Letter from Athens
Yiorgos Haris is a cardiologist with a private practice in Faliro, an affluent suburb of Athens, mainly inhabited by descendants of refugees from Constantinople, as Greeks still call Istanbul. He was educated in Bologna, Italy, back in the 1970s, when due to a shortage of places in Greek universities, thousands of young Greeks studied abroad.
He and his Italian wife, Rita, regularly do social work and it is usual for him not to take any money from people who face difficulties making ends meet. Lately, even though his own income has taken a hit because of the economic crises, he has decided to donate his commissions, on body scans that he prescribes, to a fund helping the poor.
Commissions? Well it is an established practice among the medical profession to accept commissions for any patient referred to a private diagnostic center. It is also money under the counter, so it is not taxed and what Yiorgos found to his surprise is that he didn’t have to ask for it. It came through the post in an unmarked envelope.
He faced a dilemma. He either had to break the law and accept the money or refuse the commission and just fatten the profits of the diagnostic center. So, he asked them instead to donate the money to charity.
Of course commissions to doctors are the marketing ploy of the diagnostic centers which are following a very aggressive policy to attract patients for the simple reason that there are too many of them for a country as small as Greece. To get an idea, Greece has three and a half times more body scanners than the UK, a country almost six times the size of Greece! Furthermore, it is not only body scanners.
Greece has the highest number of doctors in Europe, the highest number of apothecaries, the highest number of lawyers, the highest number of judges and the highest number of notaries. Even in secondary education where there are strikes every so often demanding the recruit of new personnel, the number of teachers is well above the European Union average.
The reason for this “overproduction” of professionals lies in history: for Greek parents giving a good education to their children was a lifelong goal and the probably the only way for them to advance socially.
Everyone was surprised a few months ago when an agricultural co-op announced that it needed to employ around 3,000 seasonal workers with good pay for three months. Even though unemployment was above 20% only 19 Greeks showed up. The rest were foreign workers. Greeks want white collar jobs only! This is one of the reasons explaining the economic crises and at the same time one of the factors making it extremely difficult to overcome it.
All these professionals not only need to make a living but also expect a high income. As a result, this would not have been possible in an open market; they have pressed the state and have been given a number of privileges which enable them to take a rent out of the economy.
For example, in Greece, a businessman or a supermarket cannot hire pharmacists and open a drugstore. Only a trained pharmacist can do that and everything is regulated – prices, opening hours etc. The result is that apothecaries in Greece operate with higher costs and at the same time with higher rates of profit.
It is the same with lawyers who have a union dictating minimum payment for their services and who by law, have to be consulted for almost all transactions in the economy. The same holds for a very great number of professions which are strictly regulated and result in higher costs for the economy.
This surplus of professionals has another effect, it encourages corruption. In state hospitals, in order to have an operation, one is expected to give a “fakelaki” to the doctor, meaning an envelope with (tax free) money. Otherwise, he may have to wait weeks, possibly months to be treated.
It can become more sinister when people get unnecessary operations or are sent to diagnostic centers for unnecessary tests. Many cardiologists have noted that the number of open heart operations in Greece is much higher, possibly double, than the rest of Europe. Indeed Yiorgos Haritakis was one of the first doctors to speak publicly about it and has given evidence to the state prosecutor for unnecessary pacemakers implanted to patients!
It is impossible to measure corruption. The think tank of the Federation of Industry nevertheless has calculated that GDP could rise by as much as 13% in 5 years from the liberalization of professions – the policy that is advocated by the troika and is being implemented by the government.
The reaction from the professionals, that is the elite of the country, is fierce. In Greece, we had the first ever strike by judges and regular strikes by doctors, lawyers even pharmacists who close their shops or refuse to cooperate with state insurance institutions and demand cash from the patients!
At the same time of course many people have come to realize that things can’t go on like that. It is absolutely necessary to modernize the economy in a new competitive basis and see the current crisis, despite the debilitating austerity, as a big opportunity.