Hungarian healthcare: Just one case of many

Today’s post was inspired by an article that appeared about a week ago in Népszabadság. Actually, it was more like a letter to the editor describing a young woman’s frustration with the Hungarian healthcare system. In this short piece of writing (about the length of one of my posts) we encounter an incredibly rude physician, long lines for most likely unnecessary procedures, and broken equipment.

Klára Kovács, the author of the article, is in her thirties. And, as she remarks in her piece, “nowadays for people like myself, in their twenties and thirties, it is taken for granted that we find recipes, music, news, and basic medical information on the internet.” So, by the time she decided that she should visit a doctor because of severe pain behind her left knee, she had a fair idea that she was dealing with a Baker’s cyst, a pocket of fluid that forms a lump behind the knee. A baker’s cyst can be caused either by an injury or by arthritis of the knee. Once the original problem is treated, the cyst may go away on its own. If not, the cyst can be drained or the doctor can prescribe a steroid shot to reduce the swelling. The literature available on the internet also mentions the possibility of ordering an MRI “to see a picture of the inside of your knee.”

It sounds simple. Well, let’s see what happens in Hungary to someone who goes to a doctor with a strong suspicion that she has a Baker’s cyst. First, she called her district clinic, where she was told that they cannot deal with her problem because her cyst can be handled only in a surgical facility. This piece of information turned out to be erroneous, and although the surgeon on duty was pleasant, he wouldn’t treat her. She had to go to the orthopedic department. There she encountered a real brute who accused her of circumventing the system by first getting an appointment with a surgeon, which allowed her to get an immediate appointment with him, instead of going to the general practitioner as is the rule.

The doctor went on and on: “Do you think that everything is permissible around here? You think that we are here to wait on hustlers like yourself? Show me your problem. Stand normally! You can’t even stand right?” He gave her hell for not coming earlier and informed Klára that Baker’s cyst is a symptom and not an illness by itself. Of course, Klára must have known all that without him because the Hungarian website’s explanation is just as thorough as the English-language one. It was also quite sensible of Klára not to rush to see a doctor because these cysts often disappear on their own after some rest and home remedies. He ended his harangue by telling her all sorts of frightening misinformation about her illness. For example, that “it is possible that the cyst will explode and with a little luck together with your whole leg will go.”

The relationship between doctor and patient should be a cooperative affair

The relationship between doctor and patient should be a cooperative effort

In any case, after this terrible scene Klára was sent for an MRI so the doctor could learn more about why the cyst appeared. What surprised me about Klára’s encounter with this doctor is that he asked nothing about her general health and lifestyle. Does she do any sports? Could she have had an injury? Did she have any operation on her knee? (As it turned out, she did.) Does she have signs of arthritis? One could find out a lot without immediately resorting to an MRI. Moreover, by then Klára was in considerable pain. According to her own description, the cyst behind her knee was as large as her whole knee. Why didn’t he drain the cyst in order to relieve the pain, at least temporarily? The Hungarian internet is full of forums of people whose cysts were drained. It is a painless procedure lasting only a few minutes.

Sending Klára to have an MRI meant starting everything from scratch. She had to go back to her general practitioner because, for an MRI, she needed a blood test to ascertain that her kidney function was okay. My first question: Why couldn’t the orthopedist give her a piece of paper which would allow her to have a blood test? My second question: Did Klára really need the blood test? While doing research for this post I learned that for some MRI scans contrast materials have to be injected, which for people with poor kidney function can be dangerous. The likelihood of impaired renal function is substantially higher in patients over 60 years old and/or people who have certain illnesses, such as diabetes. At UCLA older patients are required to have the blood test. Other patients get a questionnaire on the basis of which the doctors can pretty well identify those people who are at risk of having renal problems. They thus avoid ordering blood tests for all patients. But I guess the Hungarian healthcare system is less frugal with both money and the time of doctors and patients than UCLA is.

The second stage of Klára’s battle with the Hungarian healthcare system began with a wait in her GP’s office for an hour and a half to get a piece of paper ordering the blood test. The next day she spent two hours waiting for the blood test itself. She had 67 people ahead of her and only two nurses drawing blood. She got an appointment to have the MRI three days later, which “is considered to be a miracle in Hungary.” As it turned out, however, her praise was premature. When she arrived for her test, she was told that something went wrong with the MRI machine and if she urgently needs to have the procedure done she must try her luck at another hospital at the other end of the city. They couldn’t guarantee that the procedure would definitely be done that day. She was supposed to be there within half an hour, which given the afternoon traffic seemed an impossibility. She therefore asked for another appointment. But they couldn’t accommodate her because all the slots had already been filled for the month. She was advised to phone sometime during the last week of the month when they work on the schedule for the following month.

