CEU Electronic Theses and Dissertations, 2019
| Author | Simon, Péter |
|---|---|
| Title | The Hungarian Healthcare System's U-Turn: Recentralization and Soft Budget Constraint in the Hospital Sector |
| Summary | Although the healthcare system of Hungary could be improved in various ways, this thesis focuses on the most prevalent problems and uses a top-down approach to suggest reforms. The system went through a transition process which resulted in the emergence of market elements in the 1990s and early 2000s. However, as Kornai (2015) described Hungary’s transition in general, a dramatic U-turn came about afterwards. The thesis reveals this U-turn in relation to the governance and financing of the healthcare system showing how centralization has become significant in recent years. Both theoretical (e.g. soft budget constraint) and practical (e.g. bed occupancy rate, share of private expenditures) elements are examined. Soft budget constraint’s presence is supported by the reaccumulating hospital sector debt and the political importance of it following a similar cyclical path. This is shown with text analysis using minutes of the Parliament, a so-far unexplored method in this area. Besides, results of data envelopment analysis demonstrate that the rise of this debt is not associated with any improvement in the technical efficiency of hospitals. Further analyses present the recentralizing tendency of the current decade with the decreasing role of voluntary payments and increasing significance of central budget contributions in the Hungarian healthcare system. Policy recommendations include the restoration of local governments’ ownership of hospitals, making hospital managers responsible for the cost-effectiveness of their institutions and the reduction of hospital beds. |
| Supervisor | Mihályi, Péter |
| Department | Economics MA |
| Full text | https://www.etd.ceu.edu/2019/simon_peter.pdf |
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