Private Practice and Health Care Financing: A Comedy of Errors
Ah yes, the Great Private Practice Day—a day when politicians gather round like it’s a therapy session for their budgetary insecurities. János Kóka, a former maestro of monetary matters, bravely ventured into the treacherous waters of healthcare funding, and let’s just say he didn’t leave without a few casualties. Kóka claimed that sector-neutral financing, the magical solution to every healthcare woe, is about as realistic as getting a unicorn to do your taxes. Why? Well, apparently, the state budget is thinner than a gym rat’s patience with fries, missing a cool 3-5 percent of GDP in healthcare funds!
Private Providers: The New Kings of Care?
So, if we throw 100 billion forints at private providers, does that mean the state gets to keep the dregs, like emergency services and major surgeries? Kóka thinks that would be a risky business model—sort of like depending on a sloth to deliver your mail. It turns out that 25% of patient care in Hungary is already performed by the brave knights of the private sector. But wait, here comes the ‘cafeteria’ idea! Yes, Kóka believes that additional insurance provided by companies would let workers choose their own care, much like choosing toppings on a pizza—except in this case, you might just get a slice of… well, *actual* healthcare.
Now, enter stage left: Balázs Rékassy, playing the role of the informed doctor-economist. He suggests that it’s already a standard practice in “cultural countries” (our apologies to less cultured countries, you know who you are) for the state to buy interventions from private providers. Can you imagine? “I’ll take a hip replacement, and a side of fries, please!” But their plot twist? The Ministry of Economy is apparently holding onto its purse strings tighter than a gym teacher during dodgeball.
A hip replacement surgery costs roughly HUF 890,000, plus the cost of wage supplements, the latter of which is only financed by state hospitals from NEAK.
This little tidbit explains why private service providers might be fighting for crumbs—welcome to the Hunger Games of healthcare financing!
Waste Not, Want Not?
Next up to the plate is Péter Haraszti from TritonLife, who has noticed a tricky little thing called sector-neutral financing. Spoiler alert: it’s not working out. Imagine trying to cook a soufflé using a toaster—there’s bound to be chaos! He points out that certain private companies receive NEAK support but are paid less than what they need. It’s like asking a barista to make you a latte but only giving them enough money for a cup of water.
But here’s the kicker: Kóka claims the state hasn’t changed its reimbursement rates since 2018. As costs have soared, funding has flat-lined. You’ve got to love a healthcare system that’s more stagnant than a pond full of mosquitoes.
The state cannot or does not want to spend more on the care system, families have exhausted their financial means.
What a relatable sentiment! It’s like going to your local café and realizing you’ve spent your last penny on overpriced avocado toast.
When Prevention Is the Name of the Game
And speaking of saving dough, Kóka believes that prevention could save the day—or at least a few billion HUF. Can we get a round of applause for the idea of banning chips from school canteens? If only we could chip away at unhealthy habits the way we do at your local bar on a Friday night!
Can we actually improve healthcare by pushing fruit and veggies in schools? Kóka boldly predicts a GDP expansion of 1.5% just by promoting a healthier diet. Now, that’s the kind of math even I can appreciate, provided they offer a side of cheeky humor with those carrots.
In conclusion, healthcare financing is like a poorly written sitcom—full of plot holes, questionable characters, and episodes that leave you wanting more. Private providers may take the stage, but unless we reform the funding structure and promote preventive measures, we’ll be left with an ongoing series no one wants to binge-watch. So, let’s raise a glass (of kale smoothie, of course) to a better healthcare future, shall we?
(Cover photo: János Kóka on June 16, 2020. Photo: Zoltán Balogh / MTI)
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At the round table discussion of the Great Private Practice Day, János Kóka talked about the financing of the care system, saying that sector-neutral financing cannot be a solution because the state budget lacks resources, and the health fund is missing 3-5 percent of GDP.
“It would be risky if, say, 100 billion of this were to go to private providers, leaving emergency, intensive, oncological and major surgical tasks to the state provider. In such a situation, sector-neutral financing would shift the use of scarce care resources from the direction of the inactive, pensioners, and expectant mothers to the active,” he said.
According to his view, a larger capital investment would be needed to put the infrastructural, organizational and human resources in order. As stated at the conference, a quarter of patient care in Hungary is already provided by private providers.
Private healthcare service as a cafeteria?
The former SZDSZ politician believes that additional insurance provided by companies as an income supplement to employees would be a better way. In addition to the additional payment of the health contribution, the workers could choose where they receive patient care, which would reduce the burden on the state care system, explained the former head of the ministry.
Balázs Rékassy added that it is already an existing practice in cultural countries that the state also buys waiting-list interventions from private providers. According to the doctor-economist, this can also work in such a way that the patient pays for faster care. The specialist also revealed that a senior official of the Ministry of Economy recently informed him that there will be no more money for the lack of health resources as long as 4.5 percent of GDP must be spent annually to finance the public debt. In his view, it is not possible to provide better quality care with the current funding, so those who are forced out of public care due to waiting lists and cannot afford private healthcare are in the worst situation.