Luckily for Klára, she didn’t have to make that telephone call. The following day the cyst painlessly erupted. Gone was the pain and the swelling. Contrary to the doctor’s prophecy, her leg didn’t explode. The cyst disappeared without any medical assistance. “It seems that even the cyst didn’t want to have anything to do with this healthcare system,” Klára concluded.

June 14, 2016
Sort by:   newest | oldest | most voted
Csoda.peter
Guest

Healthcare is an easy target in every country, but that is not to say it is not a deserving one too.

My own experience of the Hungarian state system is much better than that of the UK state system and of the Hungarian private system.

Of course, you have to fight because it is a system and no two patients are the same.

Guest
“Of course, you have to fight because it is a system and no two patients are the same.” What a mixed up thinking that is! Patients should not have to “fight”- they are in a vulneralbe condition and should be treated with care and concern and professionalism, and politics should stay out of the surgery doors. And what is moretrue is that no two doctors are the same! My own experience in Hungarian medical centres varies. But the rudeness in doctors and nurses is not uncommon here. I once had a head injury which required an ambulance and I received excellent care by a doctor, who stitched it up nicely. When the stitches had to be removed, I was told it was not necessary to go to the emergency hospital again, as itcould be done at my local clinic. At the time, I still did not have my Hungarian medical papers in order, even though I am a Hungarian citizen. So I presented my European Union medical card, obtained in the UK, which entitles those carrying one to medical treatment, free of charge, anywhere within the EU. The head of the “sebész” department saw my card, ignored it and began… Read more »
Csoda.peter
Guest

Patients should not have to “fight”- CORRECT

Csoda.peter
Guest

European Union medical card, obtained in the UK, which entitles those carrying one to medical treatment, free of charge, anywhere within the EU – INCORRECT. It only entitles the holder to free Emergency treatment

Guest

Not correct. It allows for post – operative treatment to allow the patient to return home or until the patient agrees they can look after themselves at home.

So after A&E they will be admitted as an in-patient for as long as necessary – paid for by EHIC.

Csoda.peter
Guest

I stand corrected. Still not quite what our friend said.

Csoda.peter
Guest

“in the UK not only would a Hungarian have free medical care” – Not always true, only UK residents receive free medical care,but it is independent of their nationality

Jean P.
Guest

“The head of the “sebész” department saw my card, ignored it and began shouting at me – Who did I think I was, expecting free medical treatment in Hungary!? ”

If a Hungarian doctor refuses to give an EU citizen the same treatment as a Hungarian citizen is entitled to he is breaking the universal EU rule that a citizen of an EU country has equal rights with the citizens of the EU member country he is visiting. This rule covers much more than health care. The doctor should be sued. The Fidesz doctors will go on like that until they have been taught the rules by an independent judge,

webber
Guest
Csoda.peter – Either you are lying to yourself, or you are lying to us. Have you ever had to pay “paraszolvencia” or any sort of tip at all to a doctor in the UK? Of course not. Have you ever had to tip nurses in the UK to get pain relievers administered in time? Have you ever had to tip people to get clean sheets? Did you have to supply toilet paper in a hospital in the UK? Did you have to bring medical supplies for an operation in the UK? In the UK, did you have to rely on relatives for food, because otherwise you would starve in a hospital? Have you ever seen a toilet that looks like this one (Merényi Kórház, Budapest, 2016) in the UK? Have you been served anything that looks like this in the UK? Title of the picture: “This is not vomit, but a hospital lunch served to pregnant women” My own personal, and very extensive experience, lasting over decades in Hungary, and five years in the UK, is that the Hungarian system is much, much worse than the UK’s system. I could tell you a series of horror stories, things that happened… Read more »
Csoda.peter
Guest

Not often I am accused of lying. I am just recounting my own experience: the fact that it is different to yours does not make me a liar. I am sorry you have not had such a good experience

webber
Guest

Have you ever actually lived in Hungary, or are you a Transylvanian, or from some other country around Hungary with romantic ideas about the homeland?
If you have lived in Hungary, have you ever been hospitalized in Hungary?
If you have, haven’t you ever given a doctor an envelope in Hungary? A nurse? Haven’t you had to bring your own toilet paper? (etc., etc., etc.).

Or are you one of those Hungarian political elites with access to hospitals the rest of us will never see?

If you mean you’ve had good experiences as an outpatient at a clinic (SZTK), then I see what you mean. Yes, that can be okay.

But if you have been hospitalized in Hungary, I must say there is surely something wrong with your memory.

