• Spending overview
• Policy overview
• Diseases overview

Spending overview

At around 7.6% of GDP in 2008, spending on healthcare in Hungary is high in regional terms. Given the economic downturn, total health spending fell in 2009 in both US dollar and local currency terms as the government faces tight fiscal restrictions. A mild recovery is expected from 2010, but expenditure is only expected to reach 2008 levels again in 2013.

The state budget accounts for about 71% of total sector financing. Most of the rest (25%) comes from out-of-pocket payments, including to private practices and on pharmaceuticals. Rising costs in the sector, especially for pharmaceuticals, continue to put severe pressure on government budgets. In recent years the National Health Insurance Fund (OEP) has covered roughly three-quarters of the country's drug expenses. Basic health services are available through the OEP, which is part of the social security system. The OEP is separate from the government budget, but the government is obliged to cover any deficits (although it cannot use any surpluses).

In the coming years the healthcare system will still require more spending, not less, in order to bring standards of care closer to west European norms. To improve health outcomes with limited resources, the sector will need to be reoriented away from institutional care, and towards primary and preventive care. However, progress is likely to be slow, with resistance from industry lobbies, including the powerful Chamber of Doctors, which often resists calls for change.

Policy overview

Poor healthcare indicators partly reflect serious structural problems in the Hungarian healthcare system, including an excessive supply of hospital beds for acute care and a corresponding lack of emphasis on preventive care, as well as a shortage of beds for long-term illnesses. However, there has been an attempt to address this last issue, and the introduction of fiscal austerity measures in late 2006 has meant that hospitals have been forced to eliminate about 9,000 beds devoted to acute (short-term) care, out of a total of 80,000 hospital beds overall. Improvements have also been achieved through the establishment of an independent authority to oversee healthcare providers.

Problems in the sector are exacerbated by the slow progress in expanding primary healthcare and out-patient facilities, with the result that hospital care remains overly dominant in the system. These factors all contribute to long patient stays in hospital, with Hungary ranking relatively high on this measure compared with other OECD countries. All this keeps the modernisation of hospital care on hold, despite the fact that several measures were introduced in 2004 to encourage the provision of higher-quality rehabilitation services. These measures included the rationalisation of the professional certification system, the launch of a hospice programme, and the introduction of financial incentives to rehabilitation activities.

The private sector is heavily involved in providing healthcare in Hungary, even though the system is dominated by the state. There are now private-sector general practitioners (GPs) operating through their own small entrepreneurial businesses, and many doctors, nurses and ancillary providers offer services to hospitals and clinics through various outsourcing and invoicing arrangements. Foreign businesses are eager to invest in the Hungarian healthcare sector, but cite a number of regulations as obstacles. Chief among these are the arbitrary and lengthy procedures in the financing system for the adoption of new medical technologies and pharmaceuticals.

Diseases overview

The health of the Hungarian population has been poor by international standards for several decades. Hungary has the highest mortality rate of any OECD member country, the highest death rates from cancer and the second-highest death rate from heart disease. It is in the top two for mortality from heart disease and strokes. Hungarians have a rate of life expectancy at birth that is among the lowest of the OECD member countries: in 2009 life expectancy at birth was an estimated 69.3 years for men and 77.9 years for women.

However, there are signs of improvement, with life expectancy for men at a record high. Infant mortality has continued to decline, from 47.6 per 1,000 live births in 1960 to 8 per 1,000 live births in 2008. However, this is still among the highest rates in the EU.