Health Systems in Transition - Hungary - World Health Organization ...

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Health systems in transition Hungary
in improving health. The latter include services that are not included in the
International Classification of Procedures in Medicine, introduced in 1976
by WHO. In addition, cosmetic surgery, massage, abortion or sterilization
without medical indication, and the prostate-specific antigen test for screening
purposes are not covered (1997/9, 1997/14). Since 2007, treatment for injuries
resulting from extreme sport activities and vaccinations that are not part of the
government’s mandatory immunization programme are also not covered by
public sources (1997/14).
3.3.2 Collection
General government budget
There is an increasing participation of the central government budget in
financing the budget of the HIF, and the common assumption that countries
with SHI rely predominantly on wage-related contributions to fund their health
system no longer holds in Hungary.
According to the NHIFA, the total transfer from the central government
budget, including deficit financing, is planned to be almost five times higher
in 2010 (covering 47.5% of the HIF expenditure) than it was in 1997 (covering
10.9%). Hence the role of general taxes in funding of the HIF has become as
important as the role of the wage-related contributions. From the perspective
of the whole health care system, the share of tax funding among public sources
was very high already in 2002 and 2003, when the share of tax funding (with
38.5%) exceeded the share of wage-related contributions (33.6%) in 2003,
considering the deficit financing and hypothecated health care tax among tax
sources in the budget of the HIF (Table 3.4).
The hypothecated health care tax was introduced (1996/9) in 1997 to
supplement the resources of the HIF and was initially paid by employers for
each employed person as a lump sum (Table 3.5). It was intended to compensate
the HIF for social groups entitled to services but not paying contributions and
the abolition of transfers from the PIF following the pension reform (1996/8,
1996/12). This measure had an insignificant impact on the resources of the
HIF: as calculated by the authors based on NHIFA data, its share combined
with the remaining contribution of the central budget (once the PIF transfer
was abolished) reached 19.6% of the HIF budget for services excluding cash
benefits in 1997 compared to 21.2% before the reform. This is an example of
a change in the revenue mix without substantial impact on the overall income
of the HIF budget.