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Hálapénz, paraszolvencia (Hungary) (view source)
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|style="font-size:1.1em;"| Everyday informality in the Hungarian health system is based on the notions of ''hálapénz'' and ''paraszolvencia'', terms referring to a common practice of informal payments. Unlike more general ‘tip’ or ‘tipping’ elsewhere in Eastern Europe, such as | |style="font-size:1.1em;"| Everyday informality in the Hungarian health system is based on the notions of ''hálapénz'' and ''paraszolvencia'', terms referring to a common practice of informal payments. Unlike more general ‘tip’ or ‘tipping’ elsewhere in Eastern Europe, such as ''spropitné'' in Czech and ''bakshishi'' in Bulgarian (see [[baksheesh]]), the Hungarian terms ''hálapénz'' and ''paraszolvencia'' uniquely describe gratuities in the health sector. The Code of Ethics of the Hungarian Medical Chamber (2012) defines the practice, as ‘…any kind of advantage or allowance that is given to the doctor by the patient or his/her relatives subsequently, without being requested, if they do not influence the quality of the care by any means’ and adds that ‘expressing gratitude can only be voluntary’. Two features of gratuity stand out: its voluntary nature and timing. Gratuity cannot be requested and it should only be given after treatment. This distinguishes ''hálapénz'', assumed to be given out of gratitude, from bribes or kickbacks, which aim to influence outcomes (for example [[fakelaki]], [[mordida]], or [[otkat]]). | ||
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The word ''paraszolvencia'' consists the prefix ''para'' meaning beside or beyond, and ''szolvencia'' from the Latin verb ''solvere'', meaning to loosen, solve or ease something. Thus ''paraszolvencia'' refers to actions that solve (a problem or situation) outside of the formal framework. Before the Second World War, the expression was used to refer to a petty-cash fund distributed to subordinate doctors and assistants by senior doctors in private practices<ref>Kornai, J. 2000. ‘Hidden in an Envelope’, kornai-janos.hu, http://www.kornai-janos.hu/Kornai2000-Hidden-in-an-envelope.pdf</ref>. With the disappearance of private surgeries during the communist era, ''paraszolvencia'' came to refer to gift giving and became associated with ''hálapénz'', literally ‘gratuity money.’ The distinction between sociability (monetary or non-monetary gratitude) and instrumental payments (made with a view of resolving certain issues) is subtle and often results in the interchangeable use of ''hálapénz'' and ''paraszolvencia'' in order to disguise that money has changed hands<ref>Kincses, G. 2004. ‘A paraszolvencia kérdéséről’, Kincsesgyula.hu, http://www.kincsesgyula.hu/dokumentumok/paraszolvencia%20kereserol%20publikaciohoz%20004%2002.pdf</ref>. | The word ''paraszolvencia'' consists the prefix ''para'' meaning beside or beyond, and ''szolvencia'' from the Latin verb ''solvere'', meaning to loosen, solve or ease something. Thus ''paraszolvencia'' refers to actions that solve (a problem or situation) outside of the formal framework. Before the Second World War, the expression was used to refer to a petty-cash fund distributed to subordinate doctors and assistants by senior doctors in private practices<ref>Kornai, J. 2000. ‘Hidden in an Envelope’, kornai-janos.hu, http://www.kornai-janos.hu/Kornai2000-Hidden-in-an-envelope.pdf</ref>. With the disappearance of private surgeries during the communist era, ''paraszolvencia'' came to refer to gift giving and became associated with ''hálapénz'', literally ‘gratuity money.’ The distinction between sociability (monetary or non-monetary gratitude) and instrumental payments (made with a view of resolving certain issues) is subtle and often results in the interchangeable use of ''hálapénz'' and ''paraszolvencia'' in order to disguise that money has changed hands<ref>Kincses, G. 2004. ‘A paraszolvencia kérdéséről’, Kincsesgyula.hu, http://www.kincsesgyula.hu/dokumentumok/paraszolvencia%20kereserol%20publikaciohoz%20004%2002.pdf</ref>. | ||
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==Further Reading== | ==Further Reading== | ||
Ferguson, S. and Irvine, B. 2003. Background briefing: Hungary's healthcare system, Civitas, http://www.civitas.org.uk/pdf/Hungary | #Ferguson, S. and Irvine, B. 2003. Background briefing: Hungary's healthcare system, Civitas, http://www.civitas.org.uk/pdf/Hungary | ||
Gaal, P., Belli, P., McKee, M. and Szócska, M. 2006. ‘Informal Payments for Health Care: Definitions, Distinctions, and Dilemmas’, Journal of Health Politics, Policy and Law, 31(2): 251-293 | #Gaal, P., Belli, P., McKee, M. and Szócska, M. 2006. ‘Informal Payments for Health Care: Definitions, Distinctions, and Dilemmas’, Journal of Health Politics, Policy and Law, 31(2): 251-293 | ||
Kincses, G. 2011. ‘A hálapénzről, és biztos nem utoljára’, Kincsesgyula.hu, http://www.kincsesgyula.hu/dokumentumok/A_halapenzrol_nem_utoljara.pdf | #Kincses, G. 2011. ‘A hálapénzről, és biztos nem utoljára’, Kincsesgyula.hu, http://www.kincsesgyula.hu/dokumentumok/A_halapenzrol_nem_utoljara.pdf | ||
Lantos, G. and Kincses, G. 2016. ‘Így keresnek az orvosbárók évi 100 millió forintot’, Portfolio, 23 April, http://www.portfolio.hu/gazdasag/egeszseggazdasag/igy_keresnek_az_orvosbarok_evi_100_millio_forintot.230793.html | #Lantos, G. and Kincses, G. 2016. ‘Így keresnek az orvosbárók évi 100 millió forintot’, Portfolio, 23 April, http://www.portfolio.hu/gazdasag/egeszseggazdasag/igy_keresnek_az_orvosbarok_evi_100_millio_forintot.230793.html | ||