Hungary is again near the bottom of the list. This time it’s healthcare

The Health Consumer Powerhouse just released its “Euro Health Consumer Index” (EHCI) for 2017, and Hungary ranks near the bottom of the list of 31 countries in Europe. Sharing the honor with Poland, the country is in 29th place with a score of 584 out of 100. Hungary managed to fall behind even Montenegro (623 points) and Albania (596 points). Only Romania, Lithuania, and Greece scored worse than Hungary.

Let me quote what the authors of the EHCI had to say about the reasons for the disastrous performance of the Polish and Hungarian healthcare systems. After noting that these two countries, “despite having good and plentiful medical education and a long tradition of solidarity-financed public healthcare,” have done poorly on the yearly EHCI reports, the authors expressed some puzzlement over the reasons for the poor results. Eventually, they hypothesized that “in recent years, the governments seem to have focused on things other than the optimal running of the country, such as killing off the free press, politicizing the judicial system, keeping out also very modest quotas of migrants and banning abortion in all but the most extreme circumstances.” This last assertion is true only for Poland; in Hungary access to abortion is one of the few categories in which Hungary excels. The report notes that “ongoing political discussions on fundamental reform in Poland and Hungary have yet delivered little” and that “the public and the medical profession deserve better.”

This explanation for the shortcomings of the Hungarian healthcare system is far too simplistic. In their executive summary, however, the authors offer some general observations about the ingredients of successful healthcare systems, which are lacking in Hungary. Among the worst problems in the Hungarian system are the abominably long waiting lists. Pouring money into healthcare wouldn’t automatically produce a more efficient system. As EHCI puts it, there is “no correlation between accessibility to healthcare and money spent.” It is inherently cheaper to run a healthcare system without waiting lists than with waiting lists, they contend. And here comes something that Hungarian healthcare providers have a hard time of swallowing: “Healthcare is basically a process industry. As any professional manager from such an industry would know, smooth procedures with a minimum of pause or interruption are key to keeping costs low!”

The above claim is anathema to most doctors as well as to right-wing Hungarian politicians. When Viktor Orbán was still in opposition, he declared emphatically that “healthcare is not a business.” And I’m certain that most Hungarian physicians would protest at anyone calling their profession a “process industry.” They even object to the basic philosophy underlying the Health Consumer Powerhouse’s notion of a consumer-based evaluation of healthcare. As István Éger, president of the Hungarian Medical Association, corrected György Bolgár this afternoon, “of course, we deal with patients and not consumers.” So, the Hungarian healthcare system is limping along in an unbusinesslike fashion, with patients waiting for hours or weeks, at the mercy of overworked doctors. Since the profession refuses to look upon their patients as consumers, the healthcare system is simply not geared to satisfying patients’ needs. As long as this attitude prevails, little will change.

It is possible even in a relatively poor country to achieve almost instantaneous and dramatic results. The example EHCI provides is Montenegro, which within one year moved to 25th (623 points) from 34th place by introducing their own system of an open, transparent real time e-Referral system, which radically reduced waiting times. Or there is Slovakia, which improved its score by 71 points in one year. One of the reasons for this marked improvement might have been the introduction of a system of private, add-on healthcare insurance.

The study is 100 pages long and measures almost all categories related to healthcare. While Hungary is for the most part either at the bottom or in the “so-so” categories, there are a couple of areas in which Hungary leads: infant/children vaccination coverage and hours of compulsory physical education in school. The report is chock-full of statistics, which are worth studying.

Wait times: lumbar spine surgery 416 days, open-heart surgery 210 days, hip replacement 271 days

In vain did I look for coverage of the results of the EHCI in the Fidesz propaganda media. Only a few independent or government critical media outlets reported on the dismal results. In the pro-government Magyar Időthe last article on healthcare appeared on December 28, with the promise that “next year the number of people waiting for surgical procedures will be further reduced.” But in an article titled “Dear Fidesz, not Soros but the Grim Reaper should be stopped!” I learned that wait times have actually increased in the last two months.

In a related investigation, Péter Juhász of Együtt recently decided to learn more about hospital food. A friend of his who was hospitalized sent his rations to him (in exchange for non-hospital food). The hospital food was of unacceptable quality and quantity and was decidedly lacking in vitamins. Juhász endured his experiment for ten days. Predictably, he lost weight.

