Real existing Orbánism

700 000 people without healthcare

Parliament voted to ban healthcare provision to roughly 700 thousand Hungarians if they cannot pay for it. 50 thousand of them couldn’t even pay for it if they wanted to, because it requires a legal address.

But don’t worry, homelessness is illegal so it’s their choice.

I hate talking about Hungarian healthcare abroad because both the free helathcare supporters and their opponents are mistaken and wrong.

The free healthcare enthusiasts are so smitten by the dream of not having to pay that they completely disregard that it costs a lot more than it raises in taxes (even before corruption) so free healthcare will always be kicking a huge can of debt down the road. And corruption in state healthcare is just as certain as corruption (overpricing) in the US-style “private” healthcare misery – so that will cost even more.

But supporters of private healthcare are also willfully blind to the unholy alliance between state and private healthcare providers (insurers, etc.) to milk the easy money (taxpayers) wherever they can. They are so fixated on the morality of healthcare payments that they forget that it is simply not possible. The root of morality is to keep the choices and their consequences at the same individual – but health is not really a good field to apply that principle. There are accidents to begin with. But even if we blame the victims for the accidents, we still have illnesses that we don’t know how to prevent – excluding the possibility of assigning moral blame for them. If medicine could tell us with 100% certainty what to do to prevent all illnesses it would be different. But as of now the attempts to moralize who should pay for certain illnesses are simply just moral gloating.

Hungary has been laboring under the free healthcare illusion since the 1970s, when the country started to get in debt with international organisations in exchange for pseudo-market reforms. They used the debt to buy off the population with sweeteners like importing (the state!!!) real coffee and offering free healthcare and education. The well-meaning efforts to introduce semi-private enterprise into the economy have later turned out to be a mistake, as people internalized that entrepreneurs are crooks, that the easy money is state money – and that no matter how they fail, they will always get free healthcare, free schooling, etc. The quality of those free stuff has been in steady decline ever since. And the unholy mix of private and state financing has been poisoning everything, including healthcare.

Last time I found myself in a state hospital (despite being a patient of the most expensive private healthcare provider, paying on top of my state contribution), I witnessed equipment from the 70s still working, even if with a scary noise. I walked corridors that may or may not have been painted since 1970, tried to give urine samples in dedicated bathrooms that had no toilet seats, toilet paper, sink, towel, or chain to flush the toilet, and I spent hours looking at a faded felt tip drawing of a pair of lungs, neatly framed outside a radiology room – helpfully dated 1976. That framed drawing hasn’t been removed since 1976, maybe the wall hasn’t been painted either. Inside the radiology examination room, the only working X-ray machine was working at full capacity, the operators grey and thin like zombies, their protection suits mended with duct tape, but still emitting a drizzle of lead filling they periodically swept off the floor. Their robot-like dedication is all the more painful to watch if you know that they take home less than 400 euros a months – minus debt repayments. And when it came to my surgery, the window was open and pigeons were messing on the tree outside, because there is no air conditioning in operation theaters and doctors are fainting during surgery. I am not talking about some remote, village hospital. It was downtown Budapest in 2019, in the country’s leading university hospital.

There are plenty of fallacies and thinking failures surrounding the concept of free-for-all state healthcare. While advocates of it in the west are salivating at the prospect of never having to pay for healthcare again – the Real Existing Free Healthcare is kicking its last kicks in countries where it was actually introduced. Because it provides its own corruption possibilities for the crooks – just as the weird US pseudo-private, state-overregulated chaos does for insurers and hospitals.

But opponents of free healthcare are also an unpleasant bunch riddled with fallacies – one of them being that Orbán is somehow building a private healthcare system. But no. Crony-owned and state supported by subsidies and preferential legislation is not private healthcare. It is just another name for the same unholy mix.

The Orbán-government is making a point of starving the state healthcare system it inherited from the pre-1989 autocracy (called communism). Consecutive governments since 1989 have been confronted with the need to salvage it somehow – without any major effort done. The last time someone tried to make up for its financing shortage was voted down on a hyper-populist referendum led by Orbán himself – a move that cemented him as the nemesis of market-based healthcare.

But Orbán is nothing if not a chameleon. Whatever his momentary political or financial interest, he makes it look like it has always been The National Interest. (By which he really means that he is the nation.) So when he saw money in private healthcare, he made it possible and his cronies are now building private hospital buildings and “superhospitals” (whatever that might be). Where they will get the doctors and nurses in them is a mystery though. And unless Siemens decide to open diagnostic medical equipment factories in Hungary and the government starts to spend on diagnostic equipment to keep Siemens happy I can’t see how the new superhospital buildings will be populated with actual equipment.

And now he can parade around in the west and make dumb conservatives nationalists salivate at his market-based reforms.

So when it comes to Orbán’s free healthcare – it doesn’t let you off the hook and let you opt out of paying into the crumbling free healthcare system – but it also doesn’t serve actual poor people. They will now be turned away from hospitals without a valid social security number – and it gets invalidated if they fail to pay for three months. And for those who are homeless? Well, homelessness is illegal to begin with, so they have only themselves to blame that they don’t have a legal address, which is prerequisite for paying in the minimal social security contribution every month and get the bare minimum of a chance to maybe seeing a doctor one day.

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