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Reforms in Health Policy during the Greek Bailout: what makes reform successful and why?

Author

Listed:
  • Theofanis Exadaktylos
  • Nikolaos Zahariadis
  • Maria Mavrikou

Abstract

Despite consecutive MoUs (2010, 2012, 2015), Greek health reforms have been slow-moving with some successes and failures. Why did some reforms succeed while others failed to be implemented? Using the Multiple Streams Framework (MSF), this working paper presents evidence collected from interviews with health policy-related elites and stakeholders in Greece and traces the process of implementation to identify sticky points and configurations of pro- and anti-change coalitions. We hypothesise implementation outcomes are due to three factors: the strategies and power of the main non-state coalition partner (the medical profession), the size of resources needed for successful implementation, and the ability (or not) of government to mobilise public opinion. We examine three cases: the liberalisation of the pharmacy profession (successful implementation), family doctor reforms (partial implementation), and the referral system (mainly unsuccessful implementation). The working paper concludes with implications about policy implementation and practical lessons for policymakers considering possible implementation obstacles.

Suggested Citation

  • Theofanis Exadaktylos & Nikolaos Zahariadis & Maria Mavrikou, 2023. "Reforms in Health Policy during the Greek Bailout: what makes reform successful and why?," GreeSE – Hellenic Observatory Papers on Greece and Southeast Europe 188, Hellenic Observatory, LSE.
  • Handle: RePEc:hel:greese:188
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    File URL: https://www.lse.ac.uk/Hellenic-Observatory/Assets/Documents/Publications/GreeSE-Papers/GreeSE-No188.pdf
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    References listed on IDEAS

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    1. Nikitas Konstantinidis & Yannis Karagiannis, 2020. "Intrinsic vs. extrinsic incentives for reform: An informational mechanism of E(M)U conditionality," The Review of International Organizations, Springer, vol. 15(3), pages 601-632, July.
    2. Kevin Featherstone, 2011. "The JCMS Annual Lecture: The Greek Sovereign Debt Crisis and EMU: A Failing State in a Skewed Regime," Journal of Common Market Studies, Wiley Blackwell, vol. 49(2), pages 193-217, March.
    3. Sofia A. Perez & Manos Matsaganis, 2018. "The Political Economy of Austerity in Southern Europe," New Political Economy, Taylor & Francis Journals, vol. 23(2), pages 192-207, March.
    4. Alexia Katsanidou & Zoe Lefkofridi, 2020. "A Decade of Crisis in the European Union: Lessons from Greece," Journal of Common Market Studies, Wiley Blackwell, vol. 58(S1), pages 160-172, September.
    5. Simou, Effie & Koutsogeorgou, Eleni, 2014. "Effects of the economic crisis on health and healthcare in Greece in the literature from 2009 to 2013: A systematic review," Health Policy, Elsevier, vol. 115(2), pages 111-119.
    6. Keramidou, Ioanna & Triantafyllopoulos, Loukas, 2018. "The impact of the financial crisis and austerity policies on the service quality of public hospitals in Greece," Health Policy, Elsevier, vol. 122(4), pages 352-358.
    7. Sofia Vasilopoulou & Daphne Halikiopoulou & Theofanis Exadaktylos, 2014. "Greece in Crisis: Austerity, Populism and the Politics of Blame," Journal of Common Market Studies, Wiley Blackwell, vol. 52(2), pages 388-402, March.
    8. Ingram, Helen & Schneider, Anne, 1990. "Improving Implementation Through Framing Smarter Statutes," Journal of Public Policy, Cambridge University Press, vol. 10(1), pages 67-88, January.
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