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

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Health systems in transition Hungary
of their management; encouraging intersectoral cooperation to implement the
NPHP; and starting to use HTAs systematically in the reimbursement decisions
of the NHIFA on pharmaceuticals. Section 6.1.1 provides more details on these
and other reforms enacted during this period.
To compensate for revenue lost due to the large reductions in the employer
HIF contributions after 2006, the share of the central government budget
in financing the HIF was significantly increased (see subsection Revenue
collection in section 6.1.2). Several other measures were introduced to
address the financial balance of the HIF, especially the relatively high share
of pharmaceutical spending (see subsection Pharmaceuticals in section 6.1.2).
With the stated aims of improving allocative efficiency and making the
provision of health care more equitable, a flat co-payment for outpatient care
and a per diem co-payment for inpatient care were introduced in February 2007
(2006/9) and provider capacities were newly regulated starting in April 2007
(2006/12). Intense political and public opposition led to a successful referendum
against the new co-payments. Public dissatisfaction with other social policy
reforms and the global economic downturn ultimately led to the collapse of the
governing coalition (for more details see subsection A third attempt to introduce
managed competition to the health insurance system in section 6.1.1).
Forming a minority government, the Hungarian Socialist Party embarked
upon a crisis management programme with a package of severe and deeply
unpopular austerity measures. In June 2009, however, the Fidesz party won the
European parliamentary elections, paving the way for a landslide victory for
a coalition of Fidesz and the Christian Democratic People’s Party, which ran
together in the April 2010 parliamentary elections.
In May 2010, the government published a policy agenda outlining some
of its plans for the health system, including increasing public expenditure on
health, especially for the public health programme; strengthening the role
of outpatient services; preserving the single-payer health insurance system;
introducing a new system of capacity regulation based on health needs
assessment and decreasing the length of waiting lists by 50%. In October 2010,
the Ministry of National Resources (which was formed by merging the five
ministries previously responsible for social, family and youth affairs; health
care; education; culture; and sport) published a strategic plan (known as the
Semmelweis Plan) for public debate to prepare for a government resolution
containing a detailed strategy for the health care system. Moreover, a number