Challenges and Adjustments of Healthcare and Labor Policies in Greece During the COVID-19 Era: A Critical Assessment of the Key Social Policy Responses
Keywords:
Welfare state, pandemic, healthcare policy, labor policy
Abstract
The welfare state in Greece even before the outbreak of the global pandemic experienced multiple challenges and problems mainly as a result of its chronic structural, administrative, and financial problems which were further deteriorated by austerity measures. The pandemic that followed the ten-year economic crisis led to a new multifaceted crisis, adding further pressure on the National Health System as well as on the labor market, and precipitating the uptake of targeted measures and policies to support both the NHS with equipment, staff, and employment due to the imposition of national and local lockdowns. Confronted with such weaknesses, the establishment of a new welfare state would need to bear a higher degree of flexibility, inclusivity, and efficiency in order to live up to the increasing societal, health, and economic demands. In this sense, the aim of this paper is to explore the variations in health and labor policies (two key pillars of the welfare state) during the COVID-19 pandemic and assess whether there is a need for further interventions with regard to social security and prosperity of citizens. The methods followed include the analysis of secondary quantitative data collected from a range of international and national databases. The analysis shows that – among new challenges such as telework - in the labor market policies, while there is a trend during the pandemic of decreasing in-work poverty and unemployment, still Greece faces more problems than the majority of the EU member states, in terms of job inclusion and poverty reduction. At the level of healthcare policy, during the crisis, although Greece increased its spending on NHS support compared to the pre-pandemic era in 2020, these increases were below those of the majority of EU Member States and structural problems still exist.
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References
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2. Betcherman, G., Giannakopoulos, N., Laliotis, I., Pantelaiou, I., Testaverde, M., Tzimas, G. (2020). Reacting Quickly and Protecting Jobs: The Short-Term Impacts of the Covid-19 Lockdown on the Greek Labor Market. Institute of Labor Economics Discussion Paper Series, No. 13516. http://dx.doi.org/10.2139/ssrn.3660262 .
3. Bolton, S. C., Charalampopoulos, V. and Skountridaki, L. (2019). Selective consent and dissent: professional response to reform in the post-crisis Greek NHS. Work, employment and society, 33(2): 262-279.
4. Davaki, K. and Mossialos, E. (2005). Plus ça change: health sector reforms in Greece. Journal of Health Politics, Policy and Law, 30 (1–2): 143–167.
5. Economou, C. (2010). Greece: health system review. Health Systems in Transition, 12(7): 1–180.
6. Economou, C. (2019). Health Systems in Transition (HiT) profile of Greece. Available at: https://www.hspm.org/countries/greece09062014/livinghit.aspx?Section=5.1%20Public%20health&Type=Chapter (Accessed: 18/03/2022).
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10. Greek Institute of Labor (2021). The current situation and prospects of the Greek economy. Report on Economic Developments.
11. Guillén, A. M. and Pavolini, E. (2015). Welfare states under strain in Southern Europe: overview of the special issue. European Journal of Social Security, 17(2): 147-157.
12. Health System Response Monitor (HSRM) (2020). How Much Additional Money Are Countries Allocating To Health From Their Domestic Resources? Available at: https://analysis.covid19healthsystem.org/index.php/2020/05/07/how-much-additional-money-are-countries-putting-towards-health/ (Accessed: 10/04/2022).
13. Huremović D. (2019). Brief History of Pandemics (Pandemics Throughout History). Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak, pp. 7–35.
14. International Labour Organization – The World Bank (2022). Total unemployment. Available at: https://data.worldbank.org/indicator/SL.UEM.TOTL.ZS?end=2021&locations=GR&start=2007&view=chart (Accessed: 01/05/2022).
15. International Monetary Fund (IMF) (2021). Policy responses to COVID-19. Available at: https://www.imf.org/en/Topics/imf-and-covid19/Policy-Responses-to-COVID19 (Accessed: 10/03/2022).
16. Kalaitzaki, A., Tsouvelas, G., Tamiolaki, A. and Konstantakopoulos, G. (2022). Post‐traumatic stress symptoms during the first and second COVID‐19 lockdown in Greece: Rates, risk, and protective factors. International Journal of Mental Health Nursing, 31(1): 153-166.
