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

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18 NATIONAL/CENTRAL LEVEL REGIONAL COUNTY SUB-REGIONAL SUB-REGIONAL MUNICIPAL PRIVATE SECTOR Health systems in transition Hungary Fig. 2.1 Organizational chart of the Hungarian health system, 2010 STEWARDSHIP/OWNERSHIP SERVICE DELIVERY FINANCING PUBLIC HEALTH Central Government Ministry for National Economy State Secretariat for Healthcare Ministry of National Resources State Secretariat for Education Other Ministries County Governments Municipalities Contractual relationship Hierarchical relationship Source: Adapted from Gaál,2004. National Ambulance Service National Institutes Medical Universities Clinical Departments Special Hospitals, Polyclinics County Hospitals Polyclinics Municipal Hospitals Polyclinics Primary Care Surgeries Primary Care Providers Pharmacies Private Owners Private Clinics Tax Office National Health Insurance Fund Administration Regional branches Private Hospitals Patients National Public Health & Medical Officer Service (NPHMOS) National Institutes of the NPHMOS Regional offices Office of the National Chief Medical Officer Sub-regional offices
Health systems in transition Hungary 19 2.2 Historical background Hungary has a long-standing tradition of health services dating back to the infirmaries established and run by monasteries beginning in the eleventh century. The first municipality to build a hospital was Selmec, in the northern part of the Kingdom of Hungary, in 1224. Its primary purpose was to treat injured miners. In the late Middle Ages, groups of miners joined together in this important mining town to create their own mutual assistance funds (bányatársláda), which aimed to cover the costs of sickness and injuries. The first known mutual assistance fund dates back to 1496 (Sárdi, 2003). This era of private medicine, mutual assistance funds and church-dominated charities was followed by a period during which the state assumed an increasingly dominant role in the health sector, especially in the provision of health services to the poor, public health and health insurance. In the fifteenth century, town physicians were employed to make services available to the poor, and in 1752 every county in the Kingdom of Hungary was required to offer such services. Hospitals were separated from almshouses in 1856 and offered free health care to the eligible poor in special surgeries. Act XIV of 1876 was the first piece of legislation related to public health to be passed in Hungary. Only the second of its kind in Europe, it stipulated that village and district doctors, as well as chief medical officers, must provide health services free of charge to residents with very low incomes. With regard to evolution of health insurance, Act XVI of 1840 legitimized voluntary mutual assistance funds for industrial workers (Sárdi, 2003). Some years later, in 1854, the Habsburg Emperor obliged all companies engaged in mining to set up mutual assistance funds. In 1870 the General Fund of Sick and Disabled Workers was established to manage the contributions of employers and the provision of services to employees (Tarsoly, 2000). Membership in the fund was voluntary, and its financial commitments were guaranteed by the state. These efforts produced mixed results, with 40.6% of industrial workers covered in this manner by 1885 (NHIFA, 2011). A landmark in the development of mandatory social health insurance (SHI) was Act XIV of 1891,which made such insurance compulsory for industrial workers and provided for guaranteed benefits-in-kind and cash benefits. This Act was the third of its kind in Europe, following similar legislation in Germany in 1883 and in Austria in 1887. It was refined in 1907 through legislation that set the main principles for governing SHI funds (Sárdi, 2003). At the turn of the century, a national scheme for agricultural workers was set up to cover work-related injuries (Tarsoly, 2000), and the National Fund of Patient Care was established in 1898 to reimburse health care costs for the poor.
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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
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Page 19 and 20: Abstract Hungary has achieved a suc
Page 21 and 22: Executive summary Introduction Hung
Page 23 and 24: Health systems in transition Hungar
Page 31 and 32: 1. Introduction 1.1 Geography and s
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4. Physical and human resources 4.1
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5. Provision of services Health car
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6. Principal health reforms 6.1 Ana
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8. Conclusions Since the mid-1990s,
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The Health Systems in Transition pr
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The European Observatory on Health
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