Guest
London Calling! Yes webber what you say is all too familiar – including having to take your own AA batteries if you hope to have basic physiological measurements like blood pressure (like blood pressure!!!!). What is missing from people’s experiences on this post is that the reason the doctor had a hissy fit – for doing the common – sense arranging of her appointment is that she prevented the doctors from scheduling the appointments to ensure the wealthy-looking are given the far distant appointment’s – also they are conditioned to offer to jump the queue. The poor get the distant appointments anyway. They are ever going to pay. Why? You can probably work it out yourself. The patient is then more likely to divvy up a larger ‘envelope’ as the doctor says ” well I’m afraid the waiting list is rather long – but I’ll see what I can do ” (hint hint!) I know from the nurses we help to come here that the senior doctors manipulate this for all they are worth – they are very wealthy from the ‘halopenze’ – apologies for the spelling! There are plenty of nightmare stories where they even neglect the poorer patients… Read more »
Csoda.peter
Guest

I went yesterday and I go again on Friday

webber
Guest

SZTK or hospital?
Either way – I hope you are fine and that your experience is not bad. Just because we disagree doesn’t mean I wish you ill.

Csoda.peter
Guest

Oh and I spent May in hospital.

For clarity’s sake, I should add that I don’t judge the quality of the medical treatment I receive by the quantity of toilet paper.

webber
Guest

No toilet paper vs toilet paper in toilet.

Do you not judge quality by tips you are expected to give? I do.

Food you are served?
I do.

Cleanliness, or lack thereof?
I do.

Friendliness of staff?
I do.

If you have been or are going to a certain clinic at Kékgolyó u., my sympathies are redoubled. It is an exceptionally good place (an exception to the awful experiences I have had elsewhere). But even there, one must bring one’s own supplies and must be prepared to tip the staff fairly heavily (the staff are, otherwise, mostly great).

Guest

Re: ‘paraszolvencia’

Is that what they call it? I knew about it from way back when and it was hard to really process that one. ‘Tipping’ a doktor for his services? Are you kidding me? But it makes sense since when all that was instituted since doktors were making 5 fts a week and respect wasn’t accorded to them. The communists no doubt felt it was bourgeois. I would think the Magyar doctors who treated me as a child would have been glad they left to do their important work away from that ‘alternative’ thinking which is now pretty ingrained in the health system. They practiced medicine far away in more ways than one from that ‘tipping point’ there in the old world.

From the piece it would appear that the country could do well to focus not only on the process of developing doktors in universities but developing new approaches to the execution and delivery of health care to citizens. But I’m not to sure ‘uj’ is up there when it comes to approaches. The ‘hand me down system’ is just too too entrenched.

Csoda.peter
Guest

Thank you for your sympathies, Webber.

My experience is not universally good anywhere, but the system and the hospital here did do a very good job on me and I am recovering very rapidly. For me, that is the bottom line as well as the reason I decided to share my non-consensus opinion.

And yes I agree with you about the Kégolyó u Oncological Institute. Another apparently fine institute I have visited a fair amount, but not as a patient.

pappp
Guest
The idea is that people with any money should go to private practitioners and leave the state system altogether (of course they should continue to pay the health care contribution as part of the payroll taxation system). She should’ve gone to any one of a dozen such service providers in Budapest and for 25.000 forints including taxes (completely legal) she would’ve gotten almost immediately a kind doctor, got her blood drawn, got herself checked properly. Admittedly an MRI or a surgery would’ve cost more, but the doctor may have told her that they were unnecessary. This is one of the faults of democracy. Voters never cast votes based on the perceived quality of state services like health care and education or the promise of such services by competing parties. Only in the wet dreams of liberal philosophers. Voting is never rational and voters can’t imagine that they will ever go to a doctor (which is a cognitive issue). It’s a remote possibility at any one time for most people. Plus being conscious about our health is very much a middle-class things which we know is absent in Hungary . The goal is thus the same as in education. Middle-class/upper class… Read more »
webber
Guest

“Voters never cast votes based on the perceived quality of state services like health care and education.”
Wrong.
Look up examples online if you like. Health care has been a very hot topic in British elections, for example. Education has been the topic of local elections in American states so many times over history that you could write a book of many volumes on the topic.

