A first: Nine opposition parties agree on long-range healthcare priorities

Today was an extraordinary day, one that few people believed would ever come to pass. All nine opposition parties, including Jobbik, signed onto a “national healthcare minimum,” a document that outlines the basic steps that must be taken to salvage the sinking ship of Hungarian healthcare. Fidesz was also invited to the discussions that preceded the final act of approval, but the government party refused to participate.

How did this project come into being? The description of the process might be educational for crafting future agreements in fields that shouldn’t fall victim to party politics.

First, I should say a few words about the man, Gyula Kincses, without whom this healthcare minimum project couldn’t have taken place. Kincses was an ear-nose-throat specialist who eventually moved over to healthcare management and politics. He began his political career as an MDF member of parliament (1990-1994), but he was always more interested in healthcare management. It didn’t matter which party was in power, they all relied on his advice and expertise–from Viktor Orbán (1998-2002) through all subsequent governments–that is, up until 2010. He reached the pinnacle of his career during the Gyurcsány administration when he served as undersecretary of health.

By now Kincses is retired, but he is still extremely active. In the last five years he has been writing a blog called Asztalfiók (Desk drawer) in which he analyzes various aspects of healthcare. He is regularly asked to comment on health issues by Hír TV and ATV. As far as I know, he has not been asked for advice by this government.

Gyula Kincses

On June 14, 2017, the Friedrich-Ebert-Stiftung and Political Capital held a conference titled “Can Healthcare be cured?” where, in addition to healthcare professionals, representatives of several opposition parties were invited to participate. Tímea Szabó (Párbeszéd), László György Lukács (Jobbik), Ákos Hadházy (LMP), Imre László (DK), and László Szakács (MSZP) were among the speakers. Naturally, Fidesz was also invited, but they ignored the event. At this conference Jobbik’s Lukács was the only person to stress the “necessity of a consensus among the representatives of political life, which would elevate the issue of healthcare over and above the usual political skirmishes.” This suggestion moved Gyula Kincses, who was in the audience, to ask Lukács whether he would sponsor such a resolution.

The Hungarian media didn’t waste much time on this conference. The only article I found appeared on Jobbik’s internet news site Alfahír, which makes sense since it was a Jobbik politician who accepted the challenge of getting all the parties involved in working out a national minimum. A month later, on July 28, Népszava reported that the representatives of nine parties with measurable support (DK, Együtt, Jobbik, LMP, Kétfarkú Kutya, MSZP, MoMa, Momentum, and Párbeszéd) had gathered to try to identify the most basic elements necessary for a coherent healthcare policy that could be sustained over time. One of the problems Hungary, like most countries, faces is that when a new administration comes into power it brings with it politicians with new ideas who immediately dismantle everything the previous administration had accomplished. An agreement on healthcare—or, for that matter, on education—over the long run would eliminate this extremely destructive practice. Surprisingly, it turned out that the parties actually agreed on many of the elements Kincses found important. By the end of July Kincses was greatly encouraged by the level of cooperation he had received. Kincses gave an interview to Egyenes beszéd (ATV) in which he stressed that Fidesz would be a welcome member of the team, but the government party was steadfastly refusing to participate. However, he said, they are still waiting.

Although Kincses didn’t brag about it, by that time the document was more or less ready. By early August the final text was sent to the participating parties for discussion and for a final word of acceptance or rejection. At that time Alfahír still expressed its doubts whether all the parties would accept the final text. Well, today we at last found out that Kincses accomplished the close-to-impossible task. All nine parties decided to support the nine basic elements of the document.

The Hungarian media can occasionally be more than irritating. None of the articles covering this story lists all nine points, but I managed to find that the parties committed themselves to spending at least 9.4% of the Hungarian GDP (EU average) on healthcare. Currently the figure is only 7.1%. Of this, the state pays 4.8%, while the rest is paid by individuals. Out of every 100 forints spent on healthcare, 40 forints are paid by Hungarian citizens, which is much higher than in other EU countries. The plan would lower that figure to 30%. Everyone who is insured would receive the same quality care, though private insurers could offer additional services. The document includes a promise of graduated, substantial salary raises for healthcare workers over the next five years and the restoration of the old “social security system,” which was abolished by the Orbán government and replaced with a system financed by taxation.

The first party to sign was Jobbik, followed by DK. By now only a few haven’t yet gotten around to signing the document.

Magyar Idők has been silent about this whole project. In the past few months the government media has reported nothing about the discussions concerning long-term healthcare plans. It was only Pesti Srácok which today sarcastically announced that “the great opposition cuddling materialized; of course, Jobbik is among them.” Otherwise, the paper summarized the document accurately.

