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

Health systems in transition Hungary 27
of technical groups were established to prepare policy interventions with the
participation of representatives of the professional organizations in the autumn
of 2010.
2.3 Organization
The main actors responsible for providing or financing health services are
defined in Act CLIV of 1997 on Health (1997/20). The most important of these
are the National Assembly, the central government, the State Secretariat for
Healthcare (within the Ministry of National Resources), the NPHMOS and,
in general, the owners of health facilities, who since 1990 have been mainly
country and municipal governments (1990/3).
2.3.1 The National Assembly
The National Assembly is Hungary’s unicameral parliament and a key actor in
decision-making at the national level for all areas of public policy, including
health. The final size of the HIF budget (and of its more than 30 sub-budgets),
for example, is legislated by the Assembly, as are provider payment methods
(see section 3.4.3 and subsection Provider payment methods in section 6.1.2).
The Assembly also sets the HIF contribution rate on an annual basis. Although
most of the Assembly’s decisions need only a simple majority, the constitution
requires a two-thirds majority to pass legislation related to fundamental
democratic institutions, such as local governments. This provision limits the
discretion of the government in enacting health care reform.
2.3.2 Central government
The central government formulates, evaluates and implements health policy
and is also the most important regulator of the health sector. Indeed, it is the
chief regulator of health services, exercises statutory supervision over the HIF,
and has direct control over the NHIFA, including its purchasing decisions. In
addition, the central government provides conditional and matching grants to
local governments for renovating health care facilities. The central government
also delivers public health and some tertiary care services.
Since 1990 the central government has no longer been the main source
of funding or main supplier of health services. Together with the National
Assembly, it is responsible for administering health financing, resource
allocation and provider payment methods through its direct control of the