Abstract
Resource scarcity is an important issue of health care systems worldwide. WHO highlighted the importance of having earmarked revenues for sustainability of health systems. Our aim is to show examples of possible innovative financing by earmarking certain taxes and revenues in Hungary. A retrospective, descriptive study was conducted by analysing nationwide data from the National Health Insurance Fund Administration of Hungary. Amount of income and its share of the Health Insurance Fund (HIF) were assessed of the following revenue sources: health contribution (subsidy on incomes that are otherwise not levied for health); payment of medicament producers and distributors; accident tax (paid by vehicle operators to cover for health expenditures due to road accidents); public health product tax (PHPT, upon unhealthy food, beverages and certain alcoholic drinks) and the health contribution of tobacco companies in 2015. Period of 1997-2018 were analysed. Health contributions gave 14.45% of all income in 1997, it reached its highest in 2000 (24.71%) since then its decreasing (2018: 7.44%). Medicament producers/distributors pay their contribution since 2003, which grew from 6.3 billion HUF (17.67 million EUR; 0.61% of HIF) to 88.2 billion HUF (247.35 million EUR; 3,75%) by 2018. Although accident tax was in force in 2012-2019 only, its income increased by 72.3% (43.3 billion HUF, 121.43 million EUR; 1.84%) during this time. PHPT is imposed on unhealthy food/beverages since 2011, and on alcoholic drinks since 2015, it brought 40.6 billion HUF (113.86 million EUR; 1.73%) in 2018. PHPT has a uniquely wide range of products and became a stable, reliable source for health care, while other earmarked taxes could not persist (e.g. accident tax, contribution of tobacco companies). Earmarking taxes of products or services that - even indirectly - affect health care should be optimized for the sake of long-term sustainability.
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