This was confirmed by the economist Lívia Lengyel, a TOP30 Most influential actor editor-in-chief of the publication. As he underlined, sector-neutral financing has no raison d’être in such a resource-deficient system. Now, 2.5 percent of health care expenses in proportion to GDP are wage costs.
A hip replacement surgery costs roughly HUF 890,000, plus the cost of wage supplements, the latter of which is only financed by state hospitals from NEAK
– mentioned as an explanation how this could produce losses for private service providers.
János Kóka: The state system is wasteful
Péter Haraszti, the founder of TritonLife, said that even today there is a certain degree of sector-neutral financing, but this is not what I would like to see in the future, and there are no appropriate regulations for it. “Certain private companies now receive NEAK support, but service providers receive less compensation than the real cost for certain interventions, which is a construction from the past, and no new licenses have been issued in the last 5-7 years. The current financing and regulatory environment should be changed in order to create a better structure,” he explained.
János Kóka pointed out that these amounts have remained unchanged since 2018, while the costs have roughly doubled since then. According to him, the problem is not only that healthcare is underfunded, but also that resources are distributed poorly. Balázs Rékassy added that hospital managers today do not have much room for maneuver in this regard.
The state cannot or does not want to spend more on the care system, families have exhausted their financial means, but the companies would have the appropriate framework for this, with whom it would be possible to agree on the provision of additional insurance in exchange for a tax discount, with which, according to calculations, additional resources of 300 billion forints could come to the health sector. Through such a system, at least one million Hungarian families would have access to well-organized private healthcare
– explained the former SZDSZ politician. According to Péter Haraszti, the private sector strengthened in this way could take a significant burden off the state supply. The former head of the ministry also emphasized that further transformations would be necessary.
There are more than 100 hospitals in Hungary, half of which must be closed. Politics must finally own up to this mess
he declared. He explained all this by saying that people can receive better care at clinics with more experience in certain interventions. Balázs Rékassy added: the situation is similar in small-town obstetrics, and in addition, many ward doctors practice well past retirement age. “Don’t expect to save life after a heart attack where doctors see no more than forty such patients per year, but where at least fifteen thousand,” said János Kóka. According to him, the other institutions could be excellent social institutions.
Prevention could save a lot
Speaking about the National Health Insurance Fund (NEAK), he said that it is unable to perform its control functions as a real social insurance company, it is currently only a payment facility, and should immediately receive HUF 15 billion for its operation. As he highlighted, more emphasis should also be placed on prevention, which, according to his estimation, could mean a 1.5 percent GDP expansion for the economy, and a thousand billion HUF cost reduction for the health sector.
“Of course, this could not be achieved immediately, but after decades,” he added. In his view, one of the simplest measures leading to prevention would be, for example, to ban chips from school canteens and to increase the public health product tax by five times, as well as to promote healthy food and the consumption of fruits and vegetables in public education.
(Cover photo: János Kóka on June 16, 2020. Photo: Zoltán Balogh / MTI)
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Tion calls for a significant overhaul in the healthcare system, where a more controlled and efficient use of healthcare resources is critical.
### Examining the Private Sector’s Role
The ongoing discussions surrounding the privatization of healthcare in Hungary reveal a push towards integrated public-private partnerships. Kóka’s argument advocating for a system where private providers could alleviate the strain on public healthcare by offering additional insurance reveals the potential for innovation in financing healthcare. This could empower families, allowing them the choice of care without solely relying on public health resources.
As more discussions emerge about decreasing government spending on healthcare while ensuring access and quality, the solution may not lie strictly in privatization or conventional public funding alone, but in a balance that leverages both sectors effectively. The administrative hurdles and constant underfunding of the state system hinder improvement, emphasizing the need for both structural reforms and a collaborative approach between public and private sectors.
### Transformation Through Preventive Care
Implementing a preventive care model could offer a sustainable solution to Hungary’s healthcare crisis. Promoting healthier lifestyles, such as through healthier school lunches, can foster long-term change in public health outcomes which in turn could lead to reduced strain on the healthcare system. Kóka’s bold predictions of a GDP increase through healthy dietary shifts are significant, emphasizing the economic benefits of investing in public health measures.
Promoting health from an early age could foster a transformative effect in realizing both individual and societal health outcomes. Investing in preventive care not only addresses the immediate financial concerns but may also yield greater returns as overall public health improves.
### Concluding Thoughts
The dialogue surrounding the future of healthcare in Hungary stresses a need for creative solutions that integrate different funding sources, accountability, and efficiency in resource allocation. By reshaping financing structures and prioritizing preventive care, Hungary can navigate its current healthcare challenges and set the foundation for a more sustainable healthcare system. As we look ahead, it is clear that the need for transformative changes has never been more pressing, and innovative thinking will be vital in achieving these goals.
