User fees for public health care services in Hungary: expectations, experience, and acceptability from the perspectives of different stakeholders

Objective: The introduction of user fees for health care services is a new phenomenon in Central-Eastern European Countries. In Hungary, user fees were first introduced in 2007, but abolished one year later after a referendum. The aim of our study is to describe the experiences and expectations of health system stakeholders in Hungary related to user fees as well as their approval of such fees.

Method: For our analysis we use both qualitative and quantitative data from focus-group discussions with health care consumers and physicians, and in-depth interviews with policy makers and health insurance representatives.

Results: Our findings suggest that the reasons behind the unpopularity of user fees might be (a) the rejection of the objectives of user fees defined by the government, (b) negative personal experiences with user fees, and (c) the general mistrust of the Hungarian population when it comes to the utilization of public resources.

Conclusion: Successful policy implementation of user fees requires social consensus on the policy objectives, also there should be real improvements in health care provision noticeable for consumers, to assure the fees acceptance.