President Sólyom and the Hungarian health care reform

Surprise, surprise!  Sólyom didn’t sign into law the proposed health care bill. Not that for a moment I thought he would just sigh and sign, but I was afraid that he would send the bill to the Constitutional Court for review. Because it seems to me that if President (formerly Chief Justice) Sólyom sends something over to the Constitutional Court, especially if he points out to the honorable members what he sees as problematic, you can bet your bottom dollar that the honorable members will wholeheartedly agree with the former chief justice on every point. (If for no other reason Sólyom’s former position on the court should have precluded him from consideration as a presidential candidate, but I have the feeling that those who came up with his name never thought of this particular problem.)

In any case, one can be quite happy that he decided only to send the bill back to Parliament for further consideration because, if all goes well, that will be the end of the story. If–with or without change–the parliamentary majority votes again to approve the bill, according to the Hungarian constitution Sólyom will have to sign. Right now the socialists and the liberals swear that they will not waver. However, the bill has to be discussed once again in committees and in full session, and if the government parties decide to wait until the first days of the normal parliamentary session the whole painful business will go on again for at least two more months. Meanwhile, of course, the opposition will be also active and there will be renewed propaganda against the reforms. There may be new strikes, further threats from the Hungarian Medical Association. In brief, all the horrors of the last year and a half will be repeated again.

The letter Sólyom wrote to Katalin Szili and the Parliament is an interesting document. In the preamble of the six-page letter, he summarizes his objections. First he disapproves of "the methods of the bill’s framing." Second, according to him "the bill doesn’t contain all the necessary guarantees." And third, "the bill’s effects are uncertain." One could, of course, say: indeed, the only certainty in this life is death (which may be expedited if Hungarian health care isn’t improved).

According to Ferenc Kumin, earlier "political scientist" now the "famulus" of Sólyom–as one of his critics called him, the President has been diligently consulting with experts on health care issues. The problem with "experts" in general and in Hungary even more so, is that there are right-wing experts and left-wing experts. Experts on both sides have all sorts of titles and positions but not suprisingly they hold entirely different views on almost everything under the sun. Knowing Sólyom, I’m sure he invited both sides, inquired about their opinions, and then picked and chose whatever he liked. The result is a patchwork of often contradictory opinions.

Sólyom emphasizes that such a far-reaching reform as this health care bill must be based on consensus in parliament. It cannot become a political football. Unfortunately, it has already become one: the Fidesz refuses any kind of cooperation with the other parties in this question or anything else. But I don’t think that Sólyom’s chiding of Fidesz will make the slightest difference in this respect. Sólyom also bemoans the lack of trust on the part of the population without which, according to him, no such far-reaching and important law should be enacted. The only thing he seems to forget that it is the Fidesz, with a great deal of help from the medical establishment, that foments the dissatisfaction.

Another complaint is that no "impact study" was undertaken during the preparation of the bill. But health care reform is exceedingly complicated, and it’s virtually impossible to foresee all possible ramifications. Moreover, I think that most impact studies are simply wasteful bureaucratic exercises.

While Sólyom goes into great detail about the extra cost of running several funds and therefore seems to support one centralized system and national solidarity (i.e. everybody according to his means and everybody according to his needs), he complains about the lack of real competition which, according to him, can be achieved only through competition among the health providers. But this, to my mind, means privatization of hospitals, something which would be an even more radical departure from the earlier socialist system.

I’m sure that they will be many comments from real health experts on Sólyom’s epistle. Here I have just jotted down my first thoughts on the document.