Part I — Situation overview

On 1 September 2026 the Government — on a submission by the Ministry of Finance — tabled before Parliament the 125-page proposal amending the Act on the 2026 budget. One of the most examined elements of the document is healthcare financing. According to Portfolio’s detailed analysis, the amendment created the separate budget chapter of the Ministry of Health, but the items placed there match to the forint the figures that in the original budget still appeared under the interior chapter — so the extra funding is not to be sought here. In the balance of the central subsystem, however, the expenditure appropriation of the Health Insurance Fund rises from 4,945 billion forints to over 5,112 billion forints, which is plus 167 billion forints compared with the original 2026 plan, and plus 210 billion forints compared with actual performance in 2025. The individual lines have moved too: pharmaceutical subsidy rose from 434 to 474 billion forints, high-cost pharmaceutical financing from 195 to 243.3 billion forints, and the curative-preventive appropriation from 974 to 1,044 billion forints, while the appropriations for general practitioner care and for inpatient specialist care remained unchanged. The 500 billion forints a year of extra health funding much quoted before the election cannot be identified in this form in this year’s amended budget; the effects of the pay settlement for health professionals do not appear in it either.

The background runs on two threads. One is the deficit path: in August the government prepared the amendment with a deficit target of 7.5 per cent — the annual minus planned into the budget in advance, measured against gross domestic product (GDP). For this, on a government submission, Parliament also broadened the exception rule of the Stability Act, so that a budget entailing a rise in public debt should be acceptable not only in a recession but also in the case of three years of economic stagnation. MIAK published an analysis of this on 25 August, which asked for an item-by-item derivation of the deficit and for the indication of a path leading back to the 3 per cent reference value — the present post is about what can be seen of this in the document as submitted. The other thread is the revenue side. On the same day it became known that the winding-up of 16 public interest asset management foundations not engaged in higher education activity had been completed, and that public assets with a book value of at least 1,284 billion forints had come back under direct state control. It also emerged that the government had regrouped some 2.48 billion forints from the Central Residue Settlement Fund to set up the new asset recovery office — that is, the office itself does not yet even appear in the budget.

MIAK’s reading: the daily debate is about the level of the deficit, whereas the most sensitive point of the document as submitted is the backing of the revenue side. The recovered foundation assets are book value, not cash; the final deadline for EU funds to arrive is 31 December; and the asset recovery proceedings have not even started. All three items are real, but all three carry a different degree of certainty, and at present this difference is not visible in the budget balance. The same is true of the extra health funding: to the question “how much more has it become”, the document yields three different, equally defensible answers, depending on whether we measure against the original 2026 plan, actual spending in 2025, or the 2025 appropriation. The credibility of a budget is not decided by the size of the deficit figure, but by whether the assumptions behind it are public and can be called to account.

Part II — Foundations in the literature

Three international analytical frames speak directly to the questions of the document as submitted. The International Monetary Fund’s (IMF) World Economic Outlook 2025 names as the condition of fiscal credibility the publication of medium-term fiscal frameworks with clear reference values, a pre-announced adjustment path and contingency scenarios for handling shocks. The same document stresses that in uncertain times scenario planning in itself improves credibility. The same institution’s Fiscal Monitor volume dealing with health spending turns the “how much money” question into a “for what result” question: it introduces the concept of the spending efficiency gap — the difference between actual outcomes and the best outcome achievable from the same resources — and proposes institution-building, transparency and multi-year planning reforms. And the OECD’s Health at a Glance: Europe 2024 provides the set of indicators by which the result of extra health funding can be measured: avoidable mortality, the share of household out-of-pocket payments and unmet need for care, in European comparison. The detailed treatment of the literature — author by author, with quotations — can be found in section 6.4 Literature in detail.

Part III — MIAK’s concrete proposal

MIAK proposes three measurable measures. All three can be carried out during the parliamentary debate on the submitted proposal, by an amending motion or a government supplement.