17. Karanikolos, M., Mladovsky, P., Cylus, J., Thomson, S., Basu, S., Stuckler, D., Mackenbach, J. P. and McKee, M. (2013). Financial crisis, austerity and health in Europe. The Lancet, 381 (9874): 1323-1331.
18. Karger, H. (2014). The Bitter Pill: Austerity, Debt, and the Attack on Europe’s Welfare States. The Journal of Sociology & Social Welfare, 41 (2): 33-53.
19. Kotroyannos, D., Lavdas, K. A., Tzagkarakis, S., Kamekis, A. and Chourdakis, M. (2013). Solidarity and Welfare State in Greece. GSTF International Journal of Law and Social Sciences (JLSS), 2 (2): 7-11.
20. Kousi, T., Mitsi, L.C., Simos, J. (2021). The Early Stage of COVID-19 Outbreak in Greece: A Review of the National Response and the Socioeconomic Impact. Int J Environ Res Public Health, 18(1): 322.
21. Kringos, D.S., Boerma, W.G.W., Van der Zee, J. and Groenewegen, P.P. (2013). Europe’s strong primary care systems are linked to better population health, but also to higher health spending. Health Aff., 32(4): 686–694.
22. Matsaganis, M. (2011). The welfare state and the crisis: the case of Greece. Journal of European Social Policy, 21(5): 501-512.
23. Melidis, M. and Tzagkarakis, S. I. (2021). The evolution of social vulnerability in Greece during the economic crisis (2008-2017), European Societies, 24 (2): 229-250, DOI: 10.1080/14616696.2021.2007973
24. Ministry of Interior (2020). Census. Human Resources Register of the Greek State. Available at: https://hr.apografi.gov.gr/login (Accessed: 10/10/2021) [in Greek].
25. Ministry of Finance (2020). 2021 Budget Report. Available at: https://www.minfin.gr/documents/20182/14940417/%CE%95%CE%99%CE%A3%CE%97%CE%93%CE%97%CE%A4%CE%99%CE%9A%CE%97+%CE%95%CE%9A%CE%98%CE%95%CE%A3%CE%97+2021.pdf/9df8e59d-dc88-47f6-9285-b7edfc69e220 (Accessed: 10/05/2022) [in Greek].
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27. Moreira, A., Léon, M., Coda Moscarola, F. and Roumpakis, A. (2021). In the eye of the storm… again! Social policy responses to COVID‐19 in Southern Europe. Social Policy & Administration, 55(2): 339-357.
28. Mpouzika, M. D., Mpouzika, E., Papathanassoglou, E. (2018). The effect of the Greek financial crisis on the operation of public intensive care units. Connect. The World Critical Care Nursing, 12(2): 48–51.
29. National Public Health Organization (EODY) (2020a). Covid-19 - Guidelines. Available at: https://eody.gov.gr/neos-koronaios-covid-19/ (Accessed: 10/03/2022) [in Greek].
30. National Public Health Organization (EODY) (2020b). Guidance on contact isolation in the home, 13 March 2020. Available at: https://eody.gov.gr/en/guidance-on-self-isolation-at-home/ (Accessed: 10/03/2022) [in Greek].
31. OECD (2019). Health at a Glance. Paris: OECD.
32. OECD (2020). OECD employment outlook 2020. Paris: OECD.
33. OECD (2021). General government debt (indicator): Greece. Διαθέσιμο στο: 10.1787/a0528cc2-en (Ανάκτηση 15/03/2022).
34. OECD & World Health Organization (2021). Ελλάδα. Προφίλ Υγείας 2021. OECD & WHO acting as the host organisation for, and secretariat of, the European Observatory on Health Systems and Policies. Available at: https://ec.europa.eu/health/system/files/2022-01/2021_chp_gr_greek.pdf (Accessed: 10/05/2022).
35. Papadakis, N., Drakaki, M., Saridaki, S. (2021). The degree of desperation. Athens: Sideris [in Greek].
36. Papadopoulos, T. and Roumpakis, A. (2012). The Greek welfare state in the age of austerity: anti-social policy and the politico-economic crisis. In: Kilkey, M., Ramia, G. and Farnsworth, K. (eds.), Social Policy Review, 24, 203-227.
37. Parlapani, E., Holeva, V., Voitsidis, P., Blekas, A., Gliatas, I., Porfyri, G.N., et al. (2020). Psychological and Behavioral Responses to the COVID-19 Pandemic in Greece. Front. Psychiatry, 11: 821.
