Healthcare in Hungary

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Állami Szívkórház ("State Heart Hospital") in Balatonfüred, resort town by Lake Balaton

Hungary has a tax-funded universal healthcare system, organized by the state-owned National Health Insurance Fund (Hungarian: Országos Egészségbiztosítási Pénztár (OEP)). According to the OECD 100% of the total population covered by universal health insurance,[1] which is absolutely free for children (every people under 16), mothers or fathers with baby, students, pensioners (every people over 62), people with socially poor background, handicapped people (including physical and mental disorders),[2] priests and other church employees.[3] Health in Hungary can be described with a rapidly growing life expectancy (7.48 years growing for men and 4.92 years for women between 1993 and 2013)[4] and a very low infant mortality rate (5.1 per 1,000 live births in 2013).[4] According to the OECD Hungary spent 7.8% of the GDP on health care in 2012, total health expenditure was 1,688.7 US$ per capita in 2011, 1,098.3 US$ governmental-fund (65%) and 590.4 US$ private-fund (35%).[5]

History[edit]

Uzsoki Hospital, Budapest
Center of Cardiology and Heart Surgery in Pécs
Szent István Kórház (Saint Stephen Hospital) at Üllői Avenue, Budapest. With Szent László Kórház (Saint Ladislaus Hospital) making the largest hospital complex in Hungary, built at the turn of the 19th and 20th century.

The first hospitals go back to the 13th-century mining towns of Hungary. The first mining health insurance was founded by János Thurzó in 1496. The first modern insurer was established in 1907, named Országos Munkásbetegsegélyező és Balesetbiztosító Pénztár ("National Workers' Sick-benefit and Accident Fund").

The first steps to overall health insurance took place in the Horthy era with the creation of Országos Társadalombiztosítási Intézet (lit. "National Social Insurance Institution") in 1928 (It is the predecessor of present-day Országos Egészségbiztosítási Pénztár.). Social servises got complete to 1938, at that time the Hungarian social health insurance system was the most progressive and charitable in East-Central Europe.

After the World War II the Communist government fully nationalized the social insurance, since then Hungarian healthcare system is state-owned, overall and available for all of the people.[6]

The free-market shift initiated after the end of communist rule 25 years ago put a strain on the largely centralised, wholly tax-funded public health system, which required far-reaching reforms.[7] These resulted in the creation of the National Healthcare Fund (Hungarian: Országos Egészségbiztosítási Pénztár), in 1993.[8] The OEP, predominantly based on a social insurance system,[7] is the public organization currently controlling the management of health care in Hungary.[8] Eighty-three percent of the financing for the health care comes from taxes and other public revenues.[9]

Participation in the insurance scheme is mandatory for everyone in the workforce, including also the self-employed.[10] Most private hospitals also operate under the OEP framework.[8] Because of the past hiring policies, Hungarian hospitals often have redundancies of doctors, and a lack of nurses, resulting in an unproductive misuse of human resources.[7]

So-called "gratitude payments", another communist legacy, require in practice a cash payment to have access to better treatments.[7] Medical treatment deemed "medically necessary" is provided free of charge for European citizens in the country.[11]

Infrastructure[edit]

As a high-income nation, Hungary has a relatively developed health infrastructure. Ambulances of the Országos Mentőszolgálat (OMSZ, "National Ambulance Service") reach all over the country at the very latest 15 minutes. In 2013 OMSZ built 20 new ambulance stations and renewed 60 others with the purchase of 200 new ambulances.[12]

Air ambulance service got complete to 2009 with the grand opening of Szentes air ambulance station. Air ambulance bases (in Budaörs, Balatonfüred, Sármellék, Pécs, Szentes, Debrecen, Miskolc) cover all over Hungary, helicopters reach 85% of the country's territory at the very latest 15 minutes. Every national and county hospitals have heliport, including the specialized and most professional university clinics and emergency centres in Budapest, Pécs, Szeged and Debrecen.[13][14]

Statistics[edit]

Suicide rate in Hungary (1950–2010). Since the fall of the Communism suicide rate decreased rapidly.

