-rebates proportionally with the size of investment according the European Union legislation. As the Hungarians were not able to invest the same amount of money they were not entitled to the same preferential treatment. The economic policy of the Orbán-government started
and financial resources, support for competition, freedom of economic activity and equal treatment and protection of all forms of ownership, including a private one. 12 That is, at least on the paper, it acknowledges all major principles of an open
Authors:Liuba Murauskiene, Milena Pavlova, Marija Veniute, and Wim Groot
Patient payments have not been studied systematically in Lithuania. This limits the use of empirical evidence in policy making. More systematic and detailed evidence on the patient payments phenomena in Lithuania are needed to clarify who is seeking and paying for health care services, why, and how. This paper presents the main findings from a quantitative representative population survey on patient payments in Lithuania. The study results confirm the significant scope of the patient payment practices as well as the complexity of the issue. Overall attitudes towards informal cash payments are negative but there is a rather tolerant view on gifts-in-kind. In case of health problems, access to proper (good quality) treatment is crucial. When treatment is needed, Lithuanian patients are ready to pay irrespective of the legitimacy of the payments and despite of the significant financial burden that these payments may cause. Priorities for the quality of care and the protection of vulnerable groups against financial risks are important and should be addressed when discussing the design of patient payment policies in Lithuania. The lack of a transparent political and organizational arrangements and the failure to communicate properly with the general public are the main challenges for future policy.
Authors:Ágnes Lublóy, Judit Lilla Keresztúri, and Gábor Benedek
This article studies the determinants of pharmaceutical innovation diffusion among specialists. To this end, it investigates the infl uences of six categories of factors—social embeddedness, socio-demography, scientifi c orientation, prescribing patterns, practice characteristics, and patient panel composition—on the use of 11 new drugs for the treatment of type 2 diabetes mellitus in Hungary. The Cox proportional hazards model identifi es three determinants—social contagion (in the social embeddedness category) and prescribing portfolio and insulin prescribing ratio (in the prescribing pattern category). First, social contagion has a positive effect among geographically close colleagues—the higher the adoption ratio, the higher the likelihood of early adoption—but no infl uence among former classmates and scientifi c collaborators. Second, the wider the prescribing portfolio, the earlier the new drug uptake. Third, the lower the insulin prescribing ratio, the earlier the new drug uptake—physicians’ therapeutic convictions and patients’ socioeconomic statuses act as underlying infl uencers. However, this fi nding does not extend to opinion-leading physicians such as scientifi c leaders and hospital department and outpatient center managers. This article concludes by arguing that healthcare policy strategists and pharmaceutical companies may rely exclusively on practice location and prescription data to perfect interventions and optimize budgets.
Hungary seems to have almost perennial dilemmas about the course to be taken in its foreign policy. Attempts by powerful empires (the German, the Habsburg, the Ottoman and the Russian empires) to dominate the country led to loss of independence from the 16
to the 20
century, and full sovereignty has been regained only in 1991 with the seizure of Soviet occupation. The relations with the peoples living next to or intermingled with the Hungarians have also been always difficult because of the conflicting claims to identical territories. Following the collapse of Communism there was the danger of the renewal of hostilities with those neighbours, either by opening the issue of border change, or related to the (mis)treatment of close to three million Hungarians detached from Hungary by the Peace Treaty imposed in 1920. The restraint of the Hungarian government led by J. Antall, the creation of cooperative mechanisms exemplified by the Visegrád Cooperation, and the conduct of the Euro-Atlantic partners, including measures adopted for the protection of national minorities, explain why Central Europe did not become the scene of violence which characterised the Balkans in the 1990s.
In the European Union the statutory principle of the single market of the pertinent EU Treaties applies. Especially if national norms run contrary to the realisation of EU goals, the member states are required to act unitarily and coordinated. In particular, measures effecting the unequal treatment of domestic and foreign actors can often transgress the principle of the unitary European single market and thus have to be discarded. The ambit of indirect taxation according to article 93 of the EC Treaty clearly is subject to a requirement of harmonisation, which is not existent in the ambit of direct taxation. Nevertheless, it appears that EU influence on direct taxation regarding harmonisation goals is the rule rather than the exception. The legislative competence of the member states to achieve supranational goals leads to a characteristic and inefficient legislation. Within the scope of this paper the nature of the inefficient legislation as well as the reasons of its decades-long survival will be discussed. In order to accomplish this, the eminent importance of corporate income taxation will be expounded, first in quantitative and second in qualitative terms. The characterisation of the quantitative and qualitative importance for the EU as well as for the member states will disclose how the current legislation came about. In this context the European Court of Justice will play a major role, which surpasses mere power of jurisdiction and results from an adverse distribution of competencies. On that note the logic behind the proposals of the European Commission can be examined. The paper concludes by suggesting an approach for reform based on the propositions of the European Commission.