Meanwhile the billions of forints distributed at the end of 2014 by the National Health Insurance Fund (OEP) is not sufficient to clear up public utility arrears and settle debts with suppliers.

A member of former prime minister Gordon Bajnai’s Home and Progress Association, Komáromi told ATV “we have set off on a road that leads to disaster in the health sector within a very short period of time.”

“Currently, Hungarian hospitals are loss-making independent of location and size. The institutions have been underfunded for years. There isn’t even enough money for them to sustain themselves, and for years the state has been filling up the holes at the end of the year, just as it did now,” he says.

The OEP distributed funds, just not to everyone

Nationally, 104 hospitals received a total of HUF 10.4 billion (USD 37.6 million) of the amount left over at the end of the year. However, the independent outpatient clinics received nothing, even though in previous years each institution got something. According to the Hungarian Association of Outpatient Caregivers, more than 100 specialist clinics and their municipal maintainers were adversely affected.

Independent outpatient clinics receive only 5.6 percent of the funds allocated for the maintenance of institutions despite treating every fourth patient in the country.

A lot of money is still missing

Hospitals accumulated huge debts by the end of last year and barely received enough money to cover the cost of their daily operations, according to György Velkey, president of the Hungarian Hospital Association. In an interview with Info Radio Velkey said that even after the year-end distribution of HUF 10.4 billion (USD 37.6 million), total hospital arrears exceeded HUF 70 billion (USD 253 million).

Most of the hospitals have debts that are more than 60 days past due. Medical Association secretary-general Laszlo Rásky had previously said his organization welcomed the HUF 60 billion (USD 216 million) consolidation plan promised by the government, but that was a little more than a half of the hospital debt that was past due since September 30, 2014.

Those suppliers who are unable to continue to lend to the hospitals will be forced to tie future deliveries to conditions, mainly pre-payment. For this reason, if there isn’t quick government action to clear up hospital debt, then hospitals will be forced to do without basic equipment, bandages, materials or surgical instruments, said the association.

Waiting lists may be shortened

HUF 6 billion (USD 21.7 million) is available from 1 January to shorten waiting lists, announced healthcare state secretary Gábor Zombor, who believes the results will be felt by the second half of 2015. He said that with additional resources, waiting times can be reduced to two or three months in the case of minor surgery, and to less than half a year in the case of major surgery.

Patients attracted to private hospitals

Diagnostic and therapeutic appointments are starting to grow in the outpatient clinics. For this reason, patients are going to private clinics. An estimated HUF 40-60 billion (USD 144-216 million) is spent on tests administered by private hospitals and clinics, for which the state system also has capacity. If it turns out that something is seriously wrong, then the private sector sends the patient back to the state system, where the really expensive interventions will be funded from the National Health Insurance Fund, says Komáromi.

This is verified by the fact that private insurers only contract with private health care for outpatient care. But once surgery is necessary, the people are returned to public facilities where health care is provided at unrealistically low prices.

Moreover, according to a study prepared by Union Insurance, more and more people are paying for specialist care in Hungary. While 36 percent of the active (25-55 years) age group chose private health over public in 2012, by last year this had increased to almost half (46 percent). Over the course of two years, the amount paid out by patients also increased: between tips and private health care the cost of health care increased from HUF 33,000 (USD 123) to HUF 45,000 (USD 168) per head. Last year, patients payed an average of HUF 74,000 (USD 276) per person.

The government would separate the private and public health

At a conference in October, Zombor said the government wants to separate public from private health care but that the specific plans had yet to be worked out. The idea is that public hospitals not charge patients for OEP-funded treatments, and private hospitals charge patients or the patients’ private insurance policies.

Critics of this approach are concerned that it will result in a two-tiered system where only patients who can afford it will have access to proper health care in a timely manner.

The market reacts

Index.hu writes that Hungary’s largest private clinic will soon open in a building that has stood uncompleted on the Danube for the past seven years. The 25,000 sqm, HUF 12 billion (USD 43 million) Danube Medical Center (DMC) will reportedly employ 650 people and operate much like an ordinary countryside hospital. The one-day surgery and outpatient surgery departments will begin operations in April this year, with in-patient surgeries beginning in 2016.

Some 8-10,000 specialists and about 15,000 assistants are missing from the public health care system, says Komáromi. In the Hungarian system that number ought to be able to function normally. However, if more and more patients are choosing private care, then fewer and fewer doctors will elect to work in public hospitals or clinics, even part-time. Komáromi is concerned that eventually this will result in the government closing a number of public health care facilities, especially in the countryside.

There are fewer and fewer doctors

According to data obtained from the Health Licencing Office (EEKH), as of September 2014, 1,500 doctors and nurses requested certificates attesting to their health care credentials necessary for employment abroad, virtually the same as in 2013, according to Világgazdaság. This is not equal to how many health professionals left the country. However, the growing shortage of public health care professionals in Hungary indicates many of them are trying their luck abroad.

In 2013, 405 Hungarian health care workers left to take jobs abroad. In September 2014 this number was 558, most of them doctors under the age of 30.

According to official statistics more than 8,000 doctors and more than 2,500 nurses and midwives left Hungary over the past 8 years to take jobs abroad. These numbers do not include pharmacists and other health care workers.

Hungarian Resident Association president Tamás Dénes believes the shortage of specialists is already having an adverse affect on patient safety, and the outward migration of health care professionals will continue to grow unless the government raises salaries and improves working conditions.

Source: The Budapest Beacon

The Budapest Beacon is a media partner of XpatLoop.com