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Reforms for Stability and Sustainable Growth: An OECD Perspective on Hungary (Chapter 3 - Healthcare Reform: Improving Efficiency and Quality of Care)
Reforms for Stability and Sustainable Growth: An OECD Perspective on Hungary (Chapter 3 - Healthcare Reform: Improving Efficiency and Quality of Care)
The Hungarian government has succeeded in creating a “momentum for change”, after a ten-year deadlock of reforms in the health system. The first section of this chapter describes the context of the reforms: relatively poor health status of the population and relatively low public spending on health in an international context; the underlying causes of the inadequate performance of the healthcare system; and narrow fiscal latitude for health reforms. The second part of the chapter discusses the measures taken in 2007, highlighting the important contribution of the health sector to fiscal consolidation, in particular the reform of the pharmaceutical market. The chapter also points out that cost-containment goals and regional political interests may at times have dominated efficiency and quality objectives, in particular in the reorganisation of the hospital network. In February 2008, the Hungarian Parliament passed an Act replacing the single-payer system by a decentralised system of compulsory health insurance funds with joint public-private ownership. The chapter highlights international experience suggesting that competition in health insurance markets does not automatically deliver intended improvements in cost-efficiency and quality. From this perspective, the chapter discusses the potential advantages and risks to the new health insurance system. The third part of the chapter discusses the scope for policy improvement, with some proposals for fine-tuning and extending the supply-side reforms and improving the quality and economic regulation. The need for the establishment of a long-term strategy to improve the population’s health status and to ensure sustainable financing and adequate human resources is also emphasised.
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