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The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?

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  • Gaal, Peter
  • Velkey, Zita
  • Szerencses, Viktoria
  • Webb, Erin

Abstract

Hungary, like many countries, features a complex mix of the public and private sector in the financing and provision of health care services. At the same time, the health system also faces challenges related to shortages of health professionals, low public financing, and informal payments. With the added pressure from the COVID-19 pandemic, Hungarian policymakers acted rapidly to pass a sweeping regulation aimed at these issues. Over two days, the Hungarian parliament introduced and unanimously approved a new regulation, Act C of 2020 on the Employment Status of Health Workers, that replaces the existing public employment relationship between health professionals, public providers and their controlling authorities. The Act, passed on 6 October 2020, brings the employment of health workers under strict central control by introducing a new employment status similar to that of the armed forces. The Act also provides doctors with an unprecedented 120% salary increase and criminalizes informal payments. The reception has been overwhelmingly negative, with thousands of health professionals indicating that they would not sign the new contracts, and the policy also contains serious technical and feasibility concerns. Although the first statistics show that only about 3-5% of the active workforce did not sign the contract by 1 March 2021, the implementation of the reform still faces serious challenges.

Suggested Citation

  • Gaal, Peter & Velkey, Zita & Szerencses, Viktoria & Webb, Erin, 2021. "The 2020 reform of the employment status of Hungarian health workers: Will it eliminate informal payments and separate the public and private sectors from each other?," Health Policy, Elsevier, vol. 125(7), pages 833-840.
    • Handle: RePEc:eee:hepoli:v:125:y:2021:i:7:p:833-840
    DOI: 10.1016/j.healthpol.2021.04.014
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    References listed on IDEAS

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    1. Peter Gaal, 2005. "Benefits and entitlements in the Hungarian health care system," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 37-45, November.
    2. Gaal, Peter & Evetovits, Tamas & McKee, Martin, 2006. "Informal payment for health care: Evidence from Hungary," Health Policy, Elsevier, vol. 77(1), pages 86-102, June.
    3. Quentin, Wilm & Geissler, Alexander & Wittenbecher, Friedrich & Ballinger, Geoff & Berenson, Robert & Bloor, Karen & Forgione, Dana A. & Köpf, Peer & Kroneman, Madelon & Serden, Lisbeth & Suarez, Raúl, 2018. "Paying hospital specialists: Experiences and lessons from eight high-income countries," Health Policy, Elsevier, vol. 122(5), pages 473-484.
    4. Gaal, Peter & McKee, Martin, 2005. "Fee-for-service or donation? Hungarian perspectives on informal payment for health care," Social Science & Medicine, Elsevier, vol. 60(7), pages 1445-1457, April.
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    Cited by:

    1. Winkelmann, Juliane & Webb, Erin & Williams, Gemma A. & Hernández-Quevedo, Cristina & Maier, Claudia B. & Panteli, Dimitra, 2022. "European countries' responses in ensuring sufficient physical infrastructure and workforce capacity during the first COVID-19 wave," Health Policy, Elsevier, vol. 126(5), pages 362-372.

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