Another year at health sector resilience and resilience conferences, the same thing is presented again. Theorems for public-private partnerships (PPPs), out-of-pocket discussions that burden citizens with double payments, and more around a high quality of life. For at least the last decade, many highlights have been repeated to present and apply proven models: French, Dutch, etc., to enter the mainstream of convergence and complementarity between the public and private sectors.

Practically, however, not a single step. The only attempt at practical synergy that has been correctly characterized as the first PPP attempt was the start of a collaboration four years ago for Diagnosis Related Groups (DRG) between the Hellenic Association of Insurance Companies (EAEE) and the Center for Documentation and Calculation of Hospital Services (KETEKNY). In fact, he signed the corresponding memorandum of cooperation in May 2019.

Based on the memorandum, EAEE will provide financial and technical support to selected projects needed to promote the adoption and widespread implementation of the new, Greek DRGs – of course with the blessing of the Ministry of Health, while the successful implementation of DRGs in 11 countries.

At what stage is this cooperation today, which would be based on the Greek nosological, medical-technological, financial, etc. data, make the hospital payment system a reality, balance and rationalize hospital costs?

To what extent has the goal of speedy progress in DRG piloting in public and private hospitals selected by KETEKNY been achieved since then? There is a well-known attempt at an honest pilot application in PAGNI (Heraklion, Crete), if I’m not mistaken – nothing more. And again the same philologies at conferences, with the same repeated conclusions and references to models for presentation.

Why is debate carefully avoided about the opposites and opposing tendencies that undermine the GDS in Greece? Has the possibility of convergence of interests in pricing protocols between different healthcare sectors (insurance companies, oligopoly of “multi-star” healthcare providers, private healthcare organizations and, of course, the public system) been explored? Are their interests aligned so that DRGs can move forward? Because that would be a clear principle of proving the inclination towards a viable National Health System, a system of a single, public character. That is a combination of public and private sectors with clear complementary roles.

In that case, what is the interventionist strength of the relevant ministry to allow such reform to find its way, or does it prefer the state-private parallel course as it is, leaving the field of private health care to itself? -regulation? Do nursing homes, which control the insurance market through partnerships, want DRGs? Why don’t they come up with positions and proposals at such conferences and limit themselves to individual negotiations with insurance companies? They are again interested in zeroing out annual adjustments to insurance premiums, which play at the level of 8%-10%-12%, and what strategic considerations they put forward in order to have an elementary, even if only one euro, profitability in the healthcare sector without adjustments, in order to be sustainable and at the same time affordable insurance for society as a whole at manageable costs? And if they have any thoughts, are they agreed?

To what extent is competition in the provision of services controlled?

What are the prospects for the widely available use (accessibility, low cost) of technologies in healthcare (artificial intelligence, robotics), as well as the transition to a wider outpatient treatment of patients who are now treated with expensive hospitalization?

What is the dynamics of implementation and how balanced in quality is primary health care and prevention, especially for vulnerable social groups?

To what extent has the link between health and modern living conditions (lifestyle, work, climate change, population movements) as well as social peace and cohesion been explored?

How are mental health issues, a rapidly evolving phenomenon of today, being addressed, especially in terms of insurance coverage?

The challenge is to find convincing answers to these and many other health and management questions that need to be given in practice. While the public welfare mechanism seems to be largely weakening and in decline, questions are being asked at the level of social responsibility, in the context of Goal 3 “good health and well-being” of the UN Sustainable Development Goals (SDG 3). ). With regard to the “Right to Health”, to what extent can an equal distribution of interests and concern for the health of all people be achieved, without discrimination and incessant economic bleeding for the state economy, as well as for the pocket of citizens, in order to reap the maximum benefit to society, and not enterprises in this sector.

* Mr. Yiannis Rutos is a Corporate Responsibility and Sustainability Consultant, Communications and Relationships with a particular interest in society, environment and culture.