Like governments the world over, Hungary is seeking ways to rein in spending on health care. If anything, the problem may be even more acute for the Fidesz party-led Hungarian government, which has the highest debt-to-GDP ratio in Central and Eastern Europe and aims to trim its budget deficit to close to 3% of GDP this year.
The government and the countryâ€™s pharmaceutical industry are at loggerheads on how to best tackle the issue of bringing down the roughly 340 Billion forints (1.84 billion dollars), or 1.4% of GDP, Budapest is spending on subsidizing drugs. While the government proposes to cut the subsidies, the pharmaceutical lobby suggests levying a new tax to help raise the money to keep the subsidies flowing.
While the industryâ€™s proposal will do little to address the issue of outsized spending on healthcare, the lobby does address an important issue. They want the extra tax income to be spent on higher wages for physicians and other healthcare professionals.
Hungarian doctors including job starters, have been leaving the country in increasing numbers to seek higher wages elsewhere in Europe. Some of them work part-time in neighboring Austria or even hop on a plane to work weekends, or for a week or two each month in the U.K.
Latest data from Hungaryâ€™s health care license office, or EEKH, shows that 1,777 health care workers requested a license to work abroad last year, more than twice as many as just four years ago. Within that, the number of doctors wanting to work abroad totaled 1,111, double, again from 2006. The most popular country of destination was the UK, followed by Germany, Austria, Ireland and Sweden.
Those aged between 25 and 44 were most keen to go abroad in recent years, but the numbers pf those hardly out of med school also started rising sharply.
While those numbers may seem low, the departure of doctors for better pay elsewhere is reducing Hungaryâ€™s quality of health services. The number of doctors per 1000 Hungarians was 3.1 in 2008, Organization for Economic cooperation and Development figures show, ranking Hungary above Finland, the UK and Japan. Not to mention the doctors training costs to the taxpayers.
Faced with the prospect of relatively poor pay, many of those doctors who have the opportunity and the ability are opting to leave.
Dentists, gynecologists, plastic surgeons or dermatologists â€“ those who can have a private practice â€“ can live well-off. Not least, because they can take in patients from abroad who travel to Hungary because of the relatively cheap service there. But an anesthesiologist or a radiologist – who can hardly conduct a practice outside the mostly state-run health sector- has not much choice. Many doctors have become drug sales agents for a higher wage, a company car and other benefits.
A specialized doctor earned a gross HUF 4.18 million, or 20,700 dollars a year in 2009, data from the National Employment Service NFSZ show. Thatâ€™s the official figure, but wages are so low that many health care workers do accept additional payment, untaxed and illegal, termed parasolvency, from their patients, who feel obligated and ready to pay extra in hope for extra care.
The government has turned down the drug associationâ€™s proposal to use the extra tax to raise health sector wages. The number of doctors wanting to work abroad will likely continue to rise and parasolvency will remain an accepted form of gratitude for doctors and nurses.
Are you affected by this situation?
Is it the same in your country?
How will this affect your future?
Are you a doctor that wants to work abroad because of these reasons?