Hungary

Hungary has a population of 9.7 million people (2021). The GDP per capita at Int$ 36,773is 25% lower than the European Union (EU) average at Int$ 49,024 (2021). Current health expenditure, expressed as a percentage of GDP, had an overall decreasing trend in Hungary between 2003 (8.12%) and 2019 (6.3%) and has historically been lower than the EU average, which has remained 9% or higher since 2003. Whereas per capita health expenditure has steadily increased both in Hungary (from Int$ 803 in 2000 to Int$ 2,408 in 2020) and in the EU (from  Int$ 1,815 in 2000 to Int$ 4,762 in 2020), Hungary’s health spending has been half the EU average  over two decades. 

Government transfers and compulsory contributions from employers and employees account for two thirds of all health care spending at 68.3%, pointing to high levels of out-of-pocket (OOP) spending. OOP spending as a percentage of current health expenditure in Hungary remained between 25 and 29% from 2000 through 2019, significantly exceeding the stable EU average of around 16% of current health expenditure for that period.  OOP rates decreased in 2020 due to additional public spending for the pandemic.

The Hungarian health care system has a single health insurance fund and is highly centralized. The  health insurance fund provides health care coverage for nearly all residents. The fund is administered by the National Institute of Health Insurance Fund Management, a government organization that has operated under the direct control of the Ministry of Human Capacities since 2017. The ministry has exclusive authority to  set strategic direction, control financing, determine benefit packages, and issue and enforce regulations. Contributions from employers are part of a larger social contribution tax, which also covers the pension fund. Citizens and foreigners working in the country are required to join the national social health insurance (SHI) system, ensuring 95% of them have coverage while 5% have unclear status. Most hospital spending is publicly funded, although coverage for ambulatory medical care, outpatient pharmaceuticals, medical devices and dental care is rather limited. 

Hungary has a strong health data and information system through its National e-Health Cloud, which allowed evidence-based decision making during the pandemic. Hungary plans to invest heavily in its health system until 2026, using EU grant funds to strengthen primary care, alleviate its heavy reliance on hospitals and increase doctors’ salaries to retain the health workforce.