Country Case Studies and Links
by Dan Galluppi
The Greek welfare state is relatively new and is based on concepts found in other European countries. Before the current welfare state was created, Greece was ruled by a military junta until 1974. Then as democracy was reestablished, the elections in 1981 brought the Panhellenic Socialist Party (PASOK) to power. Under PASOK, Greece's modern welfare system changed into its current framework.
In the early 1980s, despite economic problems, the Greek welfare state expanded. The health care services consisted of public hospitals, rural, and private clinics. Service received in hospitals depended upon how much a patient could pay or on a person's level of insurance coverage. Those with inadequate coverage or who could not pay, had poorer services and were assigned to poorer hospital wards. People in this situation were forced to undergo stigmatizing means testing to determine if they were eligible for a free treatment. Doctors in Greece could also work at a public hospital as well as at their own private clinics. What also tended to be a problem was the geographic distribution of hospitals and clinics. These were heavily concentrated in the cities and scarce in the small towns and rural areas. Not only was distribution a problem, but also the services provided were poor and ineffective. When the socialist party came to power, it enacted the National Health System in 1981. This was an attempt to reduce the fragmentation of the old health care system, and to control the expansion of private practices. The number of doctors and nurses in hospitals increased by 60% and 88%. Doctors could no longer engage in public and private practices. As more services became free, the demand became overwhelming. Overcrowding was not uncommon in hospitals. The conservative government elected in 1990 changed the program slightly. A fee was charged to reduce demand. The socialist party regained control in 1993, and has since made attempts to improve quality, and raise efficiency. Nevertheless, it seems that a large segment of the population does not have great confidence in the Greek health care sector since many Greeks go abroad in search of medical treatment.
The area of social security also had its share of problems. Social security was organized by occupational groups and trade union insurance funds. Some population groups, however, were not covered, while others that were covered had only access to low-level pensions, and sometimes, inadequate medical coverage. Other groups, by contrast, were covered by more than one fund, and as a result received high benefits. The main problem with social security was that it was underfunded when compared to how much of the GNP other countries devote to this area. The PASOK government acted to change social security in the 1980s, by increasing the monthly pensions for large portions of the population. Also PASOK introduced minimal pensions and medical benefits for retired farmers who had not previously paid into an insurance fund. The Socialist Government also provided social insurance coverage for Greek nationals.
Social security is made up of a collection of funds under the jurisdiction of the Ministry of Health, with unemployment and family assistance under the Ministry of Labor. The system is financed by earnings contributions from employers and employees. The government needs to subsidize some of the funds in order for the system to function. It is interesting that there is no national program for those who do not qualify for an insurance benefit or whose benefits have ceased.
While the military was in power, the education system was used as a tool of propaganda. As a result, the curriculum was based on classical Greek and Latin, and had not undergone many changes. In the 1970s, the Conservative New Democracy Party began to reorganize the education system. Education was made mandatory for ages six through fifteen, but not enforced for a lack of appropriate mechanisms. The New Democracy also established vocational and technical schools. Not only was this meant to prepare students for jobs, but it was also intended to relieve the overcrowded universities. The government also upgraded post-secondary Technical Colleges to strengthen the educational system's ability to increase the number of skilled personnel. Universities are the responsibility of the government, and are very competitive. A major problem in the Greek education system today, is the relationship between class inequality and educational attainment. This still suggests a great need for reform at all levels of the Greek education system.
The housing situation in general was very bad during the 1960s and 1970s. In 1971, only 36 percent of urban houses and 6 percent of rural houses had a bath or shower. Migration towards cities resulted in much unauthorized building and construction. The quality of this housing was poor, with little consideration given to recreation, parks, schools, or churches. Even public housing was of inferior quality, resulting in the creation of ghettos. Housing assistance consisted, for the most part of subsidized mortgages. Sometimes housing was made available for free to low income families. There was however, not much consideration given to making housing or cities more accessible to disabled persons. Home ownership is valued in Greece. Most families will buy land and build their own homes. Today, the government assists families by providing low interest loans. The state also employs its own construction company to build low cost housing for families on welfare. These homes are allocated on a lottery basis, and sometimes cause social dislocation. There is also a rent control system on apartments to avoid sudden rent increases, and evictions. Recently these controls have been relaxed, to stimulate the lack-luster housing market.
Personal Social Services were, for the most part, neglected until the end of the 1970s. Their only function was to take care of the people who fell through cracks in the system. These services were based in institutions for the orphaned, the disabled, and the elderly. A significant portion of the services provided came from private organizations (there were some 1053 by the end of the 1970s). Generally, these social services were aimed at specific categories of people, but did not work particularly well because of chronic under-funding. As people have increasingly moved to urban areas, services for the elderly have changed. Young Greeks are leaving small towns, as a result, elderly people who had previously been taken care of by their families now require public assistance. The government has created care centers in urban areas specifically for the elderly. Yet, financial constraints and cuts in the number of public employees is likely to curtail this and other programs.
Demographic and family changes have occurred in Greece, like in most EU countries. The birth rate has dropped, and so have fertility rates. This decline is a cause for great concern because it has already exceeded population replacement levels. Also infant mortality rates have declined while life expectancy has increased, boosting the share of the elderly population. The drop in marriage rates and the increase in divorce rates, although not as dramatically as in other European countries, suggests a significant change in the lifestyle. In terms of fighting poverty, it is noteworthy that the percentage of households in poverty dropped from 1980 to 1985, but had actually risen by 1988 to a higher total than in 1980. We may assume that the actual figures are probably higher and include groups like retired people, ex-farmers, and women. A specific problem that contributes to the percent of people living in poverty would be Greece's lack of a minimum income guarantee.
In many ways Greece is a late developing nation. During the last two generations Greece has seen enormous changes from a rural to an urban society. The ruling junta did little to advance the welfare state, which means that the Greek welfare state did not begin to develop until 1974. Greece is, thus, still in the process of experimentation to determine what welfare programs will work in that country. The fall of the junta has also given rise to previously unknown problems such as the changes in lifestyle. Divorce and abortions, along with problems associated with falling fertility rates, are recent developments, which present new challenges to the Greek welfare state. This means, however, that the real test has yet to come when the country is likely to experience its most severe social problems. Unless effective measures are taken to address the current social trends, the Greek welfare state may be overwhelmed at some time in the not too distant future.
Greece: What Future the Welfare State? By Peter Stathopoulos in Vic George and Peter Taylor-Gooby (1996). European Welfare Policy; Squaring the Welfare Circle St.Martin's: New York.
See also: MISSOC Country Tables