Some people might not understand the title of this piece. After all, they will argue, with this kind of mandate the new government shouldn't encounter too many problems. Yet, very rightly, Viktor Orbán's victory speech after the first round of voting emphasized the difficulties ahead.
I'm sure that when he uttered these words Orbán was thinking about the burden of turning the economy around and of remaking the country in his own image. But I see problems elsewhere. What will happen when he is unable to fulfill the expectations aroused by eight years of irresponsible promises when Fidesz was in opposition, capped even in the last moment when Orbán predicted that people will wake up in a different country on Monday morning after the elections?
General expectation is something Orbán will have to manage to prevent disappointment that may result in people turning away from him and his party. But even more dangerous are the demands of various interest groups for services rendered. The first such group has already made it clear that for their excellent job in helping Fidesz win these elections they are expecting payment. This group is the medical establishment. In just the past two days they have put forth two demands on the new government. Both mean a lot of money, and that is only the beginning.
On April 13 the Strategic Alliance for the Hungarian Hospitals (Stratégiai Szövetség a Magyar Kórházakért Egyesület) came forth. What is this "alliance"? The first time I heard of them was last summer when ten hospitals (out of the approximately one hundred) formed a pressure group that demanded more money for hospitals. The ministry at that point emphasized that the medical establishment had to understand that because of the economic crisis expenditures must be cut in all fields. But the ministry's spokesman pointed out that healthcare enjoyed top priority and therefore the hospitals were receiving the same amount of money as before. However, there was no possibility of increasing the amount.
This time in anticipation of the formation of the new government the Alliance repeated its demands. The hospitals need more money. About 38-42 billion forints more immediately, but in the long run another 100 billion must be found to take care of the hospitals' needs. According to the president of the Alliance the money allocated to them is insufficient and by April or May the hospitals will again be short of funds. In this case the same situation as last summer will present itself when the employees of the hospitals demonstrated by putting out green flags on hospital buildings and by engaging in hunger strikes. In addition to the extra money, they want to suspend certain ministerial orders which in the opinion of the president of the Alliance cannot be implemented. Finally, there was a rather oblique reference to the appreciation of people working in the healthcare field. This, translated into simple English, means higher salaries for doctors and nurses. The people who are running Hungarian hospitals simply don't care about the state of the economy or the fiscal limits imposed on the central government. The president of the Alliance clearly stated that "the financing of healthcare cannot be constrained by fiscal considerations." This in my reading means: there can be no limit to spending when it comes to financing Hungarian healthcare.
A day later the inimitable István Éger, president of the Hungarian Medical Association, made it clear that they also have demands. First Éger expressed his delight at Fidesz's winning the elections. As he said, "the gate has opened and we are going to enter. We are ready to work." I wonder what they did until now! Their first demand is to make membership in the Medical Association once again compulsory. Lajos Molnár, minister of health in the first year of the second Gyurcsány government, abolished compulsory membership. The reason for the decision was the Association's one-sided political commitment, a decision not all members supported. When the compulsory membership was lifted 30-40% of the members resigned. The reason for restoring the earlier compulsory membership is not so much for financial but rather for political reasons. In the last four years the Association functioned as a simple civic organization that was unable to lobby effectively before a law affecting them was enacted. If Orbán's government is ready to force doctors to become members, they will have to face the Hungarian Medical Association and the extremely aggressive Dr. Éger at every turn. Good luck! That would mean in my opinion that the new government would be captive to powerful interest groups within the medical establishment. In this case, any kind of necessary change in the Hungarian healthcare system may come no naught.
The other day I heard an interview with Tibor Závecz, president of Szonda-Ipsos, the polling firm. The topic was MSZP's long-term slide to the current 19-20% support among the voters. The common wisdom is that it was Ferenc Gyurcsány's speech at Balatonőszöd which was leaked and made public in September 2006 that caused the loss of support. As a consequence of this supposition comes another: the collapse of the party is Ferenc Gyurcsány's fault. The polls don't support either hypothesis. As the polls indicate, the big drop in the popularity of MSZP came in the summer of 2006 when the government had to fess up that the country's finances were in much worse shape than they had led people to believe. Interestingly enough, after the leak and the storming of the MTV headquarters, MSZP's support actually went up somewhat. In 2007-2008 the situation didn't change considerably. But then came the referendum on healthcare reform after which there was a considerable drop in support for the government party. Nonetheless, while Ferenc Gyurcsány was in office that support was still 28%. After he resigned the numbers began to slide and never reached the level recorded prior to March 2008. Szonda-Ipsos's figures are available on the firm's website.
Thus, it is clear that the drop in MSZP's popularity and the spectacular rise of Fidesz owes a lot to the commitment of the medical establishment to frustrate any change whatsoever in the field of healthcare. If one reads Lajos Molnár's memoirs it is easily understandable why. The reforms he initiated hurt the interests of important and powerful groups. However, Orbán and his government will face these same groups that are still powerful and that still look after their own interests. It might be necessary to close about half of the hospitals and the new administration might be perfectly aware of this, but it will be very difficult to say no to Dr. Éger and the others, especially since in the last four years Fidesz politicians stood by them and helped them defend their current privileges. The medical establishment knows that Fidesz is beholden to them, and it therefore demands to operate outside the world of fiscal constraints.