai-farmaka (in Greek)

“Pharmaceutical Associations: The Government Impoverishes the Uninsured”

http://www.naftemporiki.gr/story/834170/farmakeutikoi-sullogoi-i-kubernisi-eksathlionei-tous-asfalismenous (in Greek)

“Availability and Cancer Patients

http://www.topontiki.gr/article/79143/Se-diathesimotita-kai-oi-karkinopatheis (in Greek)

The Greek National Confederation of the Disabled has recently sent a emphatic letter to the Finance Minister Mr. Gikas Hardouvelis calling his attention to the extremely negative state that the disabled find themselves in due to the policies of the “memoranda”. These policies affect the disabled and their families as well. The confederation, in turn, also have economic problems since they must supplement the largest portion of the additional expenses needed. Of particular concern are those who suffer from severe disabilities, (cognitive disabilities such as down syndrome and autism, as well as cerebral palsy etc.) and their families who support them. Read more in “The Dramatic State for the Disabled
http://www.tovima.gr/society/article/?aid=613684 (in Greek)
There are cancer patients who wait more than 6 months for their therapy – and at very probable risk of dying while waiting. Read more in the article “Cancer Patients Wait Six Months for Treatment”
http://www.koutipandoras.gr/article/116381/mehri-kai-exi-mines-perimenoyn-oi-karkinopatheis-sto-esy-gia-therapeia
While all this is going on, the government suddenly finds sources of funding (both Greek and from Europe) to the tune of 40 million euro to fund various NGO’s, community clinics, municipal pharmacies and other parallel health providers while leaving the Greek public health system to crumble from underfunding . Read more in our press release “The Social Trojan Horse is Here. http///……. This one is translated into English.

All of the above reflect the imminent disintegration of the public health system. The victims of the peculiar conflict are many and unfortunately, it is not possible to list all of them since the destitute citizens suffer their destiny alone, unrecorded and unheard. These inhuman measures taken by the governments during the last four years have led to a system where only the very strong can survive.

We, here are once more calling attention to this state of affairs, and will continue to do so wherever and however we can, both within Greece and abroad. We are documenting these crimes and the data we collect will be used where it will have maximum effect in Greek as well as European courts. We’ll keep you posted as to progress.

METROPOLITAN COMMUNITY CLINIC AT HELLINIKO

Working Hours
(MONDAY - FRIDAY 10:00 - 20:00) and (SATURDAY 10:00 - 14:00)
CONTACT PHONE NUMBER: +30 210 9631950
ADDRESS: Inside the old American Military Base, 200m away from the Traffic Police of the Municipality of Helleniko, next to the Cultural Center of Helleniko
Post code TK16777, Elliniko, Attiki, Greece
Blog http://mkie-foreign.blogspot.gr/ Email mkiellinikou@gmail.com

Saturday, July 19, 2014

Has a Solution Arrived for the Uninsured?

"The exclusion of the uninsured from the public hospitals, kills" reads the banner

Press Release

Has a Solution Arrived for the Uninsured?

At last, after six years of economic austerity and four years of policies of the “memorandum” which has left the uninsured increasing excluded from the Greek public health system, it looks as if the government may be considering carrying out their constitutional obligations. Could it be that the timing for this decision is connected with the soon-to-be-released tranche of funds to the country? Another thing worth pondering is the persistence of some (journalists and politicians) in repeating that assistance for the uninsured is an obligation under the memorandum agreement. This same Greek government together with the “Troika” decreed austerity measures in May 2010 without any planning or study as to what the results would have on society. Now with new regulations enacted (Government Gazette 1465 of 05/06/2014 and 1753 of 28/06/2014) they hope to put out the fires that they ignited.

Specifically, under GG1465, uninsured Greeks and non-Greeks legally residing in the country will have hospital care without cost. We certainly consider this a step in the right direction. The main obstacle to this is the already dramatically reduced budgets for Greek public hospitals, which will be asked to cover the costs of the extended care. We have seen a lot of cases of INSURED, but indigent patients who cannot find the medications needed for treatment and troll from hospital to hospital to try and locate them. Recently, KAT hospital, one of the largest in the greater Athens area, announced it would stop performing surgery, because they don’t have the budget to cover the expenses involved. These are problems that need SOLUTIONS. We reckon that the three-member committee that will be appointed to look into these issues, will have a huge job. Official sources number uninsured citizens at 3,000,000. How can they be assisted without serious problems and huge delays?

