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Sunday, 3 June 2012

I pay (Εγώ πληρώνω)

When my family was living in New Zealand, I remember always paying doctors after a consultation. We never received free medical care apart from hospitalisation after being referred to it by our General Practitioner (GP), or because of an accident. Medication from a pharmacy was also paid for. We'd show the doctor's prescription to the pharmacist, and come back in a quarter of an hour to pick it up because it had to be prepared (unlike in Greece, where the packet is simply taken out of a drawer or cupboard, complete with the manufacturer's logo). Medical services were partly subsidised for everyone, and everyone paid more or less the same price for such services. You could choose your doctor, therefore you could choose your prices too, and if you could afford it and deemed it necessary, you could have private health insurance; but the ultimate cost of medical care in NZ (pre-1990) was democratic without private care being needed.

When I came to Greece, the last thing I had on my mind was getting sick. But eventually, like most people, I got sick enough to believe that I needed a doctor: I had a bad cold and had lost my voice completely. I asked my boss what to do; I thought she'd recommend a good GP in the area. Instead, she told me about IKA. I was covered to receive free medical care through my work by the national health system of Greece. IKA had offices and doctors' surgeries in a centralised building for the area where I was living and working. Armed with my health book (all hand-written: at the time, there was no such thing as computerisation in the state departments), I made my way to IKA.

EOPYY has now taken the place of the former IKA since the restructuring of the health and medical care sector in Greece. EOPYY covers 75% of the country's population (9.5 million Greek citizens - you don't have to be of Greek nationality to have Greek citizenship). Some of these people pay into the system, while others are dependants of those paying into it (eg my children). Now, EOPYY doesn't have enough funds to continue to provide free services, due to overuse, misuse and abuse of the free system in former times. Pharmacists are now refusing to offer the state credit in order to fill doctors' prescriptions, due to the state's outstanding debts to them (caused by a lack of funds, leading to an inability to pay). Payback time, as Ms Lagarde stated. 
The first thing that struck me was the decrepit state of the building. It was over-used and had suffered from being knocked about quite a bit. But this was to be expected; most government offices looked very much the same as this building. In a sense, I was already used to this 'style', one that I associated with Greece in general: state property looks like bombed rubble, while private property is maintained to a luxurious level. As I made my way through the maze of corridors, trying to separate the administrative section from the doctors' surgeries, I was astounded to find myself among crowds of people looking lost in space: they were queuing (in the Greek sense of the word) outside various doors, and many of these people looked like they had been through hell before they had come to the IKA offices. They looked old and/or tired, just like the building IKA was housed in, and I wondered if it was really necessary for me to take my place in a similar 'queue', one which did not seem to have a beginning or an end (but only a middle). I was ill, but no one seemed to care. Everyone seemed ill, but we all had to fend for ourselves, unless we had a friend or relative to look after us.

Pharmacy in Hania - it's got an olive tree growing in it from the basement.
Eventually, I did get through, and I got to see a grumpy middle-aged doctor, who examined me very quickly in a bright if somewhat inadequately furnished surgery. He wrote out a prescription on a stamped IKA paper, which he gave me. I then left his office - the consultation was free of charge, and the prescription costs were 25% of the price stated on the packet (which I picked up from a chemist - if the prescription wasn't written out on official IKA paper, I'd have had to pay the full price of the medication; most drugs are available without prescription for the full price from the counter). Getting somewhat lost as I exited his office, I found myself in the laboratory area where blood and urine samples were tested. I watched old people with few social skills carrying urine samples in their shaky hands, laying them on the counter, and waiting to be told where to take them to get them tested.

What on earth am I doing here? I asked myself. Since then, I've avoided using the 'free' doctors, not even for my children. I didn't want to be subjected to the torture of seeing very sick specimens of humanity (not just physically ill, but socially and psychologically ill) waiting their turn to see a free doctor. No matter how sick my children have been (and they were quite sick as babies), I preferred to save my money for doctors with waiting rooms, clean surgeries and a general interest in me*.

*** *** ***

This was the idea behind anything free in Greece: an over-used system which was systematically abused by making false claims - people would bribe doctors to give them disability pensions, uninsured patients would use other people's health books to gain access to the system, and the doctors themselves all supported this system to their own benefit. Even the administrative staff involved in the health system knew how to use it to their advantage and cheat the state out of millions of drachma/euro. The end result was that the people who were contributing to the system were not always the ones to benefit; they also had to fight for their right to get the free services - waiting time for appointments to use the system vary, with an average waiting time of at least a month. If my child has a worrying temperature, I can't wait for a month to see the paediatrician. The irony is that I see the SAME paediatrician that I would have seen in the IKA offices had I made an appointment through them. But because I choose to see her in her private surgery and not the IKA (oops, sorry, EOPYY now) offices, I pay. If I deem a visit to be non-urgent (eg a medical check-up), I make an appointment through the state system and see her without paying - but I wait a long time for the appointment to come up.

The 'free' system (still) extends to every sector in Greek society at a heavy price. Let's start with the 'free' education system: schools, schoolbooks, university studies - they are all 'free'. So why are Greeks paying over €5 billion a year on private education for their children? Our free education system is not only worthless, it is also a fraud. Sometimes, the free system bordered on the insane. Some of the freebies sound ludicrous in modern times. There are even subsidised island holidays available for pensioners and state-insured employees, where people are paid the cost of breakfast and one meal together with the accommodation costs of a modest hotel, usually on an island or other coastal resort, through Ergatiki Estia**. When I got married in 1999, as a health-insured private-sector tax-paying employee, I was entitled to a little payout from the Ergatiki Estia, just because I got married (it was something like 135,000 drachmas)! I filled in an application form in October 1999 and got the money some time the following year (they phoned me from the local offices to come and pick it up).

