A very worrying attitude has developed regarding the operation of the national health scheme Gesy – that funds are inexhaustible and that the medical services on offer must keep expanding. This attitude is encouraged by the media which have made a habit on focusing on Gesy’s weaknesses – with indignant articles about long waiting lists to see doctors and delays in patients being seen at hospital A&E departments – and demanding immediate action regardless of the costs. Then there is the ubiquitous spokesman of the patients’ association, who is constantly in the news demanding more medical services for all.

It does not help that the Health Insurance Organisation (HIO), which manages the Gesy funds, boasts about the amounts of money it has in reserves, thereby encouraging the demand for more and more spending. Yet, there have been attempts to control expenditure such as placing limits on the referrals signed off by personal doctors, restricting the number of tests a patient can have and changing the pricing of drugs among other things, all actions suggesting that funds are not unlimited, and that spending must be reined in. On another level, however, HIO is still pursuing more spending and is reportedly at odds with the finance ministry over funding.

Speaking to Trito radio on Tuesday, the chairman of the HIO, Stavros Michael, said that this year’s budget for the scheme could be increased if an agreement is reached on the entry of another private hospital into Gesy. The extra cost had not been budgeted for 2023, the finance ministry having forced HIO to reduce its expenditure for the year to €1.4 billion from its proposed €1.5 billion, on expectations that contributions would be lower. Despite the forecasts, there was no reduction in the contributions in the first months of this year, so HIO is set to table a proposal for additional spending that would require the approval of the finance ministry and the legislature.

The finance ministry is the only government agency that has been trying to impose restrictions on HIO spending and encourage some financial prudence. A letter the ministry had sent on this matter to the HIO board at the end of last year provoked a strong reaction from the latter, which demanded written assurances that the state would not put a ceiling on the contributions to Gesy. In other words, if wages rose and Gesy contributions increased, the full increase would have to be given to the scheme, as per the legislation, so it can offer more medical services. This would be a recipe for more waste when the requirement is for financial prudence and sustainable growth of Gesy.

The disagreement between the HIO and the ministry was under the previous minister. There is now a new finance minister, Makis Keravnos, who must continue his predecessor’s policy of controlling and placing limits on HIO’s spending. Failure to do so could prove disastrous for the future of Gesy.