Money talks, dogs bark, goes a Hungarian saying, and nowhere is this more true than in the health business. Yes, indeed, business. Because in Hungary, despite a national health insurance program which guarantees its citizen almost free health care, reality looks a little more grimy. If you can afford to pay your doctor under the table, you have more of a chance to survive. That’s if the post-apocalyptic conditions in hospitals don’t kill you first through one infection or another.
In most cases, the world over, if you’re sick and can’t manage, you go see a doctor. If you’re really sick, you go to the hospital. In Hungary the procedure is no different, except you shouldn’t forget to bring money. Because in Hungary you don’t only tip the cab driver, server, hairdresser, and beautician, you also tip the doctor. It’s called gratitude money (hálapénz), and is as natural and widely accepted as taking an umbrella with you when it rains.
The initial idea behind it was to say thank you to your doctor for dealing with you. With a little present, some homemade Pálinka perhaps, or homemade bacon. During communism, when these things were scarce, this evolved into hard cash. Dollars and Deutschmarks were preferred, but Hungarian Forints were not exactly frowned upon either. This being Hungary, where presentation is everything, the money was never handed over hand-to-hand, but was placed in an envelope, to make the whole thing more palatable.
What started as a way of saying thank you, has gradually evolved into a full blown extortion racket. Naturally, no one is standing at your bedside – or even by the door – with a knife at your throat, but really they don’t have to. A shrug of the shoulders, a dismissive attitude, followed by a “there’s nothing we can do,” until the money shows up, and the message is clear: if you want to get healthy, pony up. Defenders of the practice say it’s because doctors earn very little money, and deserve to make a living. Rationally thinking people look to the government and demand doctors be paid more.
“My cousin was in a car accident and jammed up his leg pretty badly,” says Sára, a student from Budapest. “The doctors said there was nothing they could do, they’d have to amputate. We raised 3 million forints (10,000€), and they said they could operate. My cousin can walk now, and you’d never be able to tell, but imagine if we hadn’t been able to raise that kind of cash.”
Sára isn’t the only example. An anecdote is making the rounds in Budapest, which may or may not be true, but illustrates the issue of gratitude money perfectly. The story has always been told to the narrator by “my friend’s mother, who works in the hospital.” It runs something like this: a patient wanted to thank the doctor for everything, and brought in a large chocolate egg with the words, “we just wanted to thank you, Doctor, for your service.”
The doctor looks at the beautifully wrapped present, and states drily – not without an all too audible note of disdain – “we normally expect money.”
“I see,” replies the patient, before enquiring, “what would be an appropriate sum?”
“Around 20,000 is usually expected,” replies the good doctor.Photo: Matt Madd