Csaba Molnár, deputy chairman of the Demokratikus Koalíció, used the EHCI report to make a campaign point: that “during the Gyurcsány government Hungary was ahead of Italy, Spain, and Ireland, while now patients die in the corridor of the emergency room.” Indeed, Hungary’s decline in the last eight years has been staggering. According to “Euro Healthcare Consumer Index 2008,” out of the same 31 countries Hungary was 13th, right after Finland, France, Estonia, Belgium, and the United Kingdom and ahead of Italy and Spain, in addition to 17 other countries. Even then Poland was close to the bottom.

Given this precipitous decline, the year-over-year drops recorded by the EHCI should receive much greater attention from the opposition parties, especially this year, a few months before the national election. The striking difference between 2008 and 2018 should be highlighted and brought home to the Hungarian people, many of who seem to have forgotten that the times before Viktor Orbán were not as bleak as the present government and even some of the opposition politicians try to portray them. And not just as far as healthcare is concerned.

February 2, 2018
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Istvan
Guest

I had to laugh Eva, I know indigent veterans here in the USA who have waited just under two full years for a hip replacement actually worse than Hungary by a good amount. Because I fortunately was an officer I have what is called TRICARE For Life and pay nothing for it on top of my old age healthcare called Medicare and use regular hospitals not VA facilities.

The one thing the study left out is how Hungarian healthcare takes bribes to get to the front of the line.

Reality Check
Guest

1) You can go to the VA site and find wait-time data the inspector general now requires them to post. For most VA provider locations 90% or more of appointments are met within three months. There is also a program that allows vets with VA benefits to use outside providers if wait times or other factors indicate the need. The VA has issues, but I think I would still take it over what the average Hungarian has to deal with.

2) In the US when we complain about healthcare you rarely hear people talk about what times. There are other issues, like cost, but wait times is hardly at the top of the list.

Istvan
Guest

Yes those wait times are now being contested by disabled veterans. Unfortunately some VA facilities falsified their data see https://www.disabledveterans.org/2017/03/06/falsified-wait-time-calculations-prevented-access-veterans-choice/ The veterans choice system also has problems.

But I do support lower income veterans having those options. Like the Hungarian national health system there has been a history of corruption in the VA system, none the less it’s far better than nothing.

I have wondered during my visits to Hungary if the veterans of the Hungarian royal army or the Jews drafted into the Labor Service from the Horthy days retained any benefits at all under communism or after transition. Clearly most of those soldiers were conscripted and the Jews were effectively slaves on the eastern front. There must have been thousands upon thousands of those men disabled for life.

Jean P
Guest

“I had to laugh Eva, I know indigent veterans here in the USA who have waited just under two full years for a hip replacement actually worse than Hungary by a good amount.”

I fail to see what is hilarious about it.

Istvan
Guest
In the Army some times soldiers laugh as a form of irony. So they get ordered to do something that is worthless or objectively stupid, or will likely get them killed, they laugh about it. To voice objection to an order, unless invited to do so by a superior which is rare indeed, is insubordination is covered under Article 91 of the Uniform Code of Military Justice. If you are a commissioned officer to be honest we were not even allowed to express ourselves by laughing, that could be considered “contemptuous” under Article 88. I suspect that is the context of my use of laugh to Eva, it is sort of imbedded in me. To be honest civilians like Eva and many politicians are aghast at how the USA treats its poorer veterans. Those of us who served in our military and have other resources have avoided the Veterans Administration hospitals probably since after the Korean War when it was flooded with WWII veterans. Walter Reed National Military Medical Center near Washington DC used to be the elite VA hospital where officers did go has even deteriorated. The reality or the secret reality is men and women who have been… Read more »
seinean
Guest

I get it like it’s the bitter-laugh burst one has when faced with absurd, uncanny situations one cannot control or influence in any way . We – Eastern Europeans – are so familiar with this unfortunately…

Member

“In the Army some times soldiers laugh as a form of irony.”

That’s pretty much the way it is in all walks of life. Jean P’s question is either ignorant or plain dumb.

Jean P
Guest

” I suspect that is the context of my use of laugh to Eva, it is sort of imbedded in me. ”

I suggest that you unbed it.

Member

Get a clue.

Member

The criminals and thieves who are masquerading as the Government have a two fold purpose running down the healthcare WITH THE DOCTOR’S SILENT AGREEMENT!

1. The sick and the elderly should die as soon as possible, they are a drain on the tax moneys leaving less for corruption and keeping them in power.