I particularly like the set-up for Greek military personnel. They are (still) able to live completely off the kindness of the state for a very long time. Wherever they are stationed, they have access to free housing in state-provided military housing blocks, complete with schools and churches (they may need to go on a waiting list for a position to come up), which entails free use of electricity, free water, free basic landline connection, virtually-free cellphone connection and - the most expensive expense this year for 'normal' Greek people - free heating. All the things that 'normal' people pay for, they get for free as military personnel. Once they come out of the system (eg they decide to move into their own home once they are stationed permanently in one area), they find themselves unable to cope with real life. When their salary doesn't go on paying basic daily expenses, they can (and do) use it to buy luxury cars and build luxury homes (generally speaking, they do not travel abroad on luxury holidays - they like the confines of their own borders and their Greek-centric lifestyles make them prefer to travel in package tours with other Greeks, so they rarely take luxury holidays). Once they start paying their electricity and heating bills instead of having them paid for by the state, they find they cannot afford to drive their luxury cars any more, and they regret building super-sonic extra-large houses which they couldn't afford to live in before they even built them. And of course, they complain about the property taxes, which they usually pay at the eleventh hour (out of fear of having their electricity supply disconnected). It should surprise no one that Greek military personnel in permanent state employment (like police officers) often come from poor families - they are encouraged to enter such professions because they do not cost the parents anything to 'educate' their children there; moreover, they are guaranteed a job (however lowly paid - it is a job after all) at the end of their studies, which offers them social stability and financial perks.

So who was paying for this free system? Taxes, I suppose. But Greeks don't pay their taxes, we often hear in the foreign media. Unfortunately, there's some truth in what the foreign media reports: some people in Greece, indeed, do not pay their fair share of taxes, finding loopholes in the system to avoid doing so, or simply just avoiding payment until they are forced to make it, by which time they have done their best to hide their money in such a way that they can declare themselves insolvent.

How come they can wait so long and pay taxes in arrears (or not at all)? That's not their problem really - that's what the state should have been doing all this time, finding ways to collect taxes and make sure they are being paid. Few employees like myself can avoid paying taxes - they are deducted automatically from my monthly salary. My employer deducts them on my behalf, so it's my employer that the state has to chase after.

There was some element of truth in what IMF chief Christine Lagarde said in the Guardian. It caused a furore among Greek people, quite frankly because it didn't sound nice:
"I think more of the little kids from a school in a little village in Niger who get teaching two hours a day, sharing one chair for three of them, and who are very keen to get an education. I have them in my mind all the time. Because I think they need even more help than the people in Athens."
Everything that sounded 'derogatory' about Greek people in that interview got reported in the mainstream media:
PASOK leader Evangelos Venizelos accused Ms Lagarde of "insulting the Greek people"... and added: "Nobody can humiliate the Greek people during the crisis." Left-wing leader Alexis Tsipras insisted: "The last thing we seek in Greece is her sympathy. Greek workers pay their taxes, which are unbearable. For tax-evaders, she should turn to Pasok and New Democracy to explain to her why they haven't touched the big money and have been chasing the simple worker for two years."
The blame game is a common trait in Greek politics: it's never our fault, it's always someone else's. But the mass media conveniently forgot to report what Lagarde said in the same interview about Greek children:
And what about their children, who can't conceivably be held responsible? "Well, hey, parents are responsible, right? So parents have to pay their tax." (Christine Lagarde)
What do you do with naughty people who find ways to avoid paying taxes? Surely they need to be punished in some way. One way to do this is to punish everyone across the board, by making everyone pay extra taxes, which is what has happened in Greece at the moment.

But isn't that unfair? Yeah, it's unfair. The truth is that even with this across-the-board tax (like the recently introduced property tax), not everyone has paid it, because they believe that they shouldn't pay it (ie in their opinion, it should not have been levied on them), even at a time when Greece needs money to prevent her from defaulting on her debts, and running the risk of not getting any more money from her 'benefactors' to prevent her from defaulting. Come to think of it, this is what child psychologists tell you to do with teenagers who continually spend their pocket money too quickly before they are due to pick up the next instalment: let them off the first time, cover them the second time, and cut them off the third time it happens. When you leave them to their own fiscal devices, eventually, they get the message and they learn.

I've been left to my own economies for all my adult life. My parents had always lived like this, both in their youth in Greece and in their middle age in New Zealand (neither of them got the chance to experience life in their older years). I haven't always been employed (both in NZ and GR), but I never got into debt. I've never wanted to be in that position, so when I was unemployed, I simply stayed put and didn't spend. It sounds like a boring life, but that's what economic austerity has always been like - unexciting. Living off other people's money is OK only if you don't have to pay it back. But that isn't how the real world operates. It's also a hard quality to teach young children these days, because they live in the instant gratification era. They think their parents are loaded with money, because - in Greece anyway - they always seem to be paying for something.

I've been paying all my life for other people's sins, sings Rita Sakellariou, but now no more, I can't do this any longer.

*If the medication prescribed by the paid doctor is expensive, I then have to get it approved by a state doctor, otherwise I have to pay the full price, which I often do, because this inevitably means more queuing and time-wasting - thankfully, we don't get that ill these days, but this is a problem for the chronically sick.
**About 2-3 months ago, I read somewhere that these had been terminated with the crisis - but I'm obviously wrong, given the dates in this article.

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