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Hungary: Entitlement to free medical care and treatment for a citizen's HIV-positive condition on his or her return to Hungary, following a three year absence from the country

According to the Consul, Cultural and Press Attaché of the Embassy of the Republic of Hungary in Ottawa, access to medical treatment is dependent on an obligation to pay into the health care system, regardless of how long a citizen has been outside of Hungary (18 Nov. 2002). A Hungarian citizen's access to free, basic medical care and treatment is determined by "being a member of the Social Security Health Fund" (Hungary 20 Nov. 2002). Being a member requires "making regular contributions through holding a regular job, or by being disabled or by being unemployed" (ibid.). This is not to say that someone who is unemployed cannot obtain medical care (ibid. 18 Nov. 2002). In that instance, the individual is required to file for unemployment benefits through the unemployment office, which then makes the necessary arrangements for such an individual to be able to access medical care (ibid.).

The Consul indicated that Hungary does not discriminate against citizens who have left and remained out of Hungary for any period of time (ibid.). Persons who return to Hungary after spending a period of time outside the country have access to emergency and basic medical care (ibid.).

According to the Consul, a Hungarian citizen who has been out of the country for any period of time can return and apply for unemployment benefits, through which he or she would be able to access basic medical care and treatment (ibid.). There is no question on the unemployment registration form concerning one's HIV sero status (whether one is HIV positive or negative), as such information is considered privileged (Hungary 20 Nov. 2002).

All resident permit holders make contributions to the Social Security Health Fund through their employment and, by virtue of this, are able to access free basic medical care and treatment (ibid.).

Information obtained from an official at the Canadian Embassy in Budapest corroborates this, although she added that "if someone has left the country and has not continued their payments [into the Fund], they lose their insurance. Regaining insurance would be more difficult – and depends on their 'status': for example, unemployment benefits are given to people only if they had at least 200 days of workdays in the last four years" (Canada 19 Nov. 2002).

The Consul stated that "specialized care" is generally not funded by the State in the case of all citizens, and that persons in need of any type of specialized care must buy additional medical insurance (Hungary 18 Nov. 2002).

According to the Hungarian Self-Help Organisation of People with HIV and AIDS (PLUSS), the Saint László Hospital is the one centre that provides medical care to persons with HIV and AIDS (PLUSS 25-27 June 2001). It is equipped with an inpatient ward and also provides outpatient treatment (ibid.).

When asked whether there were any other facilities similar to that of Saint László Hospital elsewhere in Hungary, the Consul stated that he was unaware of any others (Hungary 20 Nov. 2002). He also indicated that in all probability there was no such other facility as the statistics concerning HIV/AIDS in Hungary appear to be stable, and "not on the rise" (ibid.).

Access to medical treatment in Hungary by a citizen who is HIV-positive does not depend on where the virus was contracted (ibid. 18 Nov. 2002).

To access free medical care in Hungary, citizens must present a card at the doctor's office, clinic or hospital prior to being treated (ibid.). The card contains the holder's name, mother's name, date of birth, place of birth, date of issue, an identification number, and a number that is "the equivalent to the Canadian social insurance number" (Hungary 20 Nov. 2002).

The unemployment office makes arrangements for the issuance of such cards to persons who are unemployed (ibid. 18 Nov. 2002).

In the event that a person stops paying into the health care system or if he or she fails to file for unemployment benefits, that person is not required to return the card to the government as such cards are only issued once (ibid.).

A person's eligibility to access medical care is under periodic review by The Social Security Health Fund Central Database, which ensures that citizens are paying into the system (ibid.).

The Consul of the Hungarian embassy stated that if the government discovers that an individual is not contributing to the Health Fund, that individual would be asked to reimburse the Fund (Hungary 20 Nov. 2002). Additionally, access to medical care and treatment can be denied by health care professionals once they have been informed that an individual is not contributing to the Health Fund (ibid.). To this end, an individual's number or file is "flagged" to show that he or she has become delinquent in making contributions (ibid.). Sometimes health care professionals are notified after they have provided medical care and treatment, and have forwarded a bill to the Social Security Health Fund, which responds by stating that the individual has become delinquent in making their contributions to the Fund (ibid.). In some cases, a significant period of time can elapse between the time that an individual stops paying into the Health Fund and the time that health care professionals are notified to that effect (ibid.).

Medication in Hungary, according to the Consul, is subsidized (Hungary 20 Nov. 2002). However, the extent of the subsidization depends upon the type of drug (ibid.). Some drugs do not get subsidized (e.g. those that are new to the market), while others are subsidized 100 per cent (e.g. "generic" drugs) (ibid.). In the case of emergency treatments however, the medication used to treat patients is subsidized 100 per cent, and in effect is free (ibid.).

The Consul pointed out that negotiations between pharmaceutical companies, health care professionals and the government take place annually to determine the level of subsidization to be given to various drugs (ibid.).

According to the Consul, the health care system is "in transition" and there is room for "improvement," but it "would not fail anyone in need of medical attention" (ibid.).

The official at the Canadian embassy in Budapest also stated that "the country [Hungary] is responsible for the proper health care of all of its citizens so that there are ways in which uninsured people can get access to health care or can regain status" (19 Nov. 2002).

According to A Short Survey of Hungary for the United Nations' General Assembly in New York City 25-27 June 2001, which was published by PLUSS,

[i]n Hungary there is one centre providing medical care for PLWHA [people living with HIV and AIDS]. It is the 5th Department of Medicine at the Saint László Hospital Budapest (5DoM). It is a well-equipped inpatient ward. Inpatient service occurs here. It is also the institution for [the] treatment [of] outpatients. At time of writing, the number of outpatients of (5DoM) is about 290.

The survey also states that medical treatment is "available for every verified and registered PLWHA" . Through the Saint László Hospital in Budapest, Highly Active Antiretroviral Therapy (HAART) is available, and "[t]hose who are eligible to receive HAART and undertake it, are provided with it according to national guidelines, [which are] comparable to international ones" (ibid.). Antiretroviral treatment, including laboratory testing such as viral load, is covered by the national Health Fund and is provided free of charge to eligible patients (ibid.). The PLUSS survey also points out that "[o]ther drugs except antiviral ones are to be prescribed and paid for individually" (ibid.). Available drugs include nucleosid, non-nucleosid analogues, and protease inhibitors (ibid.).

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim to refugee status or asylum. Please find below the list of additional sources consulted in researching this Information Request.

References

Canada. Canadian Embassy, Budapest. 19 November 2002. Correspondence received from an official.

_____. 18 November 2002. Telephone interview with the Consul, Cultural and Press Attaché.

The Hungarian Self-Help Organisation of People with HIV and AIDS (PLUSS).

25-27 June 2001. "A Short Survey of Hungary for the United Nations' General Assembly in New York City." <http://www.pluss-hiv.hu.english/intro/shortsurvey.htm> [Accessed 18 Nov. 2002]

Hungary. Embassy of the Republic of Hungary, Ottawa. 20 November 2002. Telephone interview with the Consul, Cultural and Press Attaché.

Additional Sources Consulted

Hatter Society for Gays and Lesbians in Hungary did not respond to a letter requesting information within time constraints.

PLUSS Hungary (the Hungarian Self-Help Organisation of People with HIV and AIDS) did not respond to a letter requesting information within time constraints.

Internet sites, including:

AIDS Education Global Information System (AEGIS) <http://www.aegis.org>

International Gay and Lesbian Human Rights Commission <http://www.iglhrc.org/>

Ministry of Health, Social and Family Affairs in Hungary <http://www.eum.hu/eum/english/english_main.html>

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Topics: Health care, HIV and AIDS,