This is a first step but, I think, an important one. I hope there will be others to follow. They might inspire the electorate to realize that, after all, these parties can agree on issues which are important to them.

September 20, 2017
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Ferenc
Guest

Information about the Jun.14 conference available at http://www.politicalcapital.hu/rendezvenyeink.php?article_read=1&article_id=1438 , incl.32pgs document specially prepared for it – http://www.politicalcapital.hu/pc-admin/source/documents/PC_FES_egeszsegugy_2017_tanulmany_20170613.pdf
Other reports found in the media about the conference:
*HVG (Jun.14): http://hvg.hu/itthon/20170614_egeszsegugy_friedrich_ebert_stiftung_political_capital_lmp_parbeszed_mszp_jobbik_dk
*MagyarNarancs (Jun.14): http://m.magyarnarancs.hu/belpol/eu-konf-104762
*24.hu (Jun.14): http://24.hu/belfold/2017/06/14/nem-tul-nagy-kihivas-ma-belehalni-valamibe-magyarorszagon/

Media items found about the signing of ‘Healthcare document’:
*MNO (Sep.20): https://mno.hu/belfold/csak-a-fidesz-nem-tamogatja-a-nemzeti-minimumot-az-egeszsegugyben-2417946
*24.hu (Sep.20): http://24.hu/belfold/2017/09/20/a-fidesz-nem-tamogatja-a-nemzeti-minimumot-az-egeszsegugyben/ [linking to MNO]
*DK (Sep.20): http://web.dkp.hu/kozlemeny-gyurcsany-ferenc-a-dk-elnoke-alairta-az-ellenzek-kozos-egeszsegugyi-dokumentumat/
*Other sarcastic reactions, mostly about Jobbik together with other opposition parties (some even singling out Jobbik & Gyurcsany): Figyelo (Sep.20), Democrata (Sep.20), Magyar Idok (Sep.21)

Other recent healthcare related items in media:
*HVG (Sep.15): Thrombotic patient finally transported at night and including stop for hamburger [add: and another one for cigarettes…]
http://hvg.hu/itthon/20170915_Megalltak_hamburgerezni_a_betegszallitok
Reaction by son of patient: “I would say that such people should rather transport furniture, or even that not, because one has to take care of that also” [i.e.fully careless ]
*ATV (Sep.20): Is the government spending less on healthcare? Interview with Kincses Gyula [not about the document itself!]
http://www.atv.hu/videok/video-20170920-kevesebbet-kolt-az-egeszsegugyre-a-kormany

Ferenc
Guest

About the costs of Healthcare in general:
Many people in the ‘Western world’ complain about Healthcare becoming more and more expansive. Most given explanations are about developments in healthcare causing people to become older than before, people getting older so needing more care, pharmacy making newer more expensive medicine, etc.
IMHO following are mostly forgotten:
1.contrary to production of goods, healthcare can not be ‘produced’ in other ‘low wage’ countries
2.healthcare can less than other services be automated
3.only the administration part is possible to be made more efficient by information technology, but it seems instead of reducing costs, the technology is most mostly used for collecting more healthcare data (for insurance and pharmacy industries)
All makes Healthcare becoming relatively more and more expensive compared to other products and services. The involved party I consider most cynical in all this is the pharmacy industry!!

Guest
You’re right but I’d like to add a few things: Some parts of health care profit from low wage countries – nurses and docs are imported e g … A typical example from Germany: Old people who want to stay at home (and whose families can affford to pay …) engage a group of nurses from Poland or Hungary e g which work/are available 24 hours. They work for maybe 10 days or two weeks round the clock and then the next in the group takes over while the other returns home for a few weeks of rest … This works quite efficiently. And in the long run we’ll see health care/nursing done by robots – the Japanese who have a really old population are already working on it. PS and rather OT: When I started to worked in IT I had to travel a lot (in one year 120 nights in hotels was my record) so I told my bosses very soon that I wanted to work part time which they grudgingly accepted, couldn’t find another specialist … And my first wife worked a “half job” in a university hospital – usually the last 10 nights of the month,… Read more »
Guest

Health care is probably the most important topic for the next years – much more than refugees/immigrants etc which are just diversions, but it won’t be easy, especially in the corrupt Hungarian society!

Of course the ruling class is not interested – they have enough money to pay private doctors and hospitals. But the fact that the large number of Fidesz voters seems to be quiet on this always astonishes me – have they just got used to the old maxim?
Weil Du arm bist, musst Du früher sterben!

