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Greece exits the bailout program after 8 ½ years
Will this be the beginning of a new era for the Greek people?
Speech by Grigoris Sarafianos,
President of the Panhellenic Union of Private Hospitals and member of the board of the UEHP
Warsaw, 28/9/2018
23/4/2010: From the border island of Kastelorizo, Prime Minister Giorgos Papandreou announces that Greece has applied for assistance from the European Financial Stabilization Mechanism (EFSM) and signed a bailout agreement with its European partners and the International Monetary Fund (IMF).
21/8/2018: From the island of Ithaca, Prime Minister Alexis Tsipras announces the country’s exit from the era of bailouts and promises a new era, with benefits typical of pre-election periods, reminiscent of the times that led us to this financial crisis.
Towards a new policy mix for the post-bailout period
Having completed its economic adjustment programs, Greece has balanced revenue and expenses on the state budget, but this was achieved by placing an excessive burden on taxpayers, employment, and business, which led to the deceleration of the economy’s growth prospects.
Without economic and technological impetus, with a high trade deficit, a huge portfolio of non-performing loans, low productivity, extensive unemployment, and an aging population, my country cannot be limited to growth rates of 2%, because it runs the risk of becoming stuck in the category of countries with low wages, low skills, and low innovation.
This bloodletting of the real economy in order to achieve excessive surpluses must, at the very least, be exploited in favor of the productive transformation of the economy, and not be exhausted in the context of a pre-election contest of promised benefits, which will hurt the economy’s medium- and long-term prospects and send negative messages to the international markets, from which Greece remains effectively shut out.
For example, an increase in the cost of employment that is not supported by a corresponding increase of productivity may ultimately produce the opposite outcome in regards to reducing unemployment and undeclared work.
Our first priority to restart the economy cannot and should not be strengthening consumption, in an economy where 70% of the Gross Domestic Product is created by consumption, and where imports exceed exports by 21 billion euro annually. Simply because strengthening consumption will put money in “foreign” pockets, since it will not be achieved through an increase of locally produced products and an improvement of local businesses’ productivity and international competitiveness.
The first priority of economic policy should be to strengthen production through a targeted reduction of the excessive taxation of employment, which in turn will lead to an actual increase in employees’ disposable income, in investments, and in jobs. The recipients of this reduction in taxes and insurance contributions should be employees in the private sector and Greek families, who currently witness a large part of their income being directed to taxes and contributions of a non-remunerative nature.
There is extensive and demanding work left to do towards the transformation into an economy of production and exports.
The responsibility lies exclusively with all of us.
The challenges facing the entire political system, as well as the responsible economic and social agents, are at present especially high. These start with the revision of critical articles of the Greek Constitution, run the gamut of public administration operations and every sector of the economy – especially in regards to mapping out an ambitious industrial policy – and reach all the way to the digital revolution, which needs to commence immediately in my country.
We all know very well what needs to be done. What remains is the implementation.
In view of the long pre-election period stretching out in front of us (5 elections in 2019), it is crucial to avoid political polarization and the special-interest policies of the past, which draw citizens’ attention away from the economy’s persistent and urgent structural problems.
Because that would lead us to increased interest rates, unwilling investors, a setting back of development, a reduction in national standing, and a new period of spiraling and indigence.
My country is exiting the bailout deals more competitive, but also poorer.
It is of crucial important to prove that it is also exiting wiser.
With the ability to transform all its painful experiences into prudence and collaboration, in order to become a pole of stability in this problematic corner of Europe. The great sacrifices of its citizens and businesses should make a difference, so that Greece may move forward, leaving behind the distortions of the past forever.
It would be a shame for the citizens’ expectations to be dashed…
As the medium-term economic prospects do not allow for any enthusiasm, since the country has committed to a tight fiscal policy of high primary surpluses, increasing the country’s attractiveness for investments is once again focused on the effort of countering the continuous structural under-performance of Greek business.
The development dynamic remains weak, with Greek productivity dropping continuously since 2008, while today it is below 50% of the productivity of the world’s developed nations (OECD).
The banking system is unable to support the economic recovery, since the statutory framework for the reformation of the banks’ loan portfolios and for the restructuring of heavily indebted businesses is extremely cumbersome and ineffective.
Public administration continues to hinder rather than help business activity, as it strives to maintain its own privileges, at great cost to Greek society.
The potential reversal of reforms in the job market is undermining the economy’s recovery prospects, especially if the incorrect notion is allowed to prevail, that sustainable development can be built not so much on the increase of demand through competitiveness and profitable investments, but on the increase of demand through policies of income redistribution.
The tax system remains anti-development, with high tax rates directing economic activity to the shadow economy (tax evasion, contraband, undeclared work, etc.), creating disincentives for business growth and investment.
Large and organized undertakings are now facing overwhelming non-wage labor costs, due to the very high social security contributions and hyper-progressive taxation, with corporate taxation (combined profit tax, dividend tax and contributions) being among the highest in the world, and as a result they are directing investment capital and highly specialized executives away from our country.