3.1 A “conditional revenue” marker for uncertain revenue items (by the detailed debate)

On the revenue side of the amended budget three items of differing degrees of certainty are mixed together: current tax revenue, which is based on a statistical time series; EU funds, whose arrival depends on a Commission decision and on a 31 December deadline; and the revenue expected from asset recovery and from taking over foundation assets, part of which is book value and another part the outcome of proceedings that have not even started. MIAK proposes that the text of the Act show these on a separate line, marked as “conditional revenue”, indicating the condition for realisation and its expected timing. This does not reduce the revenue plan and does not call into question the soundness of the items — it merely makes visible what carries which figure. The G1 data-driven budget programme point applies the same principle to the expenditure side: every item should have identifiable content. It is separately important that amounts deriving from asset recovery proceedings that have not yet started must not appear as planned revenue — this is the number one risk to fiscal credibility, and at the same time the budgetary equivalent of the logic of the A1 public money dashboard.

3.2 A three-scenario sensitivity annex to the submitted proposal (before the final vote)

MIAK proposes that the government attach to the proposal a sensitivity annex of no more than ten pages with three scenarios: a base case; a delay of EU funds into the following budget year; and a significant shortfall in asset recovery and asset takeover revenue. In all three cases it must state how the deficit and debt paths develop, and which expenditure items enjoy priority if revenue falls short. This annex is not a forecast but a decision map: it shows what the government plans to do if its assumptions do not hold. The early warning element of the G23 debt sustainability framework builds on exactly this kind of scenario set, while the G15 counter-cyclical stabiliser answers how the adjustment can be timed so as not to deepen the downturn. According to the IMF’s analysis (see 6.4.3), it is precisely this kind of pre-prepared scenario that improves market confidence and thereby the cost of financing. In connection with this, MIAK also proposes that the opinions of the Fiscal Council and the State Audit Office (ÁSZ) be public at the time of submission, not after the close of the debate.

3.3 Output indicators alongside the extra health funding (by the start of planning for the 2027 budget)

Raising the Health Insurance Fund by 167 or by 210 billion forints says nothing in itself about whether patients’ situation improves. MIAK proposes that the explanatory memorandum of the budget Act attach three output indicators to the extra funding: the waiting list length for elective — that is, non-urgent, plannable — interventions, the share of health spending paid by patients out of their own pocket, and the indicator of avoidable mortality. All three are internationally comparable, all three are already collected today, and all three are independent of who is in government. The proposal builds directly on the E3 waiting list transparency programme point, and brings the logic of the G20 impact assessment system into the largest sectoral expenditure item. According to the argument of the Fiscal Monitor (see 6.4.1), closing the spending efficiency gap in itself brings a significant improvement in outcomes — that is, measurement is not an alternative to extra funding but the condition of the extra funding paying off.

The three proposals are held together by a single principle: a budget is credible if the uncertainty within it is shown by the document itself. Marking conditional revenue makes visible what is uncertain; the sensitivity annex shows what happens if the uncertainty turns out badly; and the output indicators show whether the money spent brought anything. None of them restricts the government’s room for manoeuvre — all three increase the public’s capacity to be informed.

Part IV — Expected effects and risks

Dimension Expected effect Risk
Economy The uncertainty of the revenue side becomes visible, improving the accuracy of market pricing and potentially reducing the risk premium Separating out conditional revenues worsens the optics of the budget in the short term, because the mass of “certain” revenue will look smaller
Healthcare The result of the extra funding becomes measurable; the improvement perceived by patients is separated from the announced sum The indicators do not improve in the short term, because the lead time of the care system is longer than a budget year — this is politically an area of attack
Public administration The sensitivity annex forces priority decisions in advance, so in a crisis there is no ad hoc withdrawal The publicity of scenarios in itself shapes expectations: publishing plan “B” in some views undermines the credibility of plan “A”
Society The out-of-pocket indicator measures the burden on households directly, not an institutional datum If the indicator is measured only annually, deterioration along the way comes to light late

The main question to be weighed runs between predictability and prudence. A budget amendment following a change of government is professionally justified: the new cabinet has the right to rearrange the envelopes according to its own priorities, and the screening of inherited obligations also calls for this. At the same time it is precisely the first amendment that is the point where revenue optimism seems cheapest and proves most expensive: the consequence of revenue that fails to arrive appears not in the next month but in the following year’s withdrawals. MIAK’s proposal does not ask for a reduction in the revenue plan, because that would not be professionally founded — the government may hold information that is not known to the public. The proposal only asks that the uncertainty be marked. The package tips over to the risk side if the sensitivity annex becomes a political trump card: in that case the government would rather not publish it, and the annex empties out into a formal exercise.