2. The people get tired of waiting and being abused and private healthcare will be the only choice to get even the slightest benefit of going to a doctor and a hospital. This is what the doctors want! MORE MONEY FOR THE SAME LOUSY, CARELESS AND USELESS WORK!

The new INFRINGEMENT, that replaced the CONSTITUTION in 2011 specifically excluded the responsibility of the Government to provide any social benefits, a social net for the taxpayers and the population. The little viktor made Hungary and all the tax moneys and EU moneys his personal property and to dole it out as he pleases with no accountability.

Guest

Gyula, you’re 100% correct!
But one has to admire the people working here, whether doctors, nurses or just cleaners – they do their best but of course it’s not enough under the circumstances when there is not enough money for repairs, for food or even toilet paper!
For those who have enough money it’s ok but …
We’ve accompanied several friends lately to hospitals in different cities and everywhere I had the chance of looking around, horrible, decaying buildings with people desperately making the best out of it.
I was often reminded of the old pre-war hospital that my first wife used to work in 40 years ago until they built a new one – so again Hungary is way behind.
Of course waiting times are a fact of life, even in Germany there is triage. But if there’s something life threatening and you’re sent away and told to come again next month as happens here …

Member

The word “admire the people working here” is perhaps a bit of an overstatement. It is well fitting for those who are excelling in their good work DESPITE the system that works against them. However, those who cannot do and will not do a good job, then became disinterested, lazy and without a care in the World should be chastized, because the society would benefit greatly, even if they would just go home and allow a big well organized general rolling strike to start, that in just a 3-4 weeks would topple the little viktor’s kingdom.
It seems to work in other societies, Germany is jst one example.

Guest

Gyula, re Germany:
Are you thinking of the strikes that Germany’s hospitals are experiencing right now, in my hometown e g?
I haven’t followed them (been in Hungary too long …) but I’ll seeor hear what came out when I return to gemany in a few days. Germany is no paradise eithe healthwise, there are also problems – lke not enough docs and nurses in many places.

wrfree
Guest

Always wondered about health care in the ‘Kadar’ time and how it stacks up today. That ‘tip’ to the doctor is still in existence. Still stands as a getting around the communistic ‘one size fits all’ attitude in care.

The illiberalists still think it’s a great holdover as they are not interested in helping to pay. They prefer to have the ‘konzumer’ handle that in order to get individualistic and ‘better’ care.

bimbi
Guest

Breaking News!
My wife listening to the radio this morning now tells me that the government realizes health care in Hungary is in a disasterous state – but they have come up with a great solution!
Each hospital has been ordered by the government to come up with two items of Good News every month (or is it every week?) so we can make everything right with a massive campaign of non-existent cheerfulness. They even have a new administrative office to count all the Good News items!
I can just imagine Mr.Habony saying, “If the lies worked for Soros, we can make them work for Healthcare because we have a gullible eat-anything public out there.”
The Mafia State bestrides Europe.

dos929
Guest
I could comment endlessly on the general state of the Hungarian ‘health-less’ system, but in-spite of the problems regarding the waiting lists in the western democracies, I doubt very much that rats are occupying some hospitals in those countries or people die forgotten for days in the toilet block or waiting for emergency care, etc… I tried to include some photos in my comments, but apparently only texts can be pasted into the comments (in-spite that I did see photos in the blog…). These photos would have shown one of the buildings in Budapest’s “Korányi Lung Disease Hospital”… The extensive decay of the buildings in and outside, rotting walls, filthy interiors, and the total absence of a sterile environment is the norm. I doubt if anyone in London or Montreal would even take their pets for treatment into such places, as yet Hungarian citizens are being taken ‘care’ in such hospitals that resemble more to the infirmaries of the colonial Africa of the last century. And it is not demagogy to compare this situation to the dozens of new stadiums, sport facilities and the likes to the general state of the Hungarian health care that could use the very same… Read more »
Richard ray
Guest

Having been participant in healthcare in Hungary and US, aside from the obvious difference in the amount of money involved, I found it very odd that the doctor’s offices were not more like a business. Older doctors were calling back to make appointments and do paperwork. There are some doctor’s offices that are fairly efficient, especially family practice (hazi) doctors and pediatricians. They had a nurse/office admin person side by side with the doctor, writing and filling in forms as we went along. The payment/salary system is broken though, so handshake money still plays an important role. Scheduling my mother in-law for two (actually three; second one had to be re-done) hip replacement was another story deserving of the low ranking.

