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

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Health systems in transition Hungary
The data on OOP payments presented in Tables 3.4 and 3.7 include estimates
of informal payments calculated by the HCSO. The practice of making informal
payments for health services is deeply embedded in the Hungarian health
care system and is therefore persistent. Although the relatively low salaries of
medical doctors and other health workers have been a major contributing factor,
eliminating informal payments will require concerted action to restore the lost
confidence in public services.
3.5 Voluntary health insurance
3.5.1 Market role and size
In contrast to Germany, the voluntary health insurance system in Hungary has
no substitutive, but only limited complementary and supplementary functions.
Buyers opt for private health insurance either to cover services not included in
the benefits basket or because they are dissatisfied with their publicly financed
care options.
Data from the OECD shows a recent boom in the sector, especially in the
case of voluntary mutual health funds, but should be interpreted with caution,
because the data collection methodology does not clearly distinguish between
the financing of private commercial insurance and that of mutual insurance
funds. In 2009, voluntary health funds still constituted only 7.4% of private
and 2.7% of total health care expenditure altogether, up from 0.6% and 0.2%
in 2000 (Table 3.1). In 2008, the commercial profit-making insurers spent HUF
5.2 billion (€19.7 million) on cash benefits and reimbursement of health services,
amounting to 0.27% total health expenditure (compared to 0.23% in 2000)
(Hungarian Financial Supervisory Authority, 2010b; OECD, 2010).
Under the communist regime, voluntary health insurance was non-existent,
with the exception of the Hungarian State Railway Employee voluntary
supplementary insurance scheme, which has operated since 1930 and where
members pay 0.5% of their salary. After the change of regime, Act XCVI
of 1993 on Voluntary Mutual Health Funds created the legal framework for
complementary insurance schemes on a non-profit-making basis, according to
the model of the French mutualité. Initially, a smaller portion of the membership
fee was a real health insurance premium, paid into a common fund or risk
pool. The larger part of contributions went to individual accounts and could
be used by the account holder only, making this rather an MSA scheme. As of
2003, the government abolished the risk-pooling element of the system, and