Part V — Measurability and summary

5.1 What is worth following? (proposed KPIs)

The performance indicators below (KPIs, Key Performance Indicators) are MIAK proposals, not government decisions:

  • Realisation of conditional revenue: the share of the revenue items shown with the “conditional” marker that is actually realised — proposed point of follow-up: the close of the first quarter (Q1) of 2027.
  • Actual development of the deficit: the intra-year course of the cash deficit compared with plan, broken down by month — one of the most important risks of the present amendment is precisely the pre-financing of EU projects.
  • Health output indicators: the average waiting list length for elective interventions and the share of health spending paid by patients out of their own pocket — proposed target: both should improve within 12 months, the latter approaching the EU average of 15 per cent.
  • Publicity of the opinions: whether the opinions of the Fiscal Council and the ÁSZ were available at the time of submission (yes/no).

5.2 Summary

MIAK’s key message: the budget amendment now submitted is risky not because of the deficit figure, but because on the revenue side items of differing degrees of certainty are mixed into a single sum. MIAK asks Parliament to require, in the course of the detailed debate, the separation of conditional revenues and the three-scenario sensitivity annex, and asks the government to attach output indicators to the extra health funding. None of these slows the adoption of the Act, and none of them reduces the government’s room for manoeuvre.

Two MIAK foundational values are in play here. Data-drivenness, because to today’s question — “how much more money has healthcare received” — three different, equally correct answers can be given from the same document; where the answer depends on the choice of the baseline, the baseline has to be stated, not the figure repeated more loudly. And accountability, because the consequence of revenue that fails to arrive is paid not by whoever planned it, but by whoever has it withdrawn from them two years later — which is why the uncertainty has to be made visible at the moment of submission. MIAK asks this standard equally of every government’s budget.

Part VI — Justifications and further sources

6.1 The framing of the press, spectrum by spectrum

In the economic band, Portfolio uniquely worked with the document itself: citing page numbers, it showed that the lines of the separate Ministry of Health chapter match the figures of the interior chapter of the original budget, then derived the size of the extra funding on three different baselines and called all three valid. The headline itself took the form of a question (“How much extra money does healthcare get?”), and the conclusion was expressly cautious: the extra 500 billion forints is not yet to be found in this year’s budget, only a slice of it. This is the day’s single treatment that made the question of the baseline explicit.

In the pro-government and conservative band, Magyar Nemzet opened from the deficit side: the headline highlighted the “amended budget containing an enormous deficit”, without any substantive derivation. The same editorial office dealt in a separate article with the assets of over 1,200 billion forints recovered from the wound-up public interest asset management foundations, but there it placed the emphasis not on the budgetary effect but on the uncertainty of the future of the institutions concerned — among them a museum and a talent development programme. The two articles together cover both faces of the revenue side, but the editorial office did not connect them.

In the general public affairs band, HVG and 24.hu carried the details: the 2.48 billion forint start-up envelope of the asset recovery office — within it 900 million forints for pay and contributions, 540 million for material expenses, and slightly more than one billion for investment. They also reported that the sum had been regrouped from the Central Residue Settlement Fund, because the new office does not yet appear in the budget. HVG carried in the same place the news that the government is also examining the abolition of the Supervisory Authority for Regulated Activities.

The difference between the bands here is not ideological but a difference in analytical depth. The deficit figure was reported by both sides, but nobody broke down the composition of the revenue side — even though this is the most sensitive point of the document as submitted.

6.2 Facts and data

Datum Value Source
Length of the amending proposal 125 pages Portfolio, 1 September 2026
Health Insurance Fund expenditure appropriation (original 2026) HUF 4,945 billion Portfolio, 1 September 2026
Health Insurance Fund expenditure appropriation (amended 2026) over HUF 5,112 billion Portfolio, 1 September 2026
Increase compared with the original 2026 plan approx. +HUF 167 billion Portfolio, 1 September 2026
Increase compared with actual 2025 performance approx. +HUF 210 billion (from HUF 4,902 billion) Portfolio, 1 September 2026
Pharmaceutical subsidy HUF 434 → 474 billion Portfolio, 1 September 2026
High-cost pharmaceutical financing HUF 195 → 243.3 billion Portfolio, 1 September 2026
Curative-preventive appropriation HUF 974 → 1,044 billion Portfolio, 1 September 2026
General practitioner care HUF 296.5 → 296.5 billion (unchanged) Portfolio, 1 September 2026
Inpatient specialist care HUF 762.6 → 762.6 billion (unchanged) Portfolio, 1 September 2026
Public assets recovered from the winding-up of foundations at least HUF 1,284 billion book value, 16 foundations Portfolio, 1 September 2026
Start-up envelope of the asset recovery office HUF 2.48 billion from the Central Residue Settlement Fund 24.hu and HVG, 31 August 2026
EU average household health out-of-pocket share 15% of total health spending (2022) OECD: Health at a Glance: Europe 2024