Aida
Guest

Good health and ipso facto good healthcare are the greatest gift we can receive. It applies to every person in society. The priority that each society, not government, determines the quality of both.
Even so, we see virtually everywhere poor health, poor healthcare and at the same time a virtual absence of any nationwide movement to secure significant and lasting improvement. At best there is political debate as to funding as for example in the UK the purpose of which is to bolster the Brexit propaganda of the Nationalist English savages. Alternatively obfuscation as in the US and finally supine acceptance as in Hungary.
Whilst I regret the suffering we are condemned to endure my sympathies do not run deep. Any nation that wants good health care can get it. Remember Cuba?

exTor
Guest

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http://www.theamericanconservative.com/articles/hungarys-acela-corridor … Hungary’s Acela Corridor [Will Collins]

Referencing highspeed railways in the US to metaphor the divide that he posits extant between cosmopolitan Budapest and the countryside, the author tries to explain some of the current Hungarian condition.

Éva (and others) will be pleased that Will Collins, a teacher of English in Eger, references Magda Szabó [“one of the great Hungarian authors of the 20th century”] more than once in trying to describe the dichotomy that exists between the two worlds of Magyarország: Budapest and the rest.

If the validity of WC’s belief be correct, then the existence of contraOrbán Budapesters may bode well for Hungary come the election in April.

MAGYARKOZÓ

exTor
Guest

Will Collins cites Paul Lendvai [Orbán: Europe’s New Strongman] in the contention that Viktor Orbán was put off by the pretentiousness of BP’s intellectuals. Collins seemed to be somewhat onside with Lendvai in the latter’s analysis of Orbán, suggesting that Lendvai was “a bit reductive”, read: simplistic, in his take on Orbán’s youth.

Viktor Orbán may have been a country hick from Felcsút, which likely had a then population of fewer than 1000, however he soon got used to the big city, becoming a student radical with (presumably) political principles.

Whether he abandoned his principles in the 1990s for more power is a matter for conjecture. Is Orbán’s move toward illiberalism merely a naked attempt to retain power or is it proof of a new political principle? Or both?

MAGYARKOZÓ

wrfree
Guest
Re: ‘Whether he abandoned his principles in the 1990s for more power is a matter for conjecture. Is Orbán’s move toward illiberalism merely a naked attempt to retain power or is it proof of a new political principle? Or both? I’m aware of the risks of putting ‘Ur-ban’ ‘on the couch’ so to speak. But as noted there has to be something there with the attitude change where he is showing many ways in what it means to be an Eastern European ‘democrat’. I am always perplexed at his dissing of the West and his courting of Putin. He wears it on his sleeves and never misses a chance to put the ‘shiv’ in to make the West bleed a bit. Revenge could be sweet but it is a poor way to make things ‘right’. He’s thrown out liberalism and added a little of the ‘boot’ and ball and chain. Perhaps pragmatism has overcome principle as it has come to him in the experience of wielding power. Can only think he may have learned a certain political principle from the Bolsheviks on through the 20th and that was namely ‘might makes right’. Rule is forged through his ‘mellow’ fist. The… Read more »
wrfree
Guest
Real interesting article. Thanks. The Prime Minister is one for contemplation. For a fellow coming from rural roots it would appear he cannot help but play in two worlds. He is like both King and Falstaff. But in both instances he could be looked at as, because of that dual nature , usually displaying an ‘us vs them’ mentality in relationships. It seems to pervade his actions and outlook on the problems of the day. He is one , like our POTUS , who generates polarizations. It’s probably hard to separate out the Felcsut from the man and that is why it is difficult to see that precisely because he emanates from a small backwater he above all should know the challenges for all ‘rural’ areas and take steps for the country’s sake to bring them more into ‘modernity’. But his ‘benevolence’ might not be the prescription as perhaps holding power is now more a goal than to ameliorate the problems the country endures as he tries to ‘fit in’ his country into our rapidly changing world. The prime minister apparently prefers to leave things as they are and letting the past centuries to continue unchanged as they roll on… Read more »
exTor
Guest

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Éva, you may want to remove Budapest Telegraph from your Noteworthy sidelist. It seems to have been transmogrified into some sort of Japanese-language website dealing with sports and betting. Budapest Telegraph evidently is no longer “a good all-around newspaper”.

MAGYARKOZÓ

exTor
Guest

http://www.budapesttelegraph.com

For those curious about the now-nonMagyar
Japanese-language look of Budapest Telegraph,
which strangely continues to use its original name.