In this framework, historical structural problems prove to be remarkably enduring and are confining the country to the investment margins.
Tax rates, corruption levels, the degree of political stability, the effective operation of institutions, an economy’s ability to innovate, the adaptability of human resources, are all crucial factors in attracting investment; the country needs to deal with these factors if it wishes to regain a place on the international investment map.
I believe that policy in the post-bailout era must be focused on targeted and realistic interventions towards the improvement of the business environment, since this is a necessary prerequisite in order to attract and strengthen investment. This is the only way to accelerate important productive investments that will increase productivity and form the foundation for rising incomes and employment.
Financial developments
Gross Domestic Product: According to provisional data from the Greek Statistical Authority, the Gross Domestic Product increased by +1.8% in the second trimester of 2018, compared to +2.5% in the first trimester of 2018 and +1.4% in 2017.
The growth of the economy in the first three months of 2018 is the result primarily of an increase in export of goods (+7.2%) and services (+12.2%), while private consumption recovered (+1%), following a significant slowdown in the second semester of 2017 (-0.4%) and zero change in the first semester of 2018.
DEVELOPMENTS IN THE HEALTH SECTOR FOLLOWING THE EXIT FROM THE BAILOUT PROGRAMS
During the bailout years, the national health system completely collapsed.
Hospitals lacked the necessary medical and nursing personnel due to immigration abroad; patients had to wait months for surgery due to an inability to procure supplies; patients had to bring personal hygiene products from home.
The fiscal adjustment imposed by the bailout programs forced governments to cut expenses drastically. Certainly, before the recession there were abuses, corruption, excesses. But we found ourselves swinging from one extreme to the other.
First of all, the primary care system stopped operating practically overnight. For decades, Greek patients got their medical examinations and diagnostic tests at state facilities, and the cost was covered entirely by the State. Whoever chose to see a doctor in private practice or a private diagnostic laboratory had to cover expenses on their own.
Overnight, in 2014, all State facilities closed down and patients chose whichever doctor in private practice they wished and whichever private laboratory they trusted. The State insurance entity covered visits to private physicians with 20€ per visit for a maximum of 200 visits per month. At diagnostic labs, electronic prescription was implemented for the first time, and insurance funds covered expenses at 1991 prices, but also implemented a 50% claw-back policy. This allowed patient needs to be adequately met.
However, the Leftist government that has been ruling the country since 2015 attempted, last fall, to re-establish the State facilities; however, doctors and nursing personnel did not respond to the call, and as a result it is not possible for these facilities to be fully operational. But the goal remains. The establishment of the institution of the family doctor, whom patients will see rather than visiting outpatient facilities at State hospitals; family doctors will then refer patients to specialized physicians at State hospitals and State diagnostic labs. But this policy is also meeting with strong resistance, and as a result it has not been fully implemented so far.
Pharmaceutical expenditure went from 6 billion euro in 2008 to just 2 billion euro and 6 million prescriptions per month, in a country with 10 million inhabitants, through the methods of reducing medicine prices by 70% and implementing closed budgets that, when exceeded, mandatory claw-back discounts are imposed on pharmaceutical companies.
Finally, 100 private clinics operate on a closed budget of 255 million euro per year, and 50 million for 35 psychiatric clinics.
Also implemented, since early 2016, is the audit of the expenses we file, but with huge cuts and with unreasonable justifications as to the selection of the right DRG; an effort is being made by the end of the year to implement auditing in real time, with the electronic linking of the clinics with the insurance organization. Our argument against the audits is that, by auditing a sample of 5% of expenses filed, the result of the cut is multiplied by 20 through the implementation of statistical and extrapolation from the sample methods. And this results in unfair and excessive financial cuts.
HEALTH POLICY AFTER THE BAILOUT PROGRAMS
A dignified health policy must, first, allow patients free access and choice of physician and treatment facility based on trust, for the rehabilitation of the health issues they face; provide adequate funding for the healthcare system based on the population’s needs and in proportion to the amounts spent by other European Union member states; and provide incentives to healthcare undertakings to promote medical tourism, introduce new technologies in healthcare, and continuously update medical equipment to keep up with constantly evolving medical technology.
We cannot deal with healthcare in the post-bailout era with irrational ideas, or with promises of benefits and hiring of unnecessary personnel, simply because there are 5 elections in 2019.
After 10 years of hardship, Greek patients deserve a better life and quality healthcare services, as available throughout the civilized world.
Vision
We envision Greece as the country where every citizen of the world will want and be able to visit, live and invest in.
We envision an open, socially responsible and financially liberal member-state of the European Union that will promote strong growth as a factor of social cohesion.
We want a Greece that is a dynamic center at the European periphery, with stable institutions and an attractive socioeconomic environment that promotes exports, innovative entrepreneurship, production and quality services, sustainable growth, knowledge, cohesion, equal opportunities, and the rule of law.
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