Two remarks on the table. First: the increases of 167 and of 210 billion forints are not data contradicting one another — the first measures against the original plan for this year, the second against last year’s actual spending, and according to Portfolio’s analysis the latter comes closer to the real situation. Second: the 1,284 billion forints is book value, not cash revenue; the difference between the two is one of the most important questions of the present budget, but one not discussed in the daily press.

6.3 Policy dimensions

  • Economy (programme points) — showing the degree of certainty of the revenue side, sensitivity analysis of the debt path, the methodology of spending review;
  • Healthcare (programme points) — the distribution of the extra funding, waiting list transparency as an outcome yardstick, the development of the household out-of-pocket share;
  • Public administration and e-government (programme points) — the procedure for creating the new budget chapter and the documentation of the regrouping from residue settlement.

An important public-law delimitation: the amended budget was submitted by the Government, and Parliament decides on its adoption — enacting the budget Act is the exclusive competence of Parliament, which is why the formulation “the government adopted the budget” is wrong. The opinion-giving competence of the Fiscal Council and of the State Audit Office is separate from this: both give a professional opinion, but neither decides on the Act, and the ÁSZ does not “call the government to account” but audits and reports to Parliament.

6.4 Literature in detail

6.4.1 International Monetary Fund: Fiscal Monitor — Health Spending

The IMF’s regular publication on fiscal matters places spending efficiency at the centre, and its most important concept is the spending efficiency gap: the difference between the actual outcome of public spending and the best outcome achievable from the same resources. According to the report’s summary, this gap is on average around 31 per cent in advanced economies, 34 per cent in emerging markets and 39 per cent in low-income developing countries. From this the document draws the conclusion that growth prospects can be substantially improved by reallocating spending and improving efficiency, without the overall level of spending rising. Among the proposed instruments, institutional reforms come first:

“To increase spending efficiency, countries should make institution-building reforms a priority. These reforms should focus on combating corruption and enhancing transparency and accountability through robust mechanisms to control expenditure and publish budgets.”

The report separately highlights the improvement of the budgetary procedure, and names the introduction of multi-year planning frameworks as an instrument that connects strategic spending plans with the annual budget. Translated to the Hungarian situation: the present extra health funding of 167 or 210 billion forints can in itself be judged neither a success nor a failure — the question is what result the system delivers for that sum, and this can only be answered with output indicators. This is the direct basis of MIAK’s proposal 3.3.

📖 Source: International Monetary Fund: Fiscal Monitor — Health Spending

6.4.2 OECD: Health at a Glance — Europe 2024

The joint publication of the OECD and the European Commission measures the performance of EU health systems in eight chapters; from the perspective of the present Hungarian question, the financing and the access chapters are the most important. According to the publication, EU health spending fell back to 10.4 per cent of GDP in 2022 from 10.9 per cent in 2021, because after the pandemic other crises — the energy and cost-of-living crisis — pushed healthcare further back among government priorities. At the same time the publication also points out that the level of spending in itself does not say enough: on the EU average, household out-of-pocket payments make up 15 per cent of total health spending, but the share exceeds 30 per cent in Lithuania, Latvia, Bulgaria and Greece, while remaining below 10 per cent in Croatia, France and Luxembourg.

The publication separately highlights the example of Cyprus: with targeted state investment, the household out-of-pocket share fell from 44 per cent in 2018 to 15 per cent by 2022. From the perspective of the present Hungarian debate this is the most important lesson. The out-of-pocket share is an indicator that measures the burden on households directly, not the internal data of the institutional system, and it cannot be improved by communication. That is precisely why MIAK proposes that this indicator too should figure among the outcome yardsticks of the extra health funding — alongside waiting list length and avoidable mortality, which the publication likewise reports regularly.

