Act XCVI of 1993 on Voluntary Mutual Health Funds created Hungary’s legal framework for complementary insurance schemes. However, in 2003, the government abolished the risk-pooling element of the system. Currently, the system operates as a pure medical savings account (MSA) scheme (see Section 3.5 in the 2011 Hungarian HiT).
By the end of the second quarter of 2023, Hungary had 16 voluntary health funds, covering almost 1.1 million residents, an increase of 33,000 members compared to the end of last year. An increasing number of people pay out of pocket for private health services due to difficulties accessing public care (for example, long waiting lists). Those contributing through a health fund are entitled to a tax refund of 20% of their payment, with a maximum of HUF 150,000 (€395) per year.
According to recent data from the National Bank of Hungary (MNB), voluntary health fund services saw a 26% increase in the first half of 2023 compared to the same period in 2022, totaling HUF 38.86 billion (around €102 million). Notably, expenditures for supplementing or replacing social security health services (for example, private doctor, diagnostics, etc.) rose by 34%, now constituting 40% of all health fund expenditures, up from 19% a decade ago. Pharmaceutical expenditure increased by 23% to HUF 15 billion (around €40 million), while expenses for medical aids rose by 23% to HUF 5.5 billion (€14.5 million).
The soaring expenses (and payments) pose a significant access barrier for the population. A survey conducted by the Premium Health Fund, with more than 10 000 participants, investigated how fund members experienced the negative economic changes over the past year. The findings revealed that while 45% reported no change in their financial situation, 40% experienced a deterioration in their standard of living. Despite attempts to save, 33% had to increase family healthcare expenses. Participants cut back spending on food supplements (37%), private doctors (34%), and healthy eating (29%). Two-thirds of respondents reported unmet needs due to financial difficulties. While most people postponed dental treatments (32%), people also missed private medical appointments, diagnostic procedures, and physical therapy.
According to the survey, the majority of respondents use private medical care. While some find these increasingly expensive, leading them to prefer public healthcare, more are forced to use private doctors due to limited access to state-funded care.
The survey data indicates a negative shift in patients’ perceptions of the accessibility of public healthcare. Meanwhile, the continuous decrease in purchasing power limits their ability to access appropriate care through private providers. These factors can result in long-term adverse health and pose prolonged challenges for the healthcare system.