The 2015 national budget submitted to the Hungarian parliament last week does not increase state funding of public health care, to the disappointment of health care professionals and policy experts alike.
Napi.hu writes that the budget does not mirror the strategy set out by the state secretary for health care Gábor Zombo last month. Earlier there had been talk about the national government making additional funds available to Hungary’s chronically underfinanced public health system necessary to clear up mounting hospital arrears. It was believed that such a move would clear the way for the introduction of long-overdue “structural reforms”.
As of the end of September 2014 state budgetary institutions belonging to the Ministry for Human Resources owed HUF 77 billion to suppliers and contractors, of which roughly three-quarters was owed by hospitals. Napi.hu writes that hospital debts are likely to increase in the absence of a major infusion of state funds.
A recent study of the period 2005-2013 prepared by health care specialist PX Consulting indicates that Hungary’s health system continues to fall behind that of the rest of Europe. Although Poland and Estonia have yet to completely catch up to Hungary when it comes to the quality of public health care, the Czech Republic and Slovakia have reportedly overtaken Hungary due, in large part, to a significant increase in public spending. Napi.hu reports that over the past nine years per capita health care spending increased 36 percent in Austria, 42 percent in the Czech Republic, 71 percent in Estonia, 78 percent in Poland and 85 percent in Slovakia.
During the same period health care spending in Hungary increased a mere 25 percent, although in 2005 Hungary’s per capita public health expenditures exceeded Poland’s and Estonia’s by 40 percent and Slovakia’s by 20 percent.
In 2005 Hungary spend HUF 396 billion on the care of hospitalized patients. By 2013 this amount had only increased some HUF 11 billion to HUF 407 billion. The number of patients cared for in hospital decreased during this period by 415,000, in part due to a 10,000-bed reduction in hospital capacity.
Between 2005 and 2013 public monies spent per patient treated increased from HUF 138,000 to HUF 165,000. Napi.hu points out that the nominal 19 percent increase in spending on health care was more than offset by a 20 percent devaluation of the forint against the euro.
Government attempts at “centralization” and “optimization” notwithstanding, the number of patients transported by ambulance only decreased 16 percent between 2005 and 2013. During this period, however, the number of ambulances decreased 46 percent, resulting in a significant increase in the number of patients delivered per ambulance.
From 2010 the government has placed emphasis on the “optimization” of medicine consumption with the avowed goal of decreasing the cost of medicaments. Within the framework of the government-subsidized medicine program, in 2009 HUF 145 million of prescription medicine was administered for an average of 1.2 doses per resident. The number of doses increased just 1 percent between 2010 and 2014, although not uniformly throughout the country.
Napi.hu writes that as a result of the government’s forced generic drug program, between 2009 and 2013 the non-subsidized cost of the subsidized medicine program to consumers decreased from HUF 116 billion to HUF 109 billion. However, the business daily points out that in 2012-2013 alone internet drug sales increased some 11 percent, raising the total cost of drugs consumed by consumers some HUF 15 billion to HUF 147 billion.
During this period the cost to the government of subsidizing prescription drugs decreased from HUF 34 billion to HUF 31 billion.
In 2008 out of 24 European countries surveyed, Hungary’s public health system was ranked in the bottom quarter. By 2012 Hungary ranked dead last when it came to cancer and diseases of the digestive system, and second to last in deaths caused by circulatory diseases.