Medical Care and Life Under Austerity

Life under austerity shows why Syriza is fighting it so hard

By Jamie Jordan

June 9, 2015—Greece has been a key talking point at the G7 summit of economic powers. The current impasse in negotiations between the Syriza-led government and the country’s creditors comes down to some significant differences in opinion over austerity. While Angela Merkel says time is running out for Greece to accept the reforms required for its bailout funds, Syriza continue to question conditions that require cuts to the country’s pensions, civil service and VAT (Value Added Tax) reform.

Alexis Tsipras’s firm stance against austerity has led to the Greek government being labeled as intransigent throughout negotiations. The analogy that has become common is that Greece is a patient that refuses to take its medicine. But the irony of this is that the country’s healthcare system has borne the brunt of austerity measures—the extent of which has become evident to me while carrying out my PhD fieldwork, focusing on the restructuring taking place in Greece’s political economy and welfare state.

Greece has undergone significant reforms in the five years since the debt crisis began. But the focus on Syriza undoing this and acting intransigently at the negotiating table ignores the depth of austerity that Greeks have endured and how this continually tests the cohesion of Greece’s social fabric.

The austerity experience

In order to understand why further austerity is so strongly rejected in Greece it is imperative that we understand how it has been experienced. One of the areas where this can be seen most vividly is in the country’s healthcare provision.

Access to healthcare and medicine in Greece is traditionally based on social security contributions made through employment, which can then also be used by immediate family members. But these contributions have become increasingly more difficult to maintain as the effects of austerity have bitten.

Statistics around employment and income highlight why. Since 2010 (when austerity was first introduced) there has been a fall in GDP of 25 percent and unemployment has ballooned to 26 percent of the total population (up from 7.7 percent in 2008). The figures are even more stark when we consider that youth unemployment, which stood at a staggering 58.3 percent in 2013, remains around 50 percent. And, of all those who are unemployed, 19 percent have been for a year or more.

Systemic cuts

This inability to pay for healthcare is then compounded by the fact that only one in ten receive some form of unemployment benefit), which could provide a buffer against these growing insecurities. For those who still have “wage-related income,” there has been a decrease per household by an average of 10.9 percent between 2008 and 2012 or 34.6 percent for those already in the lowest income bracket. Many will tell you they are lucky to earn just 400 a month from a full-time job. All of this is exacerbated by lower income groups seeing their tax burden rise by 337.7 percent.

The effects of austerity on the economy and employment has itself created a difficult enough situation for Greek citizens to access healthcare. This has been compounded by the specific measures taken to the healthcare system. As a study in the Lancet highlights, “from 2009 to 2011, the public hospital budget was reduced by over 25 percent,” while there was an introduction of “new charges for visits to outpatient clinics and higher costs for medicines.” The overall reform effort has produced a 47 percent rise in people who feel they are not receiving the healthcare they medically require.

As the authors of the study recognize, none of this is to deny the need for reform of a health system that already did not adequately meet the needs of its users. But “the scale and speed of imposed change limited its capacity to respond to its population’s increased health needs.” This is putting things very politely.

Solidarity movements

Where there has been a severe curtailment of people’s ability to access healthcare, there has in turn been a flourishing of solidarity. So many of the most vulnerable Greeks now find their needs met through volunteer run Social Clinics (and many other solidarity structures).

These clinics were first set up by volunteers in the wake of the anti-austerity Squares Movement in 2011 to meet the growing medical needs no longer met by the state. The larger organizations, such as those in the Athens suburb of Helliniko or city of Thessaloniki, attempt to provide comprehensive primary level provision—anything from dentistry to psychiatry. Most also organize social pharmacies, to dispense much needed medicines to people who can no longer access them from the state. In all, there is a national network of about 50 clinics.

These organizations are proving to be profoundly important. Without them, the severely underweight babies who were being brought to the Helliniko Clinic because parents had to cut their baby’s milk formula from one-to-six parts, instead of one-to-three, or the two cancer patients who donated ten days of their drugs each to ensure that a third person could have at least the same as them, would not have their needs addressed.

While completely run through voluntary work with all donations, equipment and medicine provided through donations, it is important to emphasize the fact that the individuals who organize the clinics do not consider this an act of charity. It is very much a social movement that is run democratically and, as well as providing medical care to citizens in need, aims to show the reasons why these people are asking for help.

Strange logic

For all their success, volunteers at the social clinics never expected their organizations to be around for so long. Now they do not expect them to disappear any time soon, as Syriza struggles to combat calls for further austerity measures. This, despite the fact that their existence shows that the state is failing to meet the basic healthcare needs of its citizens, instead having to rely on volunteers.

But it seems that somewhere along the way the experience of austerity has been lost on those who continue to believe in its logic. And where principles of solidarity and democracy are so richly practiced by those involved in austerity-countering initiatives like Greek social clinics. These very same principles are being actively undermined by Greece’s creditors—even though they are meant to be the bedrock of the European project.

No one I spoke to in Greece negated the responsibility that had to be taken for past failings that led to the crisis of 2010. But neither should this make us blind to the failings of the politics of austerity that have dominated the European landscape. It seems likely that if Greece continues to be considered the patient that didn’t take enough of its medicine, further prescriptions of the very same medicine are only likely to lead to an overdose with further tragic consequences

Jamie Jordan ESRC PhD is a candidate in politics and international relations at University of Nottingham.

—The Conversation, June 9, 3025