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

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68 Health systems in transition Hungary Fig. 3.4 Financial flows tax subsidies State/national budget Insured/employers Companies Resident patients Non-resident patients Non resident third party payers Tax office hypothecated health care tax Private financing system central transfers Local taxes wage-related contributions Other ministries Ministry of Natural Resources Local budgets HIF / NHIFA Private/voluntary health insurers/MSA Charities/NGO’s /Corporations OOP payments Governmental financing system Transfers within system payer 4 payer 5 Social insurance financing system Transfers between systems PRIVATE payer 0 payer 1 payer 2 payer 3 For other providers see Table 3.3 GP’s Public Health Ambulatory specialities Acute hospitals Pharmaceuticals Medical aids NATIONAL AND LOCAL GOVERNMENT SOCIAL HEALTH INSURANCE SERVICE PROVIDERS
Health systems in transition Hungary 69 Fig. 3.5 Total expenditure on health according to source and administering agent, 2009 Source: Author’s adaptation based on WHO NHA. 32.5% HIF Contributions 10.9% Government (central and local budgets) 24.0% Hypothecated tax and other HIF transfers 23.7% Out-of-pocket payments 2.7% VHI (premiums and MSA) 2.2% Non-profit institutions 1.7% Corporations 2.3% Other SHI contributions (e.g. self-employed) Whereas recurrent expenditure is financed by the HIF, nearly all capital investment related to outpatient and inpatient care is financed by the central and local governments. Nonetheless, the central government still pays for recurrent expenditure related to certain services (for example, high-cost high-technology treatments and public health) and covers co-payments for residents with very low incomes. Since the mid-1990s, governments in Hungary have used cuts in the SHI contribution rate as one of their main tools for boosting employment, but have failed to compensate the HIF adequately for the resulting shortfall in revenue, leading to a prolonged financial imbalance (see section 3.3.3). Private health insurance plays a fairly limited role in health care financing, with a share of 2.7% of the total health expenditure in 2009 (Table 3.1). Most of the expenditure under the private health insurance heading is actually not insurance, but individual medical savings accounts (MSAs) without any pooling across individuals beyond the family. The MSA scheme has benefited from tax subsidies, but in recent years these subsidies have been reduced and the scope of services that the MSA scheme can cover was also restricted. Overall, OOP expenditure continues to be the dominant form of private expenditure in Hungary (see section 3.4).
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Health Systems in Transition Vol. 1
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Health Systems in Transition Péter
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Contents Preface
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Preface The Health Systems in Trans
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Acknowledgements The Health System
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Health systems in transition Hungar
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xii Health systems in transition Hu
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xiv Health systems in transition Hu
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Abstract Hungary has achieved a suc
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Executive summary Introduction Hung
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1. Introduction 1.1 Geography and s
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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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10. Appendices 10.1 References Ád
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The Health Systems in Transition pr
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The European Observatory on Health
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