The inequity of informal payments for health care: the case of Hungary. 2006

Agota Szende, and Anthony Johr Culyer
Covance Health Economics and Outcomes Services, Springfield House, Hyde Street, Leeds LS2 9LH, UK. szende@btinternet.com

As in most countries of Central and Eastern Europe, informal payments have been a characteristic feature of the Hungarian health care system both during and since the demise of Soviet type socialist rule. Although informal payments continue to be so characteristic in the region, little empirical evidence exists on their scope or working. As far as equity is concerned, it has sometimes been suggested that physicians play a 'Robin Hood' role and subsidise the poor at the expense of the rich. With the aid of an interview survey of a representative sample of the Hungarian population, we examine the distribution of the burden of informal payments across income groups. Results indicate that informal payments are a highly regressive way of funding health care, with Kakwani progressivity indices of -0.38, -0.39, -0.35 and -0.36 for GP, outpatient specialist, hospital, and total care, respectively. The finding that people with lower income pay proportionally more for public health care through informal payments underlines the emptiness of the 'Robin Hood' claims and the need for reform.

UI MeSH Term Description Entries
D007407 Interviews as Topic Works about conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes works about school admission or job interviews. Group Interviews,Interviewers,Interviews, Telephone,Oral History as Topic,Group Interview,Interview, Group,Interview, Telephone,Interviewer,Interviews, Group,Telephone Interview,Telephone Interviews
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011203 Poverty A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level. Federal Poverty Level,Federal Poverty Threshold,Indigency,Low-Income Population,Absolute Poverty,Extreme Poverty,Indigents,Low Income Population,Federal Poverty Levels,Indigent,Level, Federal Poverty,Low Income Populations,Low-Income Populations,Population, Low Income,Population, Low-Income,Poverty Level, Federal,Poverty Threshold, Federal,Poverty, Absolute,Poverty, Extreme
D003695 Delivery of Health Care The concept concerned with all aspects of providing and distributing health services to a patient population. Delivery of Dental Care,Health Care,Health Care Delivery,Health Care Systems,Community-Based Distribution,Contraceptive Distribution,Delivery of Healthcare,Dental Care Delivery,Distribution, Non-Clinical,Distribution, Nonclinical,Distributional Activities,Healthcare,Healthcare Delivery,Healthcare Systems,Non-Clinical Distribution,Nonclinical Distribution,Activities, Distributional,Activity, Distributional,Care, Health,Community Based Distribution,Community-Based Distributions,Contraceptive Distributions,Deliveries, Healthcare,Delivery, Dental Care,Delivery, Health Care,Delivery, Healthcare,Distribution, Community-Based,Distribution, Contraceptive,Distribution, Non Clinical,Distributional Activity,Distributions, Community-Based,Distributions, Contraceptive,Distributions, Non-Clinical,Distributions, Nonclinical,Health Care System,Healthcare Deliveries,Healthcare System,Non Clinical Distribution,Non-Clinical Distributions,Nonclinical Distributions,System, Health Care,System, Healthcare,Systems, Health Care,Systems, Healthcare
D005260 Female Females
D005382 Financing, Personal Payment by individuals or their family for health care services which are not covered by a third-party payer, either insurance or medical assistance. Personal Expenditures,Expenditure, Personal,Expenditures, Personal,Personal Expenditure,Personal Financing
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006814 Hungary A country in Europe, northwest of Romania, south of Slovakia, and east of Austria. The capital is Budapest.
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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