System Decay

Hospitals run out of money two months into the year and can’t order supplies because Orbán is angry if they go into debt

Orbán has been raging because hospital directors dared to keep ordering supplies – even when their funding ran short. And just how early in the year it happens? Now we know: February. 

„A 35-year-old man was brought to the hospital with botulism. The medication is currently unavailable in Hungary and to get it imported would have cost 2 million forints. … Our monthly allowance had already been spent, but if we don’t import the medication, the man dies. The stakes: I get into jail or I sentence a young man to die. I authorized this one just as I authorize every such request they put on my table. I have my explanation about every item of overspending that hit my desk.” 

When asked when he can be taken to jail for this, the doctor said “whenever they want. They have every legal authorization to do so. But it may also happen if someone sues me for insufficient treatment causing permanent health damage or a death of a loved one. In this situation only those who come with cheap and easily fixable problems don’t send us into bankruptcy.” 

State healthcare is wasteful and low quality. It is also kicking its last in Hungary, leaving out hundreds of thousands from healthcare while exposing the rest to subhuman hospital conditions and rampant corruption in the form of bribing doctors for attention.

Doctors and nurses are in extremely short supply, they are breathtakingly underpaid and overworked, and when one drops dead, an entire town or district scrambles to replace him.

Hospitals, in the meanwhile, are also old crony cemeteries. It has been under communism, and it has been ever since. Orbán didn’t use his 10 years of unlimited power to do anything about it. (The contrast with his lavishly financed football mania is well warranted as both healthcare and spectator sports are financed by the taxpayer.)

After the 2019 municipal election non-victory healthcare has been one of the issues identified as dangerous to Fidesz. It is a miracle that Orbán’s core supporters (50+) haven’t chalked it up to him yet. Cancer deaths, preventable deaths, hospital infections, emergency room overcrowding, ambulance call time – they all lag way behind European standards. (So does healthcare spending but that’s a stupid metric – by that logic the US should be paradise.)

But even after Orbán apparently decided to finally address healthcare after a decade of defiant silence and patient-blaming, he still couldn’t say anything that wasn’t completely tone deaf and didn’t betray his disgust with public healthcare users.

At the only press conference he gives in a year (a new invention that is carefully crafted in a way that it doesn’t really pose a publicity risk to him) he addressed healthcare, for instance. The mere fact that he did it was extraordinary – Fidesz simply ignores topics that are not in their interest. But the way he addressed it opened the penknife in your pocket – as Hungarians put it.

Instead of promising something shiny that they won’t keep in the end (the go-to tool of every politician these days) Orbán got angry decided to elaborate. And he really shouldn’t have. He promised (in true micromanaging, command economy style) to have every waiting room and ward painted in hospitals. And he literally listed every type of room a patient might see in a hospital.

A lick of paint. No salaries for doctors, no reform for the irrational financing and the corrupt system of doctors’ bribes, no stupid promise that he will single-handedly fix healthcare. None of those things. Only a lick of paint – and even that must come off the already scarce budget of buying diagnostic equipment. (Waiting list for an MRI treatment is months-long, once the national cardiology center turned out not to have a heart-CT and surgery patients with open chest had to be ferried between hospitals.)*

Then he finished his train of (angry) thought by blasting hospitals for daring to go into debt – i.e. keep ordering gauze and medications even after their annual funding runs out. Because it is illegal for them to go into debt, you see? And that’s more illegal than letting patients die.

We are already used to bringing our own supplies, food, medications, gauze, even a relative to take care of us because nurses don’t have enough time. We are used to having no air conditioning and having our surgeries by open windows. We are used to irritated, overworked hospital staff because we know they are not paid and can’t say no to overtime.

Now we will get painted walls – a crony’s dumb construction company will get the job.

Orbán has been raging because hospital directors dared to keep ordering supplies – even when their funding ran short. And just how early in the year it happens? Now we know: February. 

By the end of January, over a half a dozen hospitals stopped ordering supplies because their accounts at the central budget is overdrawn and they are not allowed to buy anything on debt. Now Orbán can rant at them for letting patients die. No one even talks about reforms – but every single statistics, as gloomy as they are – keep turning out falsified and manipulated. That’s what we get: statistics and communication. And the occasional roaring righteousness.

And Orbán’s solution to hospitals’ existing debt? He gave producers of healthcare supplies an offer they can’t refuse: We pay 80% of what you are owed. Take it or leave it.

I dare you to do business in “business-friendly” Hungary…

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* As far as the development hospitals’ diagnostic equipment is concerned, it is enough to look at this article, detailing how a bunch of OfFidesz public money sponge teamed up to cream off the EU’s funding for medical equipment, how they told the hospitals what (!!!) to order and the suppliers (Siemens GE, Phillips, et.al.) how much to sell it for, setting up a cartel on both ends, then skimming the loot – pocketing 20-25 million euros. The court issued a few million in fines – Siemens even got a relief because it cooperated (even though its cooperation wasn’t necessary at all, everything is black and white in emails and documents). The loot is still eye-watering, and the message is clear: Keep stealing, the worst that can happen is that you may have to give a little of your loot back. (The same thing happens on higher political levels as well. They skim EU funds with immunity – except that the taxpayer pays the fines for them.) Next time a hospital uses ill-fitting diagnostic equipment on you (or you get a surgery because there is no MRI), don’t blame the doctors. Blame public procurement.

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