Paper Title
Are Out-of-Pocket Payments for Healthcare Related to Financial Catastrophe and Impoverishment in Greece As Crisis Deepens?

The aim of this paper is to measure the fairness of healthcare payments in the heart of economic crisis for Greek economy. National representative data was derived from Hellenic Statistical Observatory proportionally allocated to the regions based on NUTS Eurostat categorization for the period 2009-2015. Indices for financial catastrophe were developed capturing the intensity and incidence of it, allowing to capture the degree to which high out-of-pocket payments for healthcare occur among poor and non-poor households. Furthermore, measures of poverty impact were illustrated and analyzed. We find that both intensity and incidence of catastrophic out-of-pocket payments for healthcare services, in terms of total consumption as well as ability to pay, declined during 2011-2013 period but increased after that time again. We also find that incidence and intensity were concentrated among poorer households in 2009 for low thresholds, but after that year they became more concentrated among rich ones. Finally, we show that the poverty impact of out-of-pocket healthcare payments was primarily due to poor people who were becoming even poorer, rather than the non-poor being made poor. However, as crisis was being deepened, poverty impact was more severe even for richer households. Keywords - Out-of-Pocket healthcare payments; catastrophic spending; poverty impact; financial catastrophe; Greece