Despite recent improvements, life expectancy in Hungary is still among the lowest in the European Union.[15] Romani people have a life expectancy up to ten years lower than for ethnic Hungarians.[7]

Year Life expectancy (years, Man/Woman) Infant mortality rate (‰)
1949 59.28 / 63.40 91.0
1960 65.89 / 70.10 47.6
1970 66.31 / 72.08 35.9
1980 65.45 / 72.70 23.2
1990 65.13 / 73.71 14.8
2001 68.15 / 76.46 8.1
2011 70.93 / 78.23 4.9
2012 71.45 / 78.38 4.9
2013 72.01 / 78.73 5.1

[4]

Major death causes[edit]

Nemzeti dohánybolt (National Tobacco Shop) in Békéscsaba. These state-controlled shops are with the same design and regulation all over Hungary.

64,178 deaths (49.6% of all) in Hungary were caused by cardiovascular disease in 2012.[4] Number of cardiovascular disease deaths peaked in 1985 with 79,355, declining continuously since the fall of the Communism.[4] The second most important cause of death was cancer with 33,790 (26.1% of all), stagnating since the 1990s.[4] Number of accident deaths dropped from 8,760 in 1990 to 3,758 in 2012, number of suicides from 4,911 in 1983 to 2,350 in 2012.[4] According to Péter Polt, Chief Prosecutor of Hungary, there were only 133 homicides in 2012, which is the lowest data registered in the last 50 years in Hungary.[16] Homicide rate was 1.3 per 100,000 people, which is among the lowest in the World.

Major health issues[edit]

Despite recent improvements, alcoholism is still a major problem in Hungary, inherited from the Socialist era.[17] According to KSH estimations number of alcohol addicts were 1,052,000 (10% of the total population) in 1995, declined to 432,000 (4.3% of the total population) in 2005.[18] Hungarians drank 9.7 litres of pure alcohol per capita in 2011 (40% wine, 35% beer and 24% spirit in 2005[19]), annual alcohol consumption is constantly between 9 and 11.5 litres of pure alcohol since the 1970s.[20]

Smoking also causes significant losses to the Hungarian society. Share of daily smokers among adult population was 28% in 2012, dropped to 19% in 2013 due to the strict regulations.[21] Nationwide smoking bans expanded to every indoor public places (inculing pubs), the sale of tobacco is limited to state-controlled (but privately owned) tobacco shops[22] called Nemzeti dohánybolt (National Tobacco Shop), number of stores where people can buy tobacco reduced from 40,000–42,000 to 5,300.[23] In 2013 WHO awarded Prime Minister Viktor Orbán in "accomplishments in the area of tobacco control".[24]

Regional differences[edit]

According to the last Országos Lakossági Egészségfelmérés ("National Population Health Survey") was held in 2003 the most healthy region is Western Transdanubia and the last is the Southern Great Plain. There are huge differences between the western and eastern parts of Hungary, heart disease, hypertension, stroke and suicide is prevalent in the mostly agricultural and low-income characteristic Great Plain (can be described as the Hungarian Stroke Belt), but infrequent in the high-income and middle class characteristic Western Transdanubia. Central Hungary (region of Budapest) is between east and west by health.[25]

Medical tourism[edit]

Lake Hévíz, the second largest thermal lake in the world.

Hungary is one of the main destinations of medical tourism in Europe, the country is leading in dental tourism,[26][27] its share is 42% in Europe and 21% worldwide.[27][28] The first medical tourists were Germans and Austrians in the 1980s, who seek cheap and top-quality dentistry services.[29] Since the fall of the Communism medical tourism is an emerging business,[28] 60,000-70,000 people visit Hungary for dental treatments every year, making 65–70 billion HUF (~325–350 million $) revenue only in the dental sector.[27] The cost of medical treatments is between 40% and 70% of the cost in the United Kingdom, United States and Scandinavian countries.[29] The most popular medical treatments are dentistry, cosmetic surgery, orthopaedic surgery, cardiac rehabilitation, fertility treatment, dermatology, anti-aging treatment, obesity treatment, addiction programmes and eye surgery.[29] Plastic surgery is also a key sector, 30% of the clients come from abroad, they can save 40-80% of the medical expenses.[30] Hungary is home to several medicinal spas[29] (Lake Hévíz, Széchenyi Medicinal Bath etc.), spa tourism sometimes combined with other treatments.[30]