I’ve written about this before:
We’re just helping a friend who needs chemotherapy for cancer – and gets it. I’m always surprised at the willingness of the people:
docs, nurses and technicians who have to work in these horrible circumstances, old buildings, not enough money, no recognition for their services from the “leaders” …
And of course it will get worse with the continueing “ageing” of the population – even richer countries are having problems and we don’t want to look at the USA even.
We’ll be living in interesting times!

Ferenc
Guest

First I wish all the best and strength to your friend.
Then Healthcare in a corrupt society, tackle them together and healthcare will improve double!
Fidesz supporters: they seem to accept and/or forgive ‘their leaders’ for not only not improving, but even worsening the Healthcare system in Hungary. Why? No clue you’ll have to ask them!!
-Why doesn’t the opposition organize something like a Healthcare Consultation?
-Has there, during OV&Co rule, been tried any Healthcare related referendum (question)?
-As you are since quite some years in Hungary, what have you personally seen for developments in Healthcare? (only slow but steady worsening or also some positive things?)

Guest

Thank you, Ferenc!
My wife and I have been trying (mostly successfully …) to avoid the Hungarian health system, though here around Hévíz and Kezthely it’s not too bad – if you can pay …
The steady influx of foreigners all year round in Hévíz helps of course, doctors make enough money off them it seems.
I’ve had a few problems (age wise,having been born during WW2 …) but all operations etc could be done in Germany where we spend half of the year – just takes good planning …
And my regular medication I get of course in Germany too.

Member

Gyula Kincses is a straight shooter and a truly stand-up guy. That is why he has no future in Hungarian politics.

If this nine-party agreement on health care progresses, Kincses is going to become the bull’s eye on Fidesz’s dart board. He was state secretary when the Gyurcsany government passed the law on private health insurers and a supporter of the 300-forint co-pays. Fidesz successfully whipped up public hysteria over the health-reform program pushed through by Kincses’ boss, Health Minister Agnes Horvath, and her predecessor, Lajos Molnar.

Kincses will become the whipping boy for Fidesz propaganda minister Antal Rogan and his eminence grise, Arpad Habony. Fidesz will spread rumors that the nine parties’ true goal is to “privatize” health care so that George Soros can profit. Voters may not like the current state of affairs in Hungary’s hospitals, but they are the same chuckleheads who voted overwhelmingly to abolish reforms nine years ago. They will lap up Fidesz’s calumny.

That said, I wish Kincses the very best of success.

wrfree
Guest

Me too.

And there’s this quip .. ‘Physicians and politicians resemble each other in this respect, that some defend the constitution and others destroy it’. Dr. Kinces and his fellow physicians who are in the medical trenches day by day look as if they might get held up by Fidesz. It will be hard to cure them of an apparent ‘not invented here’ syndrome. So far not a good sign for the progression of healthy ‘constitutions’ in any sphere within the country.

Istvan
Guest

Magyar Nemzet had an interesting article about the private side of Hungarian health care yesterday see https://mno.hu/eletmod/tobb-ezer-lakasrendelo-mukodik-fu-alatt-2417886 The article showed that much of Hungary’s health care is now being provided outside of the national system. One statistic in the article jumped out was that 49% of the residents of Budapest utilized a private health care provider according to data provided to the paper by the Health Market Research Firm of Synapse.

It is not clear to me how the opposition plan would address this very large private sector of health care, from Eva’s summary all her summary said about this sector is “private insurers could offer additional services.” Well it looks like these additional services reprsent a big part of current Hungarian health care.

Observer
Guest

Ceterum censeo:

The parties should use this vehicle more often and should let more room to heir local branches/people to agree on common candidates in the coming elections.

Petofi
Guest

Here’s a stringent probity clause for all Hungarian politicians: 100 million and 10 years in jail if found guilty of corruption while in office.

Without the clause, Hungarians will continue to play ‘find-the-pea’ with Hungarian voters…and spirit away all available cash–

Observer
Guest

The 10 years and the confiscation of property penalties are on the books. The “if found guilty” is the harder part, although they are guilty as hell. In corrupt Hun the justice system is no exception when politicians are involved.

Petofi
Guest

‘ On the books’?
Good.
Now, let’s have the politicos sign on to it!

wrfree
Guest

Re: ‘find the pea game’

A little leviteeeee….
Hey not peas here but lemons.. wish it was in magyar …this is the way it is …😎
https://youtu.be/PWvkyW1eDWA