Another year the same story is presented again at conferences on sustainability and sustainability of the health sector. 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 step. The only attempt at practical synergy that has rightly been described as the first attempt at PPP was the start of a collaboration four years ago for Diagnosis Related Groups (DRG) between the Association of Hellenic Insurance Companies (AAEE) and the Center for Documentation and Calculation of Hospital Services (KE.TE.K.NY. ). By the way, in May 2019, a corresponding Memorandum of Cooperation was signed.

Based on the memorandum, EAEE will provide financial and technical support for the necessary individual projects so that the new, Greek DRGs can be accepted and implemented everywhere – of course with the blessing of the Ministry of Health, while the successful implementation of DRGs in 11 countries would also be studied.

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 spending?

Since then, to what extent is the goal of rapid progress in the pilot application of DRG in selected KE.TE.KNY public and private hospitals? An honest pilot attempt to apply is known, in PAGNI (Heraklion, Crete), if I’m not mistaken, nothing else. 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, a group of private doctors and, of course, the public system) been explored? Are their interests aligned so that DRGs can move forward? Because it would be a clear principle of proving the inclination towards a sustainable, National Health System, a system of a single, public nature. That is a combination of public and private sectors with clear complementary roles.

In that case, what is the intervention power of the competent ministry to find a way to enable such reform – or does it prefer the parallel course of the state and the private sector, as it is, while leaving the private health area to self-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? These, again, are interested in zeroing out the annual adjustments of insurance premiums that play at the level of 8-10-12% and what strategic considerations do they make in order to have an elementary, even if one euro, profitability in the Healthcare sector without adjustments, so that it is sustainable and at the same time affordable insurance for society as a whole at an affordable price? And if they have any thoughts, are they agreed?

How controlled is competition in the provision of services?

What are the prospects for the widespread use (accessibility, low cost) of technologies in health care (artificial intelligence, robotics), as well as the transition to a wider outpatient treatment of cases that are now treated with expensive hospitalization?

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

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

How are mental health issues, a booming phenomenon of the modern era, treated, 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 pockets of citizens, in order to reap the benefits of society for maximum benefit, and not enterprises in this sector.

* Yannis Rutos is a Corporate Responsibility and Sustainability, Communications and Relationships Consultant with a special interest in society, environment and culture.