The first Orbán government and healthcare reform

The other day I wrote about Viktor Orbán's predicament as far as Hungarian doctors are concerned because they were instrumental in helping Orbán to the pinnacle of his career by their fierce opposition to healthcare reform. I pointed that the Hungarian Medical Association and the leaders of hospitals didn't even wait for the second round of voting; they already presented their demands to the new government. Although for political reasons Fidesz in opposition was opposed to any reform, the party leaders know full well that pouring more money into healthcare without enacting structural changes is a waste of money.

Lajos Molnár's book is full of interesting tidbits about the first Orbán government's plans as far as healthcare reforms were concerned. The upshot is that in many ways the Fidesz plans were much more radical than what later, in opposition, they refused to support. When Molnár became minister of health he found all sorts of documents in the ministry which reveal the extent of these proposed changes.

Molnár quotes István Stumpf's book entitled Végjáték (Endgame, 2008) in which the former minister states that the Orbán government "was unable the realize its ambitious plans." The reason? Stumpf is silent on that score. Viktor Orbán's first choice for minister of health was Árpád Gógl who did practically nothing for two years while his successor, István Mikola, "made some changes but he didn't have anough time." Gógl prior to his appointment as minister of health was–of all things–president of the Hungarian Medical Association! So it is not surprising that he wasn't eager to introduce any change that would be opposed by the medical establishment. His successor, István Mikola, although he talked a lot, in the end achieved little. Molnár's conclusion is that the first Orbán government didn't dare to go against the medical establishment.

Within Fidesz there was a group of people that labored diligently to come up with a workable reform. One can read details of the Fidesz reform plans in the 1998 party program, which were very similar to the ones Lajos Molnár tried to introduce. The reforms envisaged by the Fidesz politicians included a reduction in the number of hospitals. There are over 100 hospitals in the country when according to most experts only 50 would do just fine. Moreover, some of these hospitals offer inferior services, which might explain some of the shortcomings of Hungarian medicine. However, Fidesz politicians knew that such a move would meet with incredible resistance from the medical establishment. So they didn't even try to implement it. Another plan was a restriction in the free choice of specialists. As it stands now patients pick their own doctors, a privilege that requires slipping some money under the table. The Orbán government wanted to put an end to this by saying that anyone who wanted to have her own obstetrician or surgeon would have to cough up "part or all of the cost." I might mention here that Molnár's plans included only a 30% surcharge in the event that the patient insists on his own doctor.

The first Orbán government was originally planning to introduce co-pay "for the benefit of private insurers." It was a far cry from the 300 Ft ($1.50) co-payment introduced by the Gyurcsány government that would have benefited the doctors and the hospitals. The Orbán government was thinking of a universal basic medical package with a minimum insurance premium; any additional services would be covered only by taking out additional insurance. So, in brief, all those reforms that Lajos Molnár tried to introduce had already been contemplated by the first Orbán government. However, in opposition for political reasons Fidesz fought against every structural change and stood by the medical establishment. In fact, only a couple of months ago Orbán wrote a letter to the directors of hospitals telling them that the time was not far off when the savior was coming and their sufferings would be over.

How will Viktor Orbán tell these people so full of expectations that reforms are necessary whether they like it or not and that there is no more money to throw into a bottomless pit? Especially since he himself knows that things cannot remain as they are. I really wouldn't like to be in his shoes. It was easy to oppose everything. It will be much more difficult to cool the expectations that he himself raised so high.

5 comments

  1. have i ever said “just because it said so”? no – i judge on ACTIONS and EVIDENCE. you have completely ignored jobbik’s conduct in the elections – and most of what i just wrote. did jobbik break the campaign spending limits? no. does jobbik maintain illegal voter databases? no. does jobbik’s program (and “rhetoric”) support increased anti-corruption and political transparency measures, as well as the decentralisation of powers? yes.
    you honestly think jobbik will “dismantle democracy”? or are not “respecting the democracy”? with what evidence? (reporters referring to jobbik as “facist” is not evidence. it is bias – the enemy of free debate.) jobbik have never said any words to this effect and never will.
    what most people “see in jobbik” is the disgusting picture the media paints – until they bother to acquaint themselves personally with the party and sees the media lies for what they are.
    “As you are surely a Jobbik supporter, you can’t see things clearly enough.” are you trying to imply that anyone who supports jobbik is too dumb to be critical of them? would you make this statement about an mszp or lmp supporter? i was not born a jobbik supporter. i had never heard of the party until recently when newspapers started calling them “facists”. at which point i decided to investigate these claims for myself, being personally opposed to corruption and dictatorship in any form. what i found in jobbik was the total opposite of what is reported – i realised i had merely been as misled by the media as you are now.
    “You can tell that you are democratic as much as you like, but people wont believe you. Because the leaders of Jobbik publicly told things that a democratic leader wouldn’t ever say.” i noticed (as usual) you have no evidence to support this, nor any of your other spurious (ridiculous, and irrelevant) historical comparisons. note that mr gyurcsany set the bar rather low for “democratic leaders” with his famed speech. i am yet to hear vona gabor say such things. nor has vona said anything like “we are buying up hungary” (or anywhere else) which according to the media was entirely fine for mr peres to say as a “democratic leader”. is the chinese communist party a “democratic party”? i haven’t heard of any US dipolmatic boycotts against them this year…
    “the observable intention matters too.” the “observable intention” is spelled out quite clearly in their election program – which you won’t have read im sure. find out what jobbik ACTUALLY stand for here: (if you can’t read hungarian)
    http://jobbik.com/temp/Jobbik-RADICALCHANGE2010.pdf
    if you are looking for a racist, facist, undemocratic party, you will be sadly disappointed to find nothing of the sort in jobbik. the shameful lies directed (solely) against this party should disgust any true democract who favours honesty and debate over smears and boycotts (like i do).
    but what do evidence and truth matter when we are fighting “nazis”, right steve? the media is perfectly unbiased and without any agenda at all, right steve? anyone who isn’t a liberal is “undemocratic”, right steve?

  2. what i mean is that jobbik’s website is the only place to get unbiased information on what the party’s program actually is. i recommend you read what they actually stand for before you scream “nazi” and “facist”.
    ah yes the spiegel. i was wondering when jobbik would start featuring in their weekly “nazis under the bed” story.
    i assure you pete that i am well informed on what the western media says about jobbik. unlike you however, i am also personally well informed as to what the members of jobbik are really like (in REAL LIFE). the difference is enormous. when articles in a german mazagine contradict what i have seen with my own eyes, i can’t help but question who are the real pigs here.
    i had already read that article. if you can’t see its strong bias and its attempts to draw parallels between unrelated political movements almost a century apart, you are blind.
    “Two young men raise their right arms in a Nazi salute and a shout goes up, first tentatively, then louder: “To the concentration camp, to the concentration camp.””
    it is obviously implied that these “young man” are – and could only possibly be – members of jobbik. therefore random nazis = (must equal) = jobbik. that is not professional journalism – that is gutter smearing and obvious bias.
    “red and white striped, much like the armbands worn by members of Hungary’s fascist Arrow Cross Party during World War II.”
    “red and white striped” and also just like the nation’s coat of arms! therefore all hungarians must be facists!? as if the arrow cross party invented the arpad stripes. this is, of course, not mentioned in an article designed for fear-mongering, rather than giving accurate information.
    “One speaker claims that Israeli investors and their local agents are in the process of buying up the country with its 10 million inhabitants.”
    you might also note that this is what Shimon Peres, president of israel said himself. this is not mentioned in the article either. is there any other way of interpreting the sentence “we are buying up hungary”? does repeating what the israeli president said, in context, make one an instant nazi? this article is misleading in the extreme.
    there are numerous other deliberately misleading omissions made in this article. even a liberal like yourself should be able to recognise a one-sided piece of clear propaganda like this.
    i always love it how the cause of hungarians’ anger is supposedly that “It was only through a €20 billion ($27 billion) loan from the International Monetary Fund, the World Bank and the EU that Hungary was able to avert national bankruptcy.” no mention of why hungary needed this loan in the first place. another deliberate omission.
    apparently wearing rooster feathers in one’s hat also makes one an instant nazi, preparing to deport jews. i ask again – is this an unbiased article?
    pete if this is how you get your information on jobbik, i can understand why you would think they are nazis. do you really believe everything you see on tv? use your brain for a second, and think why it is that the media and the corrupt hungarian left hate jobbik so viciously. you might also figure out why they have such strong support in the “Real” hungary, far from media propaganda.

  3. find out what jobbik really thinks of facists:
    http://www.jobbik.com/jobbik-announcements/3168.html
    jobbik describes the arrow cross as “a tyrannical four month long government in Hungary complicit in the holocaust.”
    jobbik describes anti-gypsy violence as “terrible crimes”
    jobbik explains (about gypsies) that “the socio-cultural economic circumstances of such people, that has led to the predominant commission of certain types of crimes; and it has nothing at all to do with their ethnic origin.”
    none of this sounds like the rhetoric of racist, violent, arrow-cross facists to me at all. read the jobbik’s article before posting another “but the media told me jobbik are nazis” story, please.

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