📖 Source: OECD: Health at a Glance — Europe 2024

6.4.3 International Monetary Fund: World Economic Outlook 2025

The IMF’s report on world economic prospects deals directly with the question of fiscal credibility, and names the publicity of medium-term frameworks as the condition of market confidence:

“Credibility is central to placing public debt on a clear downward path. Governments should publish medium-term fiscal frameworks with clear anchors, preannounced adjustment paths, and contingency plans to manage shocks.”

The report records two further relevant propositions. One is that medium-term consolidation must be based on realistic, balanced plans in which every new supportive measure is temporary, targeted and offset by clear savings. The other is that in uncertain times scenario planning itself, and a pre-prepared decision handbook, improve preparedness and credibility.

This fits the Hungarian amended budget precisely. On the revenue side of the submitted proposal there are three items — EU funds, the takeover of foundation assets and asset recovery — each of which depends on an external decision or on proceedings that have not yet started. By the IMF’s logic these are not forbidden, but they can be handled credibly only if a “what happens if it does not come in” scenario is placed alongside them. This is MIAK’s proposal 3.2, and it is the only instrument by which revenue optimism becomes not a credibility risk but an assumed, documented planning assumption.

📖 Source: International Monetary Fund: World Economic Outlook 2025

6.5 International comparison

Showing conditional revenues separately would not be a Hungarian peculiarity. In the United Kingdom the Office for Budget Responsibility prepares a separate risk report for every budget, listing item by item the uncertainty of revenue and expenditure assumptions and quantifying the main risks. In the Netherlands the economic policy analysis bureau (CPB) prepares alternative scenarios for budget planning, which are published at the time of the parliamentary debate — that is, MIAK’s proposal 3.2 is established practice there.

On the side of health output measurement the European comparison is even more telling. The Cypriot example — the fall of the household out-of-pocket share from 44 to 15 per cent within four years — shows that the indicator responds to targeted intervention, so it is not merely descriptive statistics but a policy instrument. At the same time, precisely for that reason it is sensitive: if only the spending envelope grows but the structure of care and access do not change, the out-of-pocket share may even stagnate. This is the most important reason why MIAK asks for a metric alongside the extra funding, and not for another announcement.

Economy

  • G1 — Data-driven budget
  • G23 — Public debt sustainability framework
  • G21 — Systematic review of state spending
  • G15 — Counter-cyclical fiscal stabiliser
  • G20 — Economic policy impact assessment system (Drucker audit)

Healthcare

  • E3 — Transparency of waiting lists

Transparency and anti-corruption policy

  • A1 — Public money dashboard

Proposed new programme point: Mandatory separate presentation of conditional revenue items in the budget Act — for the Economy area.

6.7 List of sources

Press sources (MIAK press monitor, 1 September 2026 — topic 2):

  • [Portfolio] Benyújtotta a kormány az új 2026-os költségvetést — Mennyi plusz pénzt kap az egészségügy? — https://www.portfolio.hu/gazdasag/20260901/benyujtotta-a-kormany-az-uj-2026-os-koltsegvetest-mennyi-plusz-penzt-kap-az-egeszsegugy-859518
  • [Magyar Nemzet] Benyújtották az óriási hiányt tartalmazó módosított költségvetést — https://magyarnemzet.hu/gazdasag/2026/08/benyujtottak-az-oriasi-hianyt-tartalmazo-modositott-koltsegvetest
  • [Portfolio] Szép csendben egy merész húzással vágja át a Tisza-kormány a költségvetési feladványt (the article was not publicly downloadable) — https://www.portfolio.hu/gazdasag/20260814/szep-csendben-egy-meresz-huzassal-vagja-at-a-tisza-kormany-a-koltsegvetesi-feladvanyt-856178
  • [Portfolio] Tisza-kormány: közel 1300 milliárd forint került vissza az államhoz, felszámolják az Orbán-rendszer örökségét — https://www.portfolio.hu/gazdasag/20260901/tisza-kormany-kozel-1300-milliard-forint-kerult-vissza-az-allamhoz-felszamoljak-az-orban-rendszer-orokseget-859514
  • [Magyar Nemzet] Ruff Bálint büszke: 1,2 billió forintot söpört be a kekvák felszámolásából — https://magyarnemzet.hu/belfold/2026/08/ruff-balint-padlassopres-allami-penz-kekvak
  • [Portfolio] Komoly bérrendezés készül a rendvédelemben, több intézkedés is a kormány előtt — https://www.portfolio.hu/gazdasag/20260831/komoly-berrendezes-keszul-a-rendvedