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The free-market shift initiated after the end of the communist rule twenty years ago put a strain on the largely centralised, wholly tax-funded public health system, which required far-reaching reforms.^[1] These resulted in the creation of the National Healthcare Fund (Hungarian: Országos Egészségbiztosítási Pénztár), in 1993.^[2] The OEP, predominantly based on a social insurance system,^[1] is the public organization currently controlling the management of health care in Hungary.^[2] Eighty-three percent of the financing for the health care comes from taxes and other public revenues.^[3]

Participation in the insurance scheme is mandatory for everyone in the workforce, including also the self-employed.^[4] Unlike the previous system, the OEP is under supervision of the local governments, and authority is shared between the municipalities and the counties.^[2] Most private hospitals also operate under the OEP framework.^[2] Because of the past hiring policies, Hungarian hospitals often have redundancies of doctors, and a lack of nurses, resulting in an unproductive misuse of human resources.^[1]

So-called "gratitude payments", another communist legacy, require in practice a cash payment to have access to better treatments, and is caused by lower-than-average wages in the health sector.^[1] The current universal coverage system is believed to be the origin of the large budget deficits of Hungary, and the recent economic crisis made a health care reform a priority for the government.^[4] Attempts at reform were so far met with resistance in the management and in the workforce,^[5] and rapidly alternating governments have been unable to make lasting changes to the system, with many governments interrupting reform programs initiated by their predecessors.^[5]

Despite recent improvements, life expectancy in Hungary is still among the lowest in Europe, even lower than in other former eastern bloc countries;^[6] minorities, such as the Roma people, have a life expectancy up to ten years lower than for ethnic Hungarians.^[1] Medical treatment deemed "medically necessary" is provide free of charge for European citizens in the country.^[7]

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