Despite government efforts the Hungarian healthcare system is still vastly underfinanced

September 28, 2017
Photo: Flickr/Alex Proimos

Despite the government’s vast salary increases for public healthcare workers in recent years, experts argue that the measures are too little, too late, reports

According to polls from the last year and a half, Hungarians consider the state of public healthcare and social stability the most pressing issues facing the country. This is in contrast to European trends, where the citizens of most EU member states consider unemployment the most important issue. Concerns over healthcare in Hungary are not baseless: compared to neighboring countries, Hungary spends very little on its public healthcare system, a hot topic at the “Healthcare In 5 Dimensions” healthcare conference held in Budapest in August.

Éva Orosz, professor of the Faculty of Social Sciences at the Eötvös Lóránd University, said at the conference that the tragic decrease in healthcare expenditures is already appearing in mortality statistics. In her lecture, Orosz argued that the blame is on political and economic decision makers for the dire lack of resources in the health sector. Orosz supported her claim by comparing healthcare indicators of Hungary with those of the neighboring countries, which began with very similar social and economic conditions after the regime changes of 1989.

The diagram below shows the difference between Hungary’s GDP (blue line) and public healthcare expenditures (red line).

Graph: Éva Orosz

“The graphic difference between the blue and the red line displays the withdrawal of funds,” Orosz explained. According to the diagram, last year public healthcare expenditures were 24 percent below the rate where they ought to be relative to the health of the economy. This 24 percent disparity, an improvement over previous years, was only achieved because the government finally began to invest money in the public healthcare system after 2012. Despite this, between 2007 and 2016 some HUF 1.836 trillion (USD 6.93 billion) vanished from the public healthcare system. As a comparison: Budapest’s annual budget is roughly HUF 300 billion (USD 1.13 billion).

“We do not find anything like this in any of the European countries. This is tragic, scandalous,” Orosz said.

The next diagram shows healthcare expenditures per capita in Hungary, the Czech Republic, Poland and Slovakia since 1989. The diagram clearly shows that although Hungary started out with roughly the same conditions as Slovakia and the Czech Republic, the latter two significantly outpaced Hungary. Even Poland, which initially lagged far behind Hungary, has managed to catch up.

Graph: Éva Orosz

Orosz also stressed that the life expectancy for Hungarians at the age of 40 did not increase as much as in other Eastern European countries. A bigger problem, Orosz argues, is that the death rate from curable diseases in Hungary is two and a half times higher than the average of the 15 most developed EU member states.

Chair of the Hungarian Medical Chamber István Éger welcomed the pay raise for doctors that was brokered last year, but he also added that the government is running late on public healthcare reform. On one hand, Éger argues, those professionals who wanted to leave the country because of the low salaries have mostly already gone. On the other hand, the internal migration of healthcare workers from the public healthcare system into the private sector is ever intensifying. Meanwhile, neither general practitioners nor public healthcare dentists can maintain their practices from the little income they have. The technical and economic staff in hospitals are also migrating into the private sector.

Deputy director of Semmelweis University’s Health Services Management Training Centre Eszter Sinkó confirmed that despite the 30 percent increase in financing of general practices in the last seven years, there are still about 350 vacant practices all over the country, most of them permanently. The number of vacant practices might increase further, Sinkó argues, as more than one-third of the current general practitioners are soon to retire. If the trends do not change, some 1 million citizens might be left without a general practitioner by 2020, according to Sinkó.