Orbán vs Healthcare

The pandemic is an odd time to attack doctors

And attacking doctors is an odd way to fix healthcare – but Orbán solves all his issues with attacking and waging wars, so what did we expect?

The oddest thing about Orbán’s pandemic response is that he chose to attack doctors. It started with the emergence of a politically active Hungarian Chamber of Doctors (MOK). For years, both the doctors and the rest of healthcare workers used to belong under unions/chambers that were headed by Orbán loyalists. That was one big reason why they never became a political factor.

That changed a couple of years ago, when when a lone doctor started to publish long and painfully tldr posts about the mismanagement of MOK. He moved from platform to platform and reported about the mismanagement of membership fees, the political servilism and the proclivity of the Chamber to transmit political will upon its members, rather than representing them – as it is bound to happen in mandatory membership representative organs.

By 2019, the lone doctor’s work has come to fruition. Enough members voted on the leadership election of MOK to oust the old and corrupt leadership. (In true Fidesz fashion, they didn’t think at first that they should leave their office just because of a result of some vote.) Then the Chamber started to actually represent doctors, including trying to aid the flow of information between hospitals during the pandemic, as the heavily centralized information monopoly by the government kept them in the dark. The Chamber has also opened a platform for anonymous whistleblowers and generally refused to be compliant and keep saying that everything is awesome in healthcare.

Before the new leadership was elected, MOK was the reason doctors haven’t become a political factor – despite the horrors in hospitals, the massive emigration, the shortage of staff and equipment, and the rampant, blatant, open and often viciously enforced corruption in hospitals. So when MOK came to consciousness, Orbán had to react. And he did so by the tool he fixed his other problems with: by attacking and silencing those who brought up the problem. By tricking politically inexperienced civilians. By using their naivety and their eagerness to believe sweet promises. To handle them in a way that kills every last bit of fighting spirit in them.

The MOK’s sudden activism during the pandemic got to the point when they were invited to meet Orbán himself. They went, they heard great things, they happily agreed, relieved that Orbán wasn’t too angry at them. They lined up for a handshake in Orbán’s palace and the papers were full of the photo and that they agreed.

As it always happens with the representatives of non-political professions, Orbán promised things with no intention to keep his promises. It happened to unions, teachers, even leaders of big multinationals – but who can blame them, Orbán regularly fucks over European politicians by lying in their face and then turning around and doing the opposite.

The old salary table for doctors looked like this:

Hungarian healthcare wages 2020

Columns H-I-J are the doctors’ gross monthly salaries in HUF. According to this, in 2020, the most senior doctor, after 49 years in the system earned a gross sum of 707 thousand HUF a month, which translates to a monthly take home (net) salary of 470 thousand HUF or 1305 EUR.

According to the much-trumpeted new salaries from 2021– as revealed after the now infamous handshake with Orbán – even the most junior doctor would make that much, and the same doctor would take home 4400 EUR.

Gross, HUF, monthly salaries according to years worked from 2021:

  • 0-2 years (rezidens) – 687 837 Ft
  • 3-5 years (rezidens) – 875 906 Ft
  • 6-10 years – 1 231 212 Ft
  • 11-15 years – 1 399 247 Ft
  • 16-20 years – 1 491 679 Ft
  • 21-25 years – 1 655 653 Ft
  • 26-30 years – 1 794 715 Ft
  • 31-35 years – 1 868 567 Ft
  • 36-40 years – 2 025 667 Ft
  • 41 years +– 2 380 057 Ft

Poor doctors had no idea what hit them – but the draft law with the new salaries and without any of the sweet promises was submitted that same day. And it had some unacceptable things in it. So they released their statement that it is not it – but that wasn’t reported in Orbán’s part of the media. They were busy trumpeting the big numbers, the millions of forints doctors would make after the raise – making sure no peasant would miss hearing about the millions and that no one has sympathy for the plight of doctors from then on. Other medical professional were not included in the miraculous salary boost either – also to isolate doctors as greedy dicks. The wage increase has thus pitted doctors against other healthcare professionals – a classic Orbán move. Not sure we, the people, benefit from this triumph of his…

MOK was shocked, but tried to keep cooperating – unilaterally. They made a statement that they are willing to sit down (again) and discuss why the new draft law is not acceptable for their members, despite the salary rise. Then they made that statement again and again. They had to find out that there would be no more communication from the ministry to supposedly ask doctors’ views.

The law promised to increase doctors’ salaries in exchange for banning bribes (which has not been illegal until now). So far so good, that’ what the non-corrupt doctors were asking for. To ban the institution of “gratitude money” from healthcare. The clampdown on those who give or accept it would start in 2021, everyone curious how it could be enforced.

Crucially, the ban on bribes is not applicable to the most corruption-infested field, to obstetricians. According to K-Monitor, a corruption database, gratitude payments are involved in 68% of births, with an average amount of over EUR 300. The government claimed “demographic reasons” for allowing corruption to keep happening in deliveries.

But banning bribes – or even the distasteful ways it could be enforced – was not what upset the Chamber of Doctors.

The draft law contained at least two unacceptable elements for doctors. One was to ban them from holding down more than one job – the absolute pillar of the current system as there simply isn’t enough of them. After their protest, the enforcement was only postponed until after the 2022 elections. It is difficult to see how healthcare would operate after that, let alone the new “superhospitals” Orbán keeps promising, like a mirage beyond the desert.

The other caveat was that doctors, too, could be stationed anywhere in the country, for up to two years. It was later reduced in time and only applicable during healthcare emergencies. But healthcare emergencies can be conjured by a penstroke of the government. In other words, doctors were screwed and could not undo it. The question is now how many would stay, sign the new contracts, and how this distasteful divide-and-conquer against healthcare workers and patients will unfold.

MOK couldn’t win against Orbán, not even during a pandemic, and the doctors were duped. It remains to be seen how they will react, especially after the public health emergency is lifted and medical professionals will be allowed to resign again. When the new law was announced, over 6000 of doctors signaled their intention to do so, but that would surely be limited by apathy and complacency. Will there be an exodus from state hospitals in 2022? That’s another government’s problem. Will they emigrate in even greater number? Orbán doesn’t seem to believe that, perhaps because he, personally, couldn’t.

And finally, what did not happen during Orbán’s big push to reform healthcare:

  • he did not allow more money to be spent on healthcare,
  • no one ordered diagnostic equipment
  • no one looked into the irrationalities of the current system for systemic reform.

The government simply clamped down on the corrupt ways doctors and patients and healthcare workers are trying to get around the obstacles in the corrupt and dysfunctional system. The obstacles and the corruption was not removed.

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