Government Gazette 1753 of 28/06/2014 covers pharmaceutical needs of uninsured Greeks and foreigners legally resident in Greece who can pay the same contribution as those insured. Expensive medications (and only expensive medications) will be provided without cost, which we feel is a positive step.

The thing that we wonder about here – and this comes from long experience - is that many of the long term unemployed will find it impossible to contribute in any way to payments. Indeed, with the last modifications to regulations, the Greek Health Ministry increased the co-pays, which creates problems for many of the low-income insured. Unfortunately, we have many examples of insured citizens who don’t have the means to pay into insurance plans. So we have to find a mechanism under which those who cannot pay can at least have access to their medication.

But at any rate, with the regulations cited above, along with the ability of public health clinics to admit uninsured patients, at least some uninsured are coming back in the Greek public health system. Those needs that are not covered are, specifically:

1) There is a cap of 340 million Euros for medication for all uninsured. If more is needed, what happens?

2) There is no mention in either of the government gazette entries of lab tests, blood tests, MRI, X-Rays etc. for outpatients visiting public health clinics and not admitted to hospital. What happens in these cases?

3) Immigrants who are not legally documented where do they go? Without any recourse to health care, they could be a public health bomb waiting to explode. What do they do? A solution should be found for them, perhaps utilizing funds from the EU.

The measures enacted for the uninsured are, without question, a step in the right direction but fall short of full and free access to the Greek public health system. The big challenge for the Greek government is to focus on proper funding and staffing of the public health system, putting a stop to “creative accounting” practices, and to put a halt to the degradation of the health services while managing funds rationally. And to do this without social/solidarity clinics, NGO’s funded by the European Union through the National Strategic Reference Framework. These funds could go directly to strengthen the Greek public health system and cover all the needs of the uninsured.

The Greek public health service is opening up, at least partially, to the uninsured. They can now access primary care (through the system’s public health clinics) and secondary level care through access to public hospitals and at least some access to medications. This has been a partial vindication of the gargantuan struggle undertaken by the volunteer community clinics and pharmacies from all over Greece – a struggle lasting three years, constantly pressuring for policies to make access to public health more inclusive rather than exclusive. The volunteers of the various social solidarity clinics feel we were able to at least partially reverse some of the disastrous policies enacted during the economic crisis.

The pressure will continue. We have never been afraid to “speak truth to power.” Our goal is to see a Greek public health system that is open to all including the most vulnerable groups. We want to correct the wrongs that lead to an impoverished society.

Below is a spot from the German “Spiegel TV” which discusses the policies of the past 4 years and shows MCCH. It is in German with Greek subtitles.

https://www.youtube.com/watch?v=UYzRGpZgNeE

Another Donation from Australia

Press Release

Another Donation from Australia

It is always pleasing when people are good enough to volunteer much needed medicines to us, especially when such a donation comes from a compatriot living in far-off Australia. On the 27^th of June we received a great deal of medicines from this individual and all we can say is that we thank him profusely from the bottom of our hearts. It is really significant that our message is heard so far away and that many Greek immigrants respond.

Our decision not to accept money is a conscious one. For one thing, we don’t want anyone to doubt that their help will reach its goal. For another, if a person wants to help and brings us medicine or some other contribution in kind, he becomes involved in lending a helping hand to those in need. The donor enters the process, and may come to the clinic and see what is being done. In this is the way people learn they can become part of the solution to our problems. The magic word and concept is self organization.

We thank wholeheartedly all those who help so much by bringing various medicines to our doors each and every week. We also wish to thank those who stand at our side in protesting against the outrageous conditions sweeping like a whirlwind through our society.

We hope our thanks can be felt in the far-flung shores of Australia. We send them our love and gratitude.

Sunday, July 6, 2014

The Metropolitan Community Clinic at Helliniko at Strasburg One More Time

Press Release

The Metropolitan Community Clinic at Helliniko at Strasburg One More Time

MCCH was invited once more to take part in an event of the Council of Europe held on June 24th in Strasbourg. This has been the second time in eight months (Read more here about the first time).

The event coincides with the opening of the new European Parliament after the latest European elections – and is therefore significant. The volunteer doctor George Vichas was our representative and spoke mainly on three issues.