MAGYARKOZÓ

wrfree
Guest

Re: ‘patients die in the corridor of the emergency room’

Sadly I really didn’t want to hear that one. I recently had a friend who never came back after a visit. I’ve always wondered about that one. Bothers me now since maybe I know too much.

And the ‘waits’. Perhaps the health care system thinks it is is doing literal ‘patients’ a favor? People sure can’t come back to them and complain about not being given time ‘to prepare’. Guess 200+ days usually does it.

Crazy. Stadiums get all the big bucks. And there’s money around of course. But leadership of course has their ‘priorities’. The mentality towards health care tells something about the mentality to quality of life. To say it needs responsible revision is an understatement. But as usual there are ‘priorities’.

exTor
Guest

http://www.budapesttelegraph.com

For those curious about the now-nonMagyar
Japanese-language look of Budapest Telegraph,
which strangely continues to use its original name.

MAGYARKOZÓ

Guest

Rather OT but very interesting stats from well known Pew Research.
I was following the correlation between religion and wealth and then found this:
http://www.pewglobal.org/2007/10/04/chapter-4-values-and-american-exceptionalism/

And this is even more interesting because Hungary is mentioned too:
http://www.pewglobal.org/2017/10/16/globally-broad-support-for-representative-and-direct-democracy/
Support for democracy and its ideas seems to be much lower in hungary than in other developed countries – even Poland!

Farkas
Guest

Very interesting, Wolfi. :-))

Surveys of the levels of political retardation in the world.

As in “Retards of the world unite, you have nothing to lose but your chains!”

Unsurprisingly, Hungary is at the leading edge in the retardation stakes.

As they say in Hungarian, aki hülye, az hülye, nem lehet rajta segíteni.

Farkas
Guest

The principal characteristics of the public health system in Hungary are monumental mismanagement, catastrophic underfunding and bottomless corruption.

As to underfunding, it is not as though there was a shortage of government funds. There is plenty of money for prestige projects, sports stadiums, and for creaming off and pocketing by the Orbán mafia.

Lower Slobbovia at its best . . .

Farkas
Guest

I don’t know how this draft got into the system, but it should be disregarded. See instead the post below.

Farkas
Guest

The principal characteristics of the public health system in Hungary are monumental mismanagement, catastrophic underfunding and bottomless corruption.

As to underfunding, it is not as though there was any kind of insufficiency of government funds in Hungary, as there seems to be plenty of money available for prestige projects, football stadiums, government propaganda campaigns and for creaming off and pocketing public funds by the Orbán mafia.

As to monumental mismanagement – which is grotesquely Kafkaesque in all areas of Hungarian public life – it is a genuine Hungarian specialty, a real Hungaricum. KuK public administration skills on turbocharge. The only instance that I can recall in Hungarian history where they had been able to demonstrate hitherto unimaginable levels of super-efficiency (and never again thereafter) was from April to July 1944, with the rounding up of over four hundred thousand provincial Jews and dispatching them to the gas chambers in Auschwitz.

As to bottomless corruption, well, there is nothing surprising there, after all it is endemic all over the Balkans and Eastern Europe.

Truly, Lower Slobbovia in full flight at its glorious best . . .

Aida
Guest

The EU as previously constructed was pretty solid. The issue as to which post communist monsters to allow to join was submerged into the debate about German influence so the Brits supported expansion at the expense of quality to water down the Gernan influence.
We have huge numbers from Eastern Europe migrating which was never the plan. Result is Brexit. Enhanced by Moscow power.

How can the EU tolerate counties like Hungary, Poland, Czechia, Austria, etc? So, where do we go from here? Well, we should not be here at all.

Istvan
Guest

Off topic but in the news. I assume Eva you saw this MTI article, https://mno.hu/kulfold/nemetorszag-vallalja-a-tortenelmi-felelosseget-a-halaltaborokert-2444839 which in a very interesting way supports the proposed Polish law making it a crime with fines or prison sentences of up to three years for anyone intentionally attempting to attribute the crimes of Nazi Germany to the Polish nation – for example, by referring to “Polish death camps”.

What the article does is take a statement from German Foreign Minister Sigmar Gabriel accepting responsibility for the death camps as somehow legitimizing the proposed Polish law through the use of journalistic juxtaposition. The MTI article ends with Polish Prime Minister Mateusz Morawiecki who had two aunts by marriage who are Jews and one who was a survivor of the Holocaust justifying the proposed law.

An interesting piece of journalism to say the least.