webber
Guest

Palika, if you aren’t a Fidesznik, you do a darned good impression of one. “they will vote for Fidesz” blah, blah, blah

webber
Guest

Pappp I should say (sorry Palika – though you, too, are acting a bit weird about Charlie)

pappp
Guest
Palika is somebody else, webber, you are paranoid, have I told you that? I say people will vote for Fidesz because it is a fact that the left-wing and liberals (people I know) have long been in denial. They still are. Most people who are not like them (that is not polished urban middle class people) do not care about middle-class issues. Poor, uneducated, rural folks care about issues which the leftist/liberal people I know find distasteful, unhealthy, childish, ridiculous. Yes pálinka, fishing, quad driving, eating a lot (quantity vs. quality) and so on. However, such rural people are the vast majority. Orban knows instinctively that these things will get him reelected. Like the Democrats look down on rednecks who love their guns. But people do love their guns and if you suggest “gun control” (itself a Republican term) they will vote against such arrogant Coastal elites. Leftists either get to love and enthusiastically sports, pörkölt, halászlé, zabálás, fishing, car fetishism, Nagy Magyarország (its paraphernalia is everywhere in rural places) or they might as well not participate as they will lose “the country”, and Budapest and a few bigger towns cannot ever compensate for the country and the ethic Hungarian… Read more »
webber
Guest

“Like the Democrats look down on rednecks who love their guns…”
Where I grew up, most Democrats also have guns.
You are just spouting nonsense as usual.

“leftists”, “left-wing”, “liberals” clueless – it’s the best impression of a Fidesznik I have ever seen.

pappp
Guest
Think what you want. Can’t you imagine a set of non-left-wing people who dislike Fidesz? I repeat again that I’m no Fidesznik in any sense of the word. And what’s the problem with the terms leftist or left-wing (baloldali)? Is there any other way to express in English that somebody is leaning toward or prefers parties that define themselves as of the political Left (baloldali)? I’m no native English speaker so I’m not sure what else to use, but I regularly see the terms I use in written, edited English. I’m not talking nonsense but you probably don’t want to face the prospect that with such an opposition activity Fidesz will continue to rule. As to gun ownership I never said that Democrats don’t own guns. What I mean was that overwhelmingly it was the Democrats who tend to raise the idea of regulation of guns and mostly Democrats from the liberal elite who live either in California or in New England. They tend to look down on rural gun-nuts and often want to regulate guns after every big massacre (not now as the Democrats realized that gun regulation is taboo, no matter how many people are killed) oblivious to… Read more »
webber
Guest

“Can’t you imagine a set of non-left-wing people who dislike Fidesz?”
Every Jobbiker I ever met HATED Fidesz.

Stop floundering on gun ownership and the rest. You are out of your element when you talk about American politics. You’ve demonstrated that amply before.

I also suggest you stay away from grand statements about politics in general.

pappp
Guest

webber, but if you concede that such a set exists then you can perhaps imagine other conservatives, not Jobbik fans, who hate Fidesz too. I think you dislike me and I figure it’s because I force you to to face the harsh reality.

webber
Guest

I consider myself rather conservative.
I consider anyone who takes economic positions you have repeatedly taken here to be a marxist.
There is nothing at all conservative about your views.

pappp
Guest

I don’t think that I’ve participated in many debates in which my position could’ve been revealed. I’m not sure I would, as many of these contentious issues cannot rationally be debated, they are rather subjective value preferences.

The only restriction on property rights I argued for was a restriction on private property under very limited circumstances. I may have also said that the discontent palpable among voters whether in the US or France or Hungary probably have to do with capitalism. This isn’t Marxism, it’s ridiculous.

petofi
Guest

Webber,
you’re being bated by an above average Troll…

Istvan
Guest
Our situation relative to the 2nd amendment and gun rights in the USA is very complex. There are many Americans who live in urban areas that support gun rights inclusive of what are long rifles, semi automatic because full automatic guns are highly regulated since the 1920s, called by opponents assault rifles. Concealed carry permits for hand guns are growing in the USA and across the country now totaling 12.8 million. There are also a few states where no permit is required at all. But overall the strongest concentrations of supporters of gun rights are in rural areas. As those who are familiar with my posts are aware I am a member of my state’s affiliate of the National Rifle Association and oppose most of the proposed changes to gun laws here in the USA. The proposed changes to gun laws, they are numerous ranging from a ban on specific weapons, limits on the size of magazines, to greater scrutiny of who can legally purchase any firearm are being proposed by largely Democrats on the Federal level will without a question become a an issue in the election for President in the wake of Orlando. There are some Conservatives who… Read more »
Jean P.
Guest

This is not the first time that the discussion about a specific Hungarian problem has ended up with apologies for the American gun obsession. Istvan has many valuable insights to share with the HS community but his explanations on that particular subject is not among them. It is irrelevant and lessens Istvans credibility.