38. Rapti, V. (2007). The Postwar Greek Welfare Model within the Context of Southern European Welfare. In: Hagemann, G. (ed.), Reciprocity and Redistribution: Work and Welfare Reconsidered, Pisa: Pisa University Press, pp. 43-60.
39. Sagan, A. et al. (2021). Health systems resilience during COVID-19: Lessons for building back better. UK: World Health Organization – European Commission – European Observatory on Health Systems and Policies.
40. Sbarouni, V., Petelos, E., Kamekis, A., Tzagkarakis, S. I., Symvoulakis, E. K., Lionis, C. (2020). Discussing issues of health promotion and research in the context of primary care during the ongoing austerity period: an exploratory analysis from two regions in Greece. Medicine and Pharmacy Reports, 93(1): 69–74.
41. Schwab, K. and Malleret, T. (2021). Η Μεγάλη Επανεκκίνηση. Αθήνα: Λιβάνης.
42. Sissouras, A. (2012). The meteoric steps of the NHS. Thirty years of the National Health System: Analysis of implementation and health policy lessons. Athens: Kastaniotis [in Greek].
43. Theodorou, M., Tsiantou, V., Pavlakis, A., Maniadakis, N., Fragoulakis, V., Pavi, E. and Kyriopoulos, J. (2009). Factors influencing prescribing behaviour of physicians in Greece and Cyprus: results from a questionnaire based survey. BMC health services research, 9(1): 1-9.
44. Tountas, G., Kyriopoulos, G., Lionis, H., Nektarios, M., Souliotis, K., Yfantopoulos, G. and Filalithis, T. (2020). The New NHS: the Reconstruction of the National Health System. Athens: Dianeosis [in Greek].
45. Tzagkarakis, S., Pappas, I. and Kritas, D. (2020). Covid-19 has brought back the necessity of the welfare state: The Greek case. HAPSc Policy Briefs Series, 1(1): 67-71.
46. Vandoros, S. and Stargardt, T. (2013). Reforms in the Greek pharmaceutical market during the financial crisis. Health Policy, 109: 1-6.
47. World Bank (2021). GDP growth: Greece. National accounts data. Available at: https://data.worldbank.org/indicator/NY.GDP.MKTP.KD.ZG (Accessed: 10/04/2022).
48. World Health Organization (WHO) (2020α). Novel coronavirus-China. Jan 12, 2020. World Health Organization. Διαθέσιμο στο: http://www.who.int/csr/don/12-january-2020-novel-coronavirus-china/en/ (Accessed: 11/03/2022).
49. World Health Organization (WHO) (2020b). 2019-nCoV outbreak is an emergency of international concern. Jan 31, 2020. World Health Organization. Available at: www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/news/news/2020/01/2019-ncov-outbreak-is-anemergency-of-international-concern (Accessed: 11/03/2022).
50. World Health Organisation (WHO) (2020c). 2019-nCoV Outbreak: First Cases Confirmed in Europe. Available at: https://www.euro.who.int/en/health-topics/health-emergencies/pages/news/news/2020/01/2019-ncov-outbreak-first-cases-confirmed-in-europe (Accessed: 11/03/2022).
51. World Health Organization (WHO) (2020d). WHO announces COVID-19 disease outbreak a pandemic. Mar 12, 2020. World Health Organization. (2020). Available at: www.euro.who.int/en/health-topics/healthemergencies/coronavirus-covid-19/news/news/2020/3/who-announcescovid-19-outbreak-a-pandemic (Accessed: 11/03/2022).
52. Xesfingi, S. and Vozikis, A. (2016). Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors. BMC Health Serv Res, 16: 94.
53. Ziomas, D., Bouzas, N., Capella, A. and Konstantinidou, D. (2019). ESPN Thematic Report on In-work poverty – Greece. European Social Policy Network (ESPN), Brussels: European Commission.
Published
2023-03-18
How to Cite
Tzagkarakis, S. I., & Melidis, M. (2023). Challenges and Adjustments of Healthcare and Labor Policies in Greece During the COVID-19 Era: A Critical Assessment of the Key Social Policy Responses. European Scientific Journal, ESJ, 19(38), 36. https://doi.org/10.19044/esj.2023.v19n38p36
Section
Special Editions
Copyright (c) 2023 Stylianos Ioannis Tzagkarakis, Michail Melidis
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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