During communist times health care became a responsibility of the state and was administered through a hierarchical model that was highly centralised. Some improvements were made to the health status of the population during the 1950s but these slowed during the 1960s. As life expectancy improved in Western Europe during the 1980s, rates in Hungary worsened. The need for change was apparent, and by 1987 a package of reforms saw the establishment of the Social Insurance Fund and recognition of private providers. Following a reformation in 1993, the Hungarian healthcare system today is principally a comprehensive, compulsory, employment-based national health insurance scheme that provides near universal coverage both in terms of treatment and in terms of population, with nearly all citizens receiving care whether or not they contribute. The management and supervision was delegated to a self-governed committee. The compensation of the providers falls within the responsibility of the National Fund and is mainly contribution orientated.¹⁵³

In 2003, the total per capita expenditure on health care¹⁵⁴ was Intl $1,269 (8.4% of GDP).¹⁵⁵ Among the countries of Central and Eastern Europe, this figure falls within a spending range of Intl $ 327 in Bosnia-Herzegovina (9.5 % of GDP) and Intl $1,669 in Slovenia (8.8% of GDP). At 5.3% the smallest spending as a percentage of GDP is in Estonia (Tables 5 and 6).

The WHO overall health system performance score places Hungary 43/191 countries. This composite measure of overall health system attainment¹⁵⁶ is based on a country’s goals relating to health, responsiveness, and fairness in financing. The measure varies widely across countries and is highly correlated with general levels of human development as captured in the human development index.