Changing the public-private mix: An assessment of the health reforms in Greece

The 1983 health reform in Greece was a major political event in the social policy agenda. The main objective of the reform was the institution of a Na tional Health System and the expansion of the health sector, improved equit y, and the assumption of full responsibility for health services delivery b y the state. An assessment of the results 10 years after full implementatio n of the reform shows that despite the expansion of the public sector, the public-private mix in financing and delivery has changed in favour of the p rivate sector, making the Greek health system the most 'privatised' among t he EU countries. The main reasons why the health reform failed to meet its objectives was the restrictive enforcement of full-time and exclusive hospi tal employment for doctors, the virtual ban on private hospital expansion, the much faster introduction and diffusion of new health technology by the private sector, and poor management, planning and control in the public sec tor. A new health reform voted into law in the summer of 1997 shows promise of redressing some of the shortcomings of the 1983 reform. (C) 1998 John W iley & Sons, Ltd.