SUSTAINABILITY OF HEALTHCARE FINANCING IN GREECE

The sustainability of healthcare financing in Greece remains a pressing policy issue due to persistent macroeconomic fragilities, demographic ageing, high medical inflation, and one of the highest out-of-pocket (OOP) burdens in the European Union. This study evaluates medium- and long-term sustainability using updated macroeconomic and demographic projections for 2024–2035 and an actuarial modelling framework. Health expenditures are projected on the basis of age-specific spending profiles, population dynamics, and medical inflation, while contribution revenues depend on employment, wages, and stable contribution rates. The analysis employs actuarial balance and solvency ratio indicators to examine baseline and alternative scenarios. Results show that expenditure growth outpaces revenue capacity throughout 2024–2035, widening funding gaps despite moderate labour-market improvements. Long-run indicators confirm that, under realistic assumptions, the solvency ratio remains below the level consistent with full financial balance, signalling structural pressure on the pay-as-you-go health insurance model. Policy implications include adopting an actuarial reserve mechanism, restructuring state funding into direct health-insurance subsidies, introducing complementary insurance to reduce OOP burden, and implementing automatic adjustment rules linked to actuarial indicators.