Hungary’s public health care system on life support

April 8, 2015

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Hungary’s state-run health care system is seriously crippled. The lack of funding and mismanagement have resulted in a shortage of supplies, limited treatment options and lack of health care professionals. Hospitals cannot pay their bills and the government does not want to admit how bad the situation really is.   In fact, the government wants to decriminalize corruption in national health care.

Suppliers aren’t being paid

Dr. Péter Holchacker, president of the Association of Health Technology Suppliers and Medical Device Manufacturers (ETOSZ), says Hungarian hospitals owe their suppliers more than HUF 90 billion (USD 327 million) for medical items. Holchacker appeared on ATV’s Start Tuesday morning and talked about his organization’s position on the lack of funding for hospitals.

“It’s not a normal situation when certain companies have to operate in a manner where half of their revenues are comprised of outstanding debt,” he said. “This is sort of like a household that’s operating in a manner where there’s no income for the first eight months of the year.  Paying taxes and salaries is a day-to-day problem when they receive little or no actual income. There isn’t sufficient funding in the Hungarian health care system,” he concludes.

Doctors aren’t doing well either

Hungarian doctors are notoriously underpaid. Their salaries are so low that, as the Budapest Beacon has reported in the past, there is a huge outflow of doctors to western and northern European countries that can afford to pay higher salaries and provide much better working environments.

Doctors who remain must confront the reality that their work only pays off if they can continue accepting cash gifts from patients in desperate need of medical care.

Doctors who promise not to leave Hungary and not to accept bribes from patients may earn an additional HUF 100-200 thousand per month (USD 363-726) per month under a new “strategy” being worked out by the government, writes hvg.hu.

State Secretary Gábor Zombor admits the plan is still in the planning phase, but so far the plan has amounted to little more than lip service.

“Gratitude money”, that is, under-the-table payments to health care professionals for better service, is a serious problem in the sector.  In many cases health care professionals would choose to work without pay if they could continue receiving gratitude money.

There is, however, a loophole that allows doctors to work at hospitals under the status of “volunteer helpers”. The loophole lets them enter into an agreement with the hospital which allows the doctor to treat patients in its facilities but without receiving income from the hospital. This construction allows participating doctors to receive subsidies to help cover the costs of their private business as well as receive gratitude money. On paper, the hospital can show that it has been able to facilitate treatment for those patients as well. The treatment also allows the patient to choose their doctor and have part of their treatment covered by the Hungarian state-run health care fund.

The National Agency of Chief Physicians is responsible for issuing the so-called “volunteer helpers” permits to doctors. According to the agency, there are 335 such doctors working as volunteer helpers at in-patient hospitals.

Ministry of Justice wants to condone corruption in Hungary’s health care system

Draft legislation recently submitted by Hungary’s Ministry of Justice would made it legal for health care professionals to accept monetary gifts, but illegal for doctors to ask for a bribe to carry out otherwise “free treatment”. The president of Hungary’s Resident Doctors Association thinks it would be mistake to legalize “soft corruption” in this way.

According to an overview of the draft legislation appearing on the ministry’s website, the law would decriminalize certain acts when it comes to health care professionals accepting monetary gifts from patients. However, a doctor who accepts a bribe for treatment that would otherwise be free would be committing a crime.

Attorney Gábor Magyar told Magyar Nemzet that the draft law was written by someone whose primary goal is to reduce the criminality of corruption in the system.

Tamás Dénes, president of the Resident Doctors Association, told Magyar Nemzet that the “gratitude money” practice in Hungary is driving doctors out of the country, and it would be a serious mistake to legitimize such “soft corruption”.  Dénes says the association’s position on gratitude money is that the government should ensure proper salaries for health care professionals and then punish every form of corruption that takes place in the system.

Referenced in this article:

Már 90 milliárddal tartoznak a kórházak, ATV.hu; 7 March 2015.

Hálapénz kerülő utakon, HVG.hu; 5 April 2015.

Hálapénz: törvényesítené a “szoftkorrupt” rendszert a kormány, HVG.hu; 8 April 2015.