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

More documents

Recommendations

Info

74 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.
Health systems in transition Hungary 75 Table 3.4 Sources of revenue as a percentage of total expenditure on health, 1995–2009 1995 2000 2005 2008 2009 Public expenditure 84 70.7 72.3 71.0 69.7 HIF a 67.2 59.3 61.0 59.2 58.8 Government a 16.8 11.4 11.3 11.8 10.9 Wage-related contributions b 52.2 34.9 36.1 37.1 32.5 General and hypothecated health care tax b 20.8 34.9 34.7 31.2 34.9 Other health insurance contributions b 11.0 0.9 1.5 2.8 2.3 Private expenditure OOP payments a 16 26.3 23.8 23.8 23.7 Voluntary health insurance a – 0.2 1.1 2.2 2.7 Non-profit institutions a – 2.8 1.6 1.9 2.2 Corporations (1) – – 1.2 1.1 1.7 Sources: a OECD, 2010 and WHO, 2011; b Authors’ estimate. The government in power between 1998 and 2002 added a proportional component to the hypothecated health care tax as of January 1999. The 11% proportional tax was levied on types of income previously exempt from HIF contributions, such as dividends, in-kind allowances and letting property. Furthermore, the lump-sum component of the hypothecated health care tax was increased from HUF 1800 (€6.8) in 1997 to HUF 4500 (€17) in 2002. However, the government in power between 2006 and 2010 reduced it again to HUF 1950 (€7.7) in 2006, then abolished it completely in 2010. The proportional component is still in effect. A new type of hybrid tax, the simplified contribution payment, was launched in 2005, applicable for persons or entrepreneurs working in the media or arts (2005/6) up to a certain income ceiling. Instead of the regular HIF contributions and income tax, the employees and employers in these occupational groups pay an overall (15% employee and 20% employer) contribution, which covers the entirety of their tax and social security obligations. Eleven percentage points of this employer contribution is earmarked as a health insurance contribution. Among other public sources of financing are general and local taxes, other contributions for persons seeking employment and persons classified as being disadvantaged regarding employment, paid by the central government budget, as well as special taxes to be paid by pharmaceutical companies and wholesalers (2006/8). These revenue sources supplement the budget of the HIF to a small extent.
Page 1 and 2:
Health Systems in Transition Vol. 1
Page 3 and 4:
Health Systems in Transition Péter
Page 5 and 6:
Contents Preface
Page 7 and 8:
Preface The Health Systems in Trans
Page 9 and 10:
Acknowledgements The Health System
Page 11:
Health systems in transition Hungar
Page 14 and 15:
xii Health systems in transition Hu
Page 16 and 17:
xiv Health systems in transition Hu
Page 19 and 20:
Abstract Hungary has achieved a suc
Page 21 and 22:
Executive summary Introduction Hung
Page 23 and 24:
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31 and 32:
1. Introduction 1.1 Geography and s
Page 33 and 34:
Page 35 and 36:
Page 37 and 38:
Page 39 and 40:
Page 41 and 42:
Page 43 and 44:
Page 45:
Page 48 and 49:
18 NATIONAL/CENTRAL LEVEL REGIONAL
Page 50 and 51:
20 Health systems in transition Hun
Page 52 and 53:
22 Health systems in transition Hun
Page 54 and 55: 24 Health systems in transition Hun
Page 89 and 90: 3. Financing 3.1 Health expenditure
Page 91 and 92: 11 10 9 8 7 6 5 4 Health systems in
Page 93 and 94: Health systems in transition Hungar
Page 103: Health systems in transition Hungar
Page 131 and 132: 4. Physical and human resources 4.1
Page 139 and 140: 120 100 80 60 40 20 0 Health system
Page 145 and 146: 5.0 4.5 4.0 3.5 3.0 2.5 2.0 Health
Page 147 and 148: 9 8 7 6 5 4 Health systems in trans
Page 155 and 156:
5. Provision of services Health car
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
6. Principal health reforms 6.1 Ana
Page 199 and 200:
Page 201 and 202:
Page 203 and 204:
Page 205 and 206:
Page 207 and 208:
Page 209 and 210:
Page 211:
Page 214 and 215:
184 Health systems in transition Hu
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
202 120 110 100 90 80 70 2800 2700
Page 234 and 235:
204 100 90 80 70 60 Health systems
Page 236 and 237:
206 14 12 10 8 6 4 2 0 Health syste
Page 238 and 239:
Page 240 and 241:
Page 243 and 244:
8. Conclusions Since the mid-1990s,
Page 245:
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
Page 258 and 259:
Page 260 and 261:
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Page 283 and 284:
10. Appendices 10.1 References Ád
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Page 293 and 294:
Page 295 and 296:
Page 297 and 298:
The Health Systems in Transition pr
Page 299:
The European Observatory on Health
show all

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

Create successful ePaper yourself

Delete template?

Save as template?