In Hungary, the Constitution (Act 20 of 1949) declares the right of everybody living in the territory of Hungary "to the highest possible level of physical and mental health." [Section 70/D Paragraph (1)] In addition, citizens have a right to social security, which involves an entitlement to benefits guaranteeing income for old people, widows, orphans and unemployed who lost their jobs due to reasons other than their own fault, or in the event of ill health and disability [Section 70/E Paragraph (1)]. The state satisfies this obligation through social security and social institutions [Section 70/E Paragraph (2)]. The Constitution sets a task for the Government to define the public system of social and health care, and to arrange for funding for these services [Section 35 Paragraph (1) subparagraph g)].

The above principles were integrated into the Constitution when it was modified on 23 October 1989, representing one of the important stations of the change of the system. Hungarian health services were available for all citizens universally since 1975 as of right, but at the time of the change of régime, the services were made subject to insurance relationship based on contribution payment obligation ('were put on an insurance basis'), from which large social groups (pensioners, unemployed, etc.) were excluded and there were some groups which were simply left out. The exceptions from contribution payment obligation were gradually reduced, and since 1996 practically all Hungarian citizens have been insured.
The most important operational principle of the health system is solidarity, which means that the insured do not pay risk proportionate insurance premium but an income proportionate contribution pursuant to the main rule. We generally talk about social insurance because of the contribution payment instead of insurance premium payment, which, in addition to the insurance element, also executes a considerable income redistribution too from those with a higher income towards those with a lower income, from the active towards the inactive (pensioners and young people), from the employed towards the unemployed, etc.

The principal piece of legislation in the health sector is the Health Act setting out the most important framework rules of health care (Act 154 of 1997), which replaced its predecessor, which had been effective for 25 years, but became obsolete (Act 2 of 1972). Its scope covers all health service providers operating and health activities pursued in the territory of Hungary, defines the rights and obligations of patients and health care employees, and the state?s responsibility for the health status of the population, the system of health services, the professional requirements of the services, and organisational and management system in the health sector. The Health Act also defines medical research conducted on humans, special procedures involving human reproduction, research with embryos and spermatozoon, basic rules of sterilisation, treatment and care of psychiatry patients, organ and tissue transplants, sets out rules relating to corpses, it also deals with blood supply and emergency health care, medical expert activities, natural medicinal factors, spas and climatic therapeutical institutes and treatment facilities.

The Health Act specifies the obligation of health employees to provide services, and it also introduces the concept of health service providers with an obligation to provide services in a particular area, including also the main rules of on-call and on-duty services. In the process of the change of the system, the Act on Local Governments (Act 65 of 1990) made local governments responsible for arranging for the delivery of health care services. The local governments are mandated to arrange for the provision of primary health care services. Specialist health care, exceeding the tasks of primary care, is an optional task. Pursuant to the provisions of this act, it is a mandatory task of county governments to provide specialist health care above the primary health care level. Local governments can fulfil their obligation to provide these services not only as owners of outpatient and inpatient specialist institutions, but also in the framework of contracts concluded with the owners of such institutions.

In accordance with the effective legislation, the health sector is currently a diverse, multi-actor system, containing local governments, the state, which is present both as a regulator and an owner, a licensing and supervisory authority operated by the state, the National Public Health and Medical Officer?s Service (NPHMOS) and the financing agency, National Health Insurance Fund.

The financing system operates on the basis of the principle that current (operating) expenses are covered from the National Health Insurance Fund, while capital expenditure (refurbishment, development, etc.) is covered by the owners (local governments and the state through various public administration agencies, e.g. ministries). This two-channel or dual financing system stops the involvement of enterprises into health services, because enterprises can recover their costs only through to the sale of services.

The majority of health expenses are covered from the state budget.

A new stage in the development of the health sector was the introduction of the Institutional Act (Act 43 of 2003) for the purpose of introducing new types of operational forms, already existing in other fields of the economy (corporate forms) in order to modernise the health care system. The Institutional Act introduced the concept of public health services (health service partly or fully financed by the budget) established rules for the organisation of public health services, and determined the conditions under which health service providers can provide public health services, and also defined responsibility for the organisation for public health services. The act also provides that local governments may satisfy their obligation to provide health services not only by operating their own service institution, but also through contracts (so-called health service contract), and defined the rules of such contracts too.

The Institutional Act contains the most important rules for the operation of public health service providers, the organisational and professional requirements, the obligation of preparing a professional plan and its content elements, rules for the financial security, control of the supply public health services, method of termination of health service contracts, and the liability for damages caused to patients. The act introduced and defined the concepts of mediation contract and health target assets. The act allowed the corporatization of whole health institutions only.

The Constitutional Court declared this act anti-constitutional for formal reasons, and annulled it with an effective date of 15 December 2003. It did not examine the contents of the act at all. The Ministry intends to cover the key elements of the regulations contained in the Institutional Act in other legal regulations.
The work assisting the enforcement of rights of users is becoming increasingly important among health, social and child protection services. The Act 154 of 1997 on health care regulates the rights and obligations of patients widely. It clearly determines the rights relating to health services, human dignity, maintaining contact, information, self-determination, study of documentation, rejection of services, and physician?s confidentiality. The act sets an obligation for the service providers to inform patients about patient rights. It also identifies the tasks of operating a patients? rights advocacy system in order to enhance awareness, enforcement and protection of rights.