See also[edit]

References[edit]

  1. ^ OECD (June 27, 2013). "OECD Health Data: Social protection". OECD Health Statistics (database). Paris: OECD. doi:10.1787/data-00544-en. Retrieved 2013-07-14. 
  2. ^ List of the entitled people for free insurance, National Healthcare Fund, 2013
  3. ^ Dőzsölők és szűkölködők - Miből gazdálkodnak az egyházak?, Figyelő (financial status of the churches in Hungary, Hungarian)
  4. ^ a b c d e f g Vital statistics, Hungarian Central Statistical Office (KSH)
  5. ^ Health: Key Tables from OECD, OECDiLibrary
  6. ^ History of social insurance in Hungary, National Healthcare Fund
  7. ^ a b c d e Hungary’s Healthcare System
  8. ^ a b c OEP - Főigazgatói köszöntő
  9. ^ Egészségügyi Minisztérium - The organisation and functioning of health insurance in hungary
  10. ^ World Health Organization - Hungary
  11. ^ Health Care Services Available During Temporary Stay in Hungary
  12. ^ Tényleg kiérnek a mentők 15 perc alatt ("Ambulances get to under 15 minutes"), Népszava (Hungarian)
  13. ^ Átadták a légimentő bázist - a legmodenebb az országban ("Air ambulance base has opened - the most modern in the country"), Városi Visszhang (Hungarian)
  14. ^ Air ambulance bases in Hungary, Hungarian Air Ambulance Plc. (English)
  15. ^ Eurostat - Life expectancy at birth
  16. ^ Polt Péter: rég volt ilyen alacsony itthon a gyilkosságok száma ("Péter Polt: number of homicides is the lowest for a long time"), HVG (Hungarian)
  17. ^ Judit Kiss - Edina Gábor: Az alkoholfogyasztás hazai tendenciái a 80-as évektől napjainkig I. ("Tendencies of the Hungarian alcohol consumption from the 1980s"), Országos Egészségfejlesztési Intézet ("National Institute for Health Development") (Hungarian)
  18. ^ Number of alcohol addicts in Hungary, 1990–2005
  19. ^ WHO Global Alcohol Report, Europe (English)
  20. ^ Alcohol, coffee, tea and tobacco consumption in Hungary (1970–2011), Hungarian Central Statistical Office (KSH)
  21. ^ Egy év alatt kilenc százalékkal csökkent a dohányosok száma ("Number of smokers declined by 9% in the last year") mno.hu (Hungarian)
  22. ^ Govt allocates HUF 450 mln to company facilitating tobacco sales monopoly, Budapest Business Journal (English)
  23. ^ Itt vannak a nemzeti dohányboltok ("Here are the national tobacco shops"), index.hu (Hungarian)
  24. ^ WHO awards Orbán in fight against “tobacco industry tactics”, Budapest Business Journal (English)
  25. ^ Országos Lakossági Egészségfelmérés ("National Population Health Survey"), 2003, Dr. Dóra Hermann: Krónikus betegségek (Chronic illnesses)
  26. ^ Hungary leading in Dental Tourism in Europe, Budapest Agent (English)
  27. ^ a b c Hungary aims at bigger bite of dental tourism, Budapest Business Journal (English)
  28. ^ a b Dental Tourism Development clinics turnover up 19%, Budapest Business Journal (English)
  29. ^ a b c d Hungarian Tourism promotes medical tourism, International Medical Travel Journal (English)
  30. ^ a b Medical tourism in good health, Budapest Business Journal (English)