Health insurance premiums have once again become the focus of intense debate in Greece, with thousands of policyholders seeing the cost of their coverage rise year after year. The decision by some insurers to increase premiums has sparked strong criticism from consumer groups and sections of the political establishment, who argue that policyholders are being unfairly burdened.

However, market insiders insist that the discussion is being directed at the wrong target. They argue that the real issue lies not with insurance companies themselves, but with the steadily rising cost of healthcare services that insurers are required to reimburse.

The Source of Premium Increases

According to well-informed sources, hospitalization costs at private healthcare facilities are rising at a pace that insurance companies are struggling to absorb. In some cases, the cost of specific surgeries or hospital stays in Greece reportedly exceeds that of comparable procedures in larger and more advanced European markets, including Germany.

As a result, insurers are paying increasingly higher reimbursements to hospitals and clinics, costs that are inevitably reflected in insurance premiums. Market observers argue that as long as the issue is addressed solely through premium controls rather than tackling hospitalization costs, pressure on premiums will continue.

The Insurers’ Dilemma

Industry executives warn that limiting premium increases alone is not a sustainable solution unless it is accompanied by measures to control healthcare spending.

Insurance companies operate under strict regulatory oversight and are required to maintain specific levels of capital adequacy and solvency. If claims payments continue to rise while premiums are artificially constrained, pressure on insurers’ capital positions will intensify.

Sources note that in such a scenario, external auditors could require insurers to strengthen their capital base, potentially through capital injections or share capital increases, to remain compliant with regulatory requirements.

Controlling Costs Through DRGs

Market participants emphasize the need for mechanisms that can effectively control hospitalization costs. At the center of the discussion is the Diagnosis Related Groups (DRG) system, an internationally recognized methodology used in many countries to determine the appropriate cost of medical procedures and hospital stays.

Supporters argue that full implementation of DRGs in Greece could significantly reduce pricing distortions, improve transparency, and create a clearer framework for reimbursements paid by insurers and public agencies. It would also allow cost comparisons between healthcare providers and encourage greater competition within the healthcare market.

“Mini Onasseio” Units in Public Hospitals

Among proposals previously put forward by the Bank of Greece is the idea of allowing insurance companies to utilize space within public hospitals to establish specialized treatment units.

According to sources familiar with the proposal, the concept involves creating small, modern, high-standard healthcare units that would operate alongside the public health system and provide additional options for insured patients. Advocates believe this could boost competition, increase available treatment capacity, and help contain costs.

The Role of One-Day Clinics

Another area with significant cost-saving potential, according to industry experts, is the expansion of one-day clinics, facilities that perform minor surgical procedures and medical treatments without requiring extended hospitalization.

Broader use of these clinics could substantially reduce overall healthcare costs. However, regulatory restrictions continue to limit their development.

Although legislative initiatives have been introduced to support the model, sources say implementation has largely occurred outside Athens and Thessaloniki—the country’s two largest healthcare markets. Expanding the framework to major urban centers could deliver significant benefits for both policyholders and insurers.

Delays in the New ELSTAT Index

At the same time, delays have emerged in the creation of a new index for calculating health insurance premium adjustments. The index is to be officially compiled by the Hellenic Statistical Authority (ELSTAT) and would replace the indicator previously produced by the Foundation for Economic and Industrial Research (IOBE).

The new index, considered crucial for accurately reflecting changes in healthcare costs, was expected to be operational from January 1 but has yet to be finalized.

According to sources, ELSTAT’s new administration has already sought technical assistance from the Bank of Greece in order to utilize available statistical data and complete the necessary work.