Guest

Re: ‘American gun obsession’

Goes back to those olden colonial days and its ‘militias’. Our ‘freedoms ‘ are ‘keverd ossze’ with hard metal and the potential for ‘tyranny’.
But then is then. Now is now. There is a multitude of opinion between all the shots…..and deaths.

petofi
Guest

(Istvan likes to listen to the sound of his own breathing.)

fixi
Guest

And the US Supreme Court agrees with Istvan.

Jean P.
Guest

Yes, and that lessens the credibility of the US Supreme Court.

webber
Guest

It rather means that you believe a part of the American Constitution should be amended.

The Supreme Court doesn’t make the laws. It just checks whether they are in accordance with the Constitution.

Jean P.
Guest

Checking is subjective. Why are all American presidents eager to appoint Supreme Court justices of their own political colour?

petofi
Guest

The average Hungarian mind being what it is…terms like left wing, socialist, liberal have been imprinted on Hungarico minds as terms of disapprobation. Thanks to the basement KGB boys and their influence in Hungary, the local ‘imprinters’ have learned this well enough.

tappanch
Guest

Orban & friends are about to acquire the largest daily Nepszabadsag to cement their media hegemony.

http://nepszava.hu/cikk/1096992-a-nepszabadsagrol-targyal-orban

webber
Guest

They already effectively control the editorial line. This will just let them change personnel. Lots of people are about to lose their jobs.

OT, but related – Someone in Fidesz is taking over Zsolnay Ceramics, as well. They drove it into bankruptcy by calling in a loan early. Zsolnay has taken it to court, but the proceedings to shut the company down have already begun regardless.

Guest

Re: ‘cementing media hegemony’

Certainly increases their ‘share of voice’ within all the political cacophony. More ‘hearts and minds’ to influence efficiently. It would appear the communication outlets for different views are getting smaller. Those may have to get more creative in an shrinking communications democracy.

petofi
Guest

The first principle of law in the Orban world: “The law is person-specific–what it is for me is not what it is for you.”

webber
Guest

ha!
I’ve often wondered whether guns introduce a certain politeness into society. The sort of random alcohol-driven violence you see on British streets on a Friday or Saturday, or carried out by football hooligans everywhere, somehow doesn’t happen in countries where any stranger one meets might be carrying a gun.
When I was a child a property-tax assessor was shot (just injured) when he walked onto a farm in a valley up the road without invitation. Unless my memory is faulty, the judge found the home-owner was simply protecting himself, because he couldn’t know who the tax assessor was.
Kind of makes state representatives VERY CAREFUL about keeping within the bounds of decency and legality.

That said, I can really see no reason for a private citizen to own an assault rifle, or any sort of machine gun.

I am sure, however, many Israelis would disagree with me on that, for pretty good reasons.

webber
Guest

(the above is a reply to Petofi’s comment below)

petofi
Guest

Yes, the ‘latest-first’ organization of this blog has made it a mess…

Guest

Just an observation.

The American Constitution was a response to rule by ‘kings’ by a group which was expected to be subservient to the ‘Crown’. Nah nah. Colonial America preferred to go another way. The Constitution to put it indelicately was the ‘f*** you to George et al.
And as a result it is the American ‘sacred’ document now handed down to posterity. And because of that orientation it is not trifled with in the sense of undergoing constant modification like some other Constitutions that seem to change with the winds. This does not of course preclude amendments taking into account problematic contemporary events but it also indicates that the founders believed that changes should not be easy to make in a writeup dedicated to the practice of good and stable government. Fiddling with words constantly would cheapen the document directing a government that still continues successfully in its ‘experiment’ of standing successfully as a beacon of freedom in the modern world. It is disheartening to see some entities not wishing to emulate it in its essence.

petofi
Guest

In Hungary…what get’s Fidesz members re-elected is the fact that Orban counts the votes…

petofi
Guest

What has happened in Hungary–the expropriation of all government levers of power by a criminal organization–is the best argument I know against gun control…

tappanch
Guest

Summary of Orban’s two-pronged plan:

Make the quality of {public health care} [public education] so bad that {patients} [parents] are forced to move to {private health care} [parochial schools].

The poor in the public systems should {die quickly} [stay ignorant].

petofi
Guest

It is abundantly clear to me that Orban’s treatment of the Hungarian populace is derogatory and punitive. The consequences of that attitude should come in for considerable debate…

Observer
Guest

The heartless attitude (embertelen) widespread in Hungarian society and fostered by the Orban regime plays a major role here. He’s been pouring poison for almost 20 years now, an appauling crime against Hungarian society (Rákosy/stalinist light).

Guest

Re: the ‘pouring of poison’

As a Magyar who was born outside the country but yet aware of comings and goings there behaviors I could not initially understand now makes perfect sense. It takes the happenstance of examining environments like one’s own and others to lend some perspective.