>anecdotally from locals reporting of income is less than 10% of actual
Factually this is BS. While there's underreporting in Greece, way more than "10% of actual" income is reported -- closer to 70% or 80% [1].
And one of the reasons it's not higher it's that there are quite high taxes (including a 24% VAT on most purchases) for little to no return from the state (no good healthcare, no money for schools, no road maintenance, etc). It's like sinking money down the drain.
([1] In fact a study by the Applied Economic Research at the University of Tübingen in Germany puts the whole Greek "shadow economy" to 20% of the GDP -- for comparison Germany's is around 10% and USA's around 5%: https://www.forbes.com/sites/niallmccarthy/2017/02/09/where-... ).
I'm sorry, what? The WHO puts the Greek healthcare system at #14. The UK is at #18, Sweden at #23, Germany's healthcare system is at #25, and Canada, Finland and the US are at #31, #31, and #37, repsectively [1][2]
And a more recent paper from The Lancet[3] puts Greece at #19. Sweden, Finland, and Canada have usurped Greece coming in at #4, #7, and #17, repsectively. That means that your healthcare system is still objective scoring better than Germany, the UK, and the US (the last of which is arguably a low, low goalpost, I admit).
>I'm sorry, what? The WHO puts the Greek healthcare system at #14.
Statistics are not necessarily the same as "ground truth".
- Hospitals are under-stuffed,
- doctors make a pittance and ask for side-money to take care of patients (what is known as the "envelope" system, from small mail envelopes where such money are customarily handed over in),
- rooms are full and patients are stuffed in beds in the hospital corridors (called "camp beds")
- waiting times are horrid
- lack of modern clinical equipment
- hospital workers are overworked
- drugs are often lacking or late
- doctors and nurses are underpaid horribly (think McDonalds level money at public hospitals)
- lack of ambulances and people dying after waiting for 2-3 hours to be taken to a hospital
and so on.
Now, despite that, there are a few things that make the Greek healthcare system still rank high: good doctors (some of the best in Europe), and a legacy of free access to healthcare for working people (who are mandatory insured) -- that is increasingly corroded and people are asked to pay ever more of medical expenses, drugs, etc.
Still better than the US, of course, but that, as you said is a pretty low bar.
Here are some more modern sources for the current (last 5-10 years situation, although some of the above issues are much older):
The WHO report was about efficiency, i.e. life years gained per euro. In that respect, we rank very high, but that might just be because there's so little money in the healthcare system that doctors have to stretch it to go a long way.
Just trying to think what the comment you're replying may have been saying - is it possible that in some of the more rural areas funding for healthcare was a victim of "austerity" and so it's lower quality than the average?
Also it seems that the WHO paper seems pretty old - I scanned it for a publishing date but couldn't see one, but all the papers it references are from 2000 or older. After the financial crisis quite a lot of public services suffered pretty badly from spending cuts. Furthermore the Lancet paper seems purely focussed on mortality over a pretty broad span of time (1990-2015), which is of course pretty important ... but is only one part of what you want to measure when talking about healthcare ("did the patient die from their knee operation" doesn't answer questions of wait times, quality or cost).
The spending cuts after austerity noted by a more recent study (Euro Health Consumer Index - https://healthpowerhouse.com/media/EHCI-2017/EHCI-2017-repor..., performed yearly) which assesses Greece a bit lower, 32nd out of 34. It seems to suggest that the cuts have a pretty significant impact:
"
Greece was reporting a dramatic decline in healthcare spend per capita: down 28 % between 2009 and 2011, but a 1% increase in 2012! This is a totally unique number for Europe; also in countries which are recognized as having been hit by the financial crisis, such as Portugal, Ireland, Spain, Italy, Estonia, Latvia, Lithuania etc, no other country has reported a more severe decrease in healthcare spend than a temporary setback in the order of < 10 % (see Appendix 2). There is probably a certain risk that the 28% decrease is as accurate as the budget numbers, which got Greece into the Euro.
"
I'm not Greek and have never experienced their healthcare system so I have no idea which of these is the most correct, and even then relying on a ranking system might not give us an accurate assessment. However I would be extremely surprised if Greece was able to continue providing healthcare of a higher standard than Germany, Sweden and such.
You’re referencing indexes of various health systems metrics, not perception of health systems, which would be the salient facet here (and might not change anything about your point).
No, it's more like the people who create the garbage and the people who should do the cleaning are not the same, and when you clean a part of the house, somebody will come over and immediately throw garbage on it.
Factually this is BS. While there's underreporting in Greece, way more than "10% of actual" income is reported -- closer to 70% or 80% [1].
And one of the reasons it's not higher it's that there are quite high taxes (including a 24% VAT on most purchases) for little to no return from the state (no good healthcare, no money for schools, no road maintenance, etc). It's like sinking money down the drain.
([1] In fact a study by the Applied Economic Research at the University of Tübingen in Germany puts the whole Greek "shadow economy" to 20% of the GDP -- for comparison Germany's is around 10% and USA's around 5%: https://www.forbes.com/sites/niallmccarthy/2017/02/09/where-... ).