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Even before the regime change, the practice of gratitude money in the Hungarian healthcare system was petrified, which over time completely reinterpreted. Patients are now stuffing white envelopes into their doctors’ pockets primarily to get better and faster care. The gratitude money had a number of negative effects, in addition to the deterioration of the doctor-patient relationship, which resulted in the enrichment of a narrow and privileged layer. At the suggestion of the Hungarian Medical Chamber (MOK), the government has put its criminal sanctions on the agenda, which was well received by the defense organization for the Origo issue. Another suggestion seems to come true: a drastic wage increase could come in the sector thanks to the government.
It could end at the end of a serious and lengthy debate with an amendment to the Penal Code. the acceptance of the tip, as well as the payment of gratitude above a certain amount, would become criminal penalties.
They were in an awkward position
In Hungarian society, gratitude money and its punishment have been the topic of conversation for decades, but the legacy of the communist system has not been removed from the Hungarian healthcare system. The thank you money was distributed primarily for the purpose of thanking the doctor who treated you this way, with a small amount of money in the envelope. Why this became a common phenomenon before regime change is quite complex. Among other things, it dates back to underpayment of doctors and uneven quality of health services, but several factors also played a role.
However, over time, gratitude money has taken on an entirely different meaning – gratitude has been replaced by the purchase of benefits, no matter how bad it sounds. Today, most patients do not want to express their appreciation with the envelope, but rather want the doctors to pay more attention to it, get better and faster care. And the doctors saw the money collected from the patient as a kind of salary supplement.
The institution of gratitude money has been completely reinterpreted over time.
One of the biggest drawbacks is that there is a kind of competition among patients for favors from doctors, which, by definition, is a situational advantage for the wealthier strata. They are the ones who can most easily afford to spend tens of thousands or even hundreds of thousands of florins for their health. So bad for the less affluent.
Approaching the matter from another angle: patients are under heavy pressure to give cash in exchange for their cure. The obligation to pay is a common mistake, nobody and nothing forced patients to do it, but under the influence of (social) pressure they release large sums from their hands.
Impaired doctor-patient relationship
Not to mention that the practice of putting envelopes in pockets creates humiliating situations for both doctors and patients. At the same time, it leads to confusing conditions in healthcare: patients pay double for their treatment, as they also contribute to social security. Also in the case of doctors, the practice turned out to be unfortunate: they expected one of their patients to reward them, and if this did not happen, they might be overwhelmed by a bad feeling. In Hungarian
gratitude results in a horrible relationship in the doctor-patient relationship.
Unfavorable situations, uncomfortable situations, expected benefits (material) to each other; In short, these are the biggest problems.
Serious business for “medical barons”
On the subject, it is inevitable to say that only a very narrow layer within the medical community is doing well to “institutionalize” gratitude money, as it is one of the most important assets in the hands of the fight against parasol. This is because, while 10 to 20 percent of doctors have a lot of money and about 30 percent have a moderately large amount of money in their pockets, the rest, that is, more than half of Doctors receive little or nothing from the patient. At this point, it should be noted that patients’ money is distributed unevenly between specialties: the phenomenon was mainly characteristic of obstetrics, surgery, internal medicine and ophthalmology.
The main recipients of gratitude money are usually seasoned and seasoned physicians working in the capital, county cities, or university clinics. In other words, this group, nicknamed the “medical barons,” is primarily interested in preserving the above conditions, maintaining the practice of gratitude money. Their efforts are not by chance:
parasolvency means terrible money, it is no exaggeration to say that a very lucrative business was built for this.
By some estimates, each year between 80 and 100 billion thank you guilders migrate into the pockets of doctors. The Pénzcentrum’s 2018 article also contained more specific data: the amount of thank you money paid per capita has more than doubled since 2010, while at that time all Hungarians received HUF 1,798 per year, last year this amount was already HUF 3,827.
Initiated movements
Various movements have also been launched to “abolish” and sanction gratitude money. Compress young doctors Hungarian Residents Association Back in 2013, he launched the anti-gratitude campaign with the slogan “Thank you from the patient, money from the state.” Tamás Dénes, the then president of the organization, who has since become two professional surgeons, explained that according to their surveys, doctors see gratitude money as a supplement to earnings.
96 percent of them want to work in a healthcare system where there is no parasolvency at all.
Patients have been found to be buying the right care this way, or because they believe they can get some benefit from gratitude money.
In 2015, a Facebook group called 1001 Doctors Without Gratitude organized doctors who came together to reject parasolvency.
Partner in the change of government
As Origo reported, in mid-January, the Hungarian Medical Chamber proposed to the government to criminalize gratuity and increase doctors’ salaries. The suggestion moved the various professional groups, and a lively debate about gratitude money resumed. Half a year later, politics also entered:
shows the government’s constructiveness in putting the chamber’s proposals on the agenda and with a good chance of accepting its rationale
According to Origo, the abolition of gratitude money and a drastic increase in doctors’ salaries will be on the agenda of Wednesday’s government meeting.
Welcomed the steps of the government to the chamber
We asked the medical room what they had to say about the events. As they write in their response, they welcome “the government’s commitment to a criminal settlement of medical wages and gratitude money.” However, they also added that the news will be discussed in more detail only in light of the exact details.
“The first step in creating health care that ensures patient safety is to replace hourly medical wages with those of fast food workers with a fair and predictable wage based on a professionally prepared salary scale by the Hungarian Medical Chamber.
Finally, it was written that the presidency of the chamber trusts that an agreement acceptable to the medical community will be reached on the payment of the salaries of the health services, thus avoiding the exacerbation of dismissals.
Two birds were hit in one go
As the advocacy organization noted in its response, there is a need to raise doctors’ salaries in addition to punishing gratitude money. They see that the latter can only be phased out of the health system.
The government is inclined to do the same: according to preliminary news
Significant wage increases in the sector could follow, doubling medical wages.
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