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

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).