The first analyzed the present situation of public health in Greece – especially as far as the uninsured are concerned, with special note on the changes since the first meeting eight months ago. The picture was not a happy one since there was an obvious deterioration on all levels of the Greek public health system.

The second subject concerned the ways in which independent and active citizens could mobilize to aid vulnerable groups victimized by the state itself with their inhuman policies. The experience and endeavors of MCCH during the last 2 ½ years were used to exemplify what independent citizens could do.

The third subject focused on the fact that the deplorable situation in Greece has reached the unpleasant necessity for legal action against so many people in the government whose policies have led to the disability and death of uninsured patients. It was also explained how these policies, besides being unethical and un-humanitarian, ended up costing the country more in the long run.

The audience was bothered by some of the hard truths presented by Dr. Vichas – especially when they heard the word “murder” likened to the deaths of uninsured patients. There are those in the Council of Europe who don’t want to hear about the guilt of politicians, whether in Greece or elsewhere in Europe that should be investigated.

All we can say is that such devastating problems should not and cannot be wished away by ineffectual resolutions and PR gimmicks. What is happening in Greece will become known. We and other volunteer community clinics and pharmacies will continue to oppose such brutal policies wherever they come from.

The Social Trojan Horse has Arrived

Press Release

The Social Trojan Horse has Arrived

When we issued the February press release entitled “Social Solidarity or Social TrojanHorse” we had in mind various community clinics and pharmacies which have sprung up in municipalities throughout Greece and are financed by the government and by the European Union. We wrote then about some problems we foresaw based n what was happening around us. These problems are no longer just thoughts – they have appeared and we should all be aware of it.

The creation of the National Network of Immediate Social Intervention (http://www.koinoniasos.gr/) is clearest example of state sponsored hypocrisy. At the same time that the Greek Public Health system is dissolving due to underfunding, the government has arranged funding, together with the European Union for organizations that barely come under the supervision of the Greek Public Health System. The Network has initial funding of €40 million. (read more at http://www.step.gov.gr/item/index/id/88). This is happening at the same time when some 10’s of millions can’t be found for treatment and medication for 3 million of our uninsured fellow citizens.

On the one hand IKA/EOPPY is much reduced in its transformation to PEDY and the dismissal of half of the medical staff. All public hospitals are underfunded to the point that insured patients, like the indigent, are not sure of finding their medication. On the other hand, the government found 40 million to fund a network of specific NGOS and support organizations within the municipalities to support those shut out of the public health system. And many of these semi-volunteer organizations have funding for only staff salaries, which means the uninsured still have to seek sources for their medication – usually at purely volunteer organizations, like ours.

In short, the state decided not to strengthen the Greek Public Health System, but use its precious funds (from both the national budget and from the European Union) to invest in unproven and new structures that cannot provide the same quality of service as public health system and are certainly not prepared to handle the huge volume handled by the Greek Public Health System.

The Social Trojan Horse is here and some will reap huge profits off all the rest of us. The 3 million unemployed are still left in the wind and await assistance. With the €40 million, the true voluntary community clinics and pharmacies could finance medication needs for the unemployed for a great long while. Patients with chronic diseases such as diabetes must continue to suffer on.

Unemployed cancer patients have only one source of help, the Cancer Clinic at Sotiria Hospital where the doctors and medical staff VOLUNTARILY give their time and provide chemotherapy to those in need (with no help from the state). Disabled patients, who are insured, are trapped in their homes because the resources that supported them (home care services) have either been underfunded or abolished altogether. The Center for Certifying Disability (KEPA) can take months to complete their admittedly difficult task, because of a shocking lack of medical resources. As mentioned above, all the public hospitals are severely underfunded and are operating on the very verge of collapse. Those insured have seen their co-pays increase for medications (in some cases 50%) (read more here http://www.mkiellinikou.org/2014/05 / 21/farmaka /) – in Greek.

The repeated recommendations for Greece from the European Parliaments (read here) and the Council of Europe (read here) and more recently by the International Labor Organization (read here) haven’t had effect in our country despite the fact that we find ourselves in the 6^th year of economic crisis.

How many more victims have to stack up before the authorities adopt what are, by now, obvious measures? Open the Greek Public Health system to all the uninsured and fund it to a level that it can carry out its mission.