The evolution of health care reforms in Greece: charting a course of change.

An examination of Greece's experience with health care reform planning over the past half century reveals a remarkable consistency in reform themes pursued by planners. However, few of the plans resulted in legislation, and of the legislation that was passed even fewer were implemented. The present paper traces out reform plans since the early 1950s and argues that legislative and implementation failures have been due to a lack of political will, insufficient attention to consensus-forming mechanisms, and inadequate consideration of the technical, administrative, and institutional feasibility of reform plans. By contrast, developments in the 1990s, which have seen three pieces of health care reform legislation, suggest that processes of health care planning and change are becoming more focused, rational and pragmatic. Macroeconomic constraints, and consensus on broader economic policies focusing on the EU convergence requirements have produced a consensus regarding the imperative of change in the health sector, and have given rise to mechanisms which facilitate the task of implementation. The most recent health care reform act (of 17 July 1997) is less radical than many of its predecessors, but includes issues that had entered the health care reform agenda as early as 1952, as well as the more current issues of health care reform agenda as early as 1952, as well as the more current issues of health sector rationalization. Implementation of the most recent legislative act has already begun.