Veto points and Conversion in Health Policy. The case of the most recent PHC system reform in Greece (Law 4486/2017)

Kanella Sibera

The dissertation examines the role of the medical profession as a veto player in any attempt of the Greek Ministry of Health to reform Primary Health Care Services in Greece (PHC). To this end we used theories and notions of social sciences, such as “conversion”, “drift”, “critical pathway, “increasing returns”, “veto point”. Our main goal is to describe the ways in which the medical profession can act as a veto player and to present all its reactions to the attempted reforms of the PHC System in Greece, especially to the most recent one.

The necessary bibliographical research comes with the research and recording of publications during the period before the legislation and during the implementation of the reform (Law 4486/2017), as well as archival material. 

The dissertation begins by presenting the theories of historical institutionalism, which served as theoretical tools of analysis. The detailed account of the history of PHC at an international level guides us to the description of its final form and content. Starting from the international level, we then focus on PHC system’s organization and provisions in Greece, where all the attempted reforms were never fully implemented. Our aim is to highlight the fact that the declarations in favor of a public and free-for-all system have been denied by the privatisation of health services. Following the presentation of the content of the PHC system established by Law 4468/2017, takes place the description of the medical profession’s dominant position, as a veto player who has the potential to impede the implementation of important parameters of the most recent reform. Focusing on the adoption of Law 4486/2017, the presentation of the reactions of the medical community to it is divided into two periods: before and after its adoption. This chapter highlights the power of this interest group, as it explains the methods chosen in order to halt the implementation of the reform.

Thesis Committee Members
Academic Year
2019 - 2020