Greece’s health care system is a mixed system comprising elements from both the public and private sectors. In the public sector, a national health service Health systems xvi in transition Greece type of system coexists with a social health insurance (SHI) model. In 2011, the National Organization for the Provision of Health Services (EOPYY) was established. It acts as the sole purchaser of health care services for patients covered by the publicly financed National Health System (known as ESY).
The private sector includes profit-making hospitals, diagnostic centres and independent practices. A large part of the private sector enters into contracts with EOPYY, providing mainly primary/ambulatory care for the ESY. After 2010, the role of voluntary initiatives, nongovernmental organizations (NGOs) and informal health care networks increased significantly. This was mainly a response to meeting the needs of the large portion of the population that most insurance coverage and access to public health care, primarily through prolonged unemployment or other inability to pay contributions. Coverage was restored through remedial legislation in 2016.
The Ministry of Health is responsible for the planning and regulation of the ESY and EOPYY. Despite the establishment of regional health and welfare authorities as far back as 2001, and their renaming as regional health authorities (YPEs) in 2004, these entities, which were intended to carry out extensive health care planning, organization and provision, have exercised only limited powers to date. This may change with the implementation of more recent primary care reforms. In 2014, legislation formally transferred all public primary care facilities, health centres and rural surgeries to the jurisdiction of the YPEs. These are expected to take up their primary care coordination roles more fully under the implementation of further reforms being rolled out from 2017 to 2020, to create a more integrated, two-tier primary care system with a gatekeeping role.
There is extensive legislation controlling the activities of third-party payers and providers of services, the purchasing process and the levels of prices and reimbursement within the ESY. The training and licensing of health professionals are also highly regulated.