[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v125y2021i7p833-840.html
   My bibliography  Save this article

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?

Author

Listed:
  • 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
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851021001123
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2021.04.014?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    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. 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.
    3. 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.
    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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Williams, Colin C. & Horodnic, Adrian V., 2017. "Rethinking informal payments by patients in Europe: An institutional approach," Health Policy, Elsevier, vol. 121(10), pages 1053-1062.
    2. Baji, Petra & Rubashkin, Nicholas & Szebik, Imre & Stoll, Kathrin & Vedam, Saraswathi, 2017. "Informal cash payments for birth in Hungary: Are women paying to secure a known provider, respect, or quality of care?," Social Science & Medicine, Elsevier, vol. 189(C), pages 86-95.
    3. Sofie Buch Mejsner & Leena Eklund Karlsson, 2017. "Informal Payments and Health System Governance in Serbia: A Pilot Study," SAGE Open, , vol. 7(3), pages 21582440177, August.
    4. Cherecheş, Răzvan M. & Ungureanu, Marius I. & Sandu, Petru & Rus, Ioana A., 2013. "Defining informal payments in healthcare: A systematic review," Health Policy, Elsevier, vol. 110(2), pages 105-114.
    5. Colin WILLIAMS & Ioana HORODNIC & Adrian HORODNIC, 2016. "Who is making informal payments for public healthcare in East-Central Europe? An evaluation of socio-economic and spatial variations," Eastern Journal of European Studies, Centre for European Studies, Alexandru Ioan Cuza University, vol. 7, pages 49-61, June.
    6. Petra Baji & Milena Pavlova & László Gulácsi & Miklós Farkas & Wim Groot, 2014. "The link between past informal payments and willingness of the Hungarian population to pay formal fees for health care services: results from a contingent valuation study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 853-867, November.
    7. Mæstad, Ottar & Mwisongo, Aziza, 2011. "Informal payments and the quality of health care: Mechanisms revealed by Tanzanian health workers," Health Policy, Elsevier, vol. 99(2), pages 107-115, February.
    8. Habibov, Nazim & Cheung, Alex, 2017. "Revisiting informal payments in 29 transitional countries: The scale and socio-economic correlates," Social Science & Medicine, Elsevier, vol. 178(C), pages 28-37.
    9. Gifford, Rachel & Molleman, Eric & van der Vaart, Taco, 2024. "It's a jungle out there: Understanding physician payment and its role in group dynamics," Social Science & Medicine, Elsevier, vol. 350(C).
    10. Ligita Gasparėnienė & Rita Remeikienė & Colin C. Williams, 2022. "Unemployment and the Informal Economy," SpringerBriefs in Economics, Springer, number 978-3-030-96687-4, October.
    11. Bíró, Anikó & Elek, Péter, 2020. "Job loss, disability insurance and health expenditure," Labour Economics, Elsevier, vol. 65(C).
    12. Li, Mingqiang & Li, Zhihui & Yip, Chi-Man (Winnie), 2022. "Informal payments and patients’ perceptions of the physician agency problem: Evidence from rural China," Social Science & Medicine, Elsevier, vol. 298(C).
    13. Wei Zhao & Qianqian Ben Liu & Xitong Guo & Tianshi Wu & Subodha Kumar, 2022. "Quid pro quo in online medical consultation? Investigating the effects of small monetary gifts from patients," Production and Operations Management, Production and Operations Management Society, vol. 31(4), pages 1698-1718, April.
    14. Mavisakalyan, Astghik & Otrachshenko, Vladimir & Popova, Olga, 2021. "Can bribery buy health? Evidence from post-communist countries," Journal of Comparative Economics, Elsevier, vol. 49(4), pages 991-1007.
    15. Gifford, Rachel & Molleman, Eric & van der Vaart, Taco, 2022. "Two sides to every coin: Assessing the effects of moving physicians to employment contracts," Social Science & Medicine, Elsevier, vol. 292(C).
    16. Danyliv, Andriy & Groot, Wim & Gryga, Irena & Pavlova, Milena, 2014. "Willingness and ability to pay for physician services in six Central and Eastern European countries," Health Policy, Elsevier, vol. 117(1), pages 72-82.
    17. Sofie Buch Mejsner & Maria Kristiansen & Leena Eklund Karlsson, 2021. "Civil Servants and Non-Western Migrants’ Perceptions on Pathways to Health Care in Serbia—A Grounded Theory, Multi-Perspective Study," IJERPH, MDPI, vol. 18(19), pages 1-17, September.
    18. Sonila Tomini & Wim Groot & Milena Pavlova, 2012. "Paying informally in the Albanian health care sector: a two-tiered stochastic frontier model," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(6), pages 777-788, December.
    19. Schmidt, Andrea E. & Merkur, Sherry & Haindl, Anita & Gerkens, Sophie & Gandré, Coralie & Or, Zeynep & Groenewegen, Peter & Kroneman, Madelon & de Jong, Judith & Albreht, Tit & Vracko, Pia & Mantwill,, 2022. "Tackling the COVID-19 pandemic: Initial responses in 2020 in selected social health insurance countries in Europe☆," Health Policy, Elsevier, vol. 126(5), pages 476-484.
    20. Luck, J. & Peabody, J.W. & DeMaria, L.M. & Alvarado, C.S. & Menon, R., 2014. "Patient and provider perspectives on quality and health system effectiveness in a transition economy: Evidence from Ukraine," Social Science & Medicine, Elsevier, vol. 114(C), pages 57-65.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:125:y:2021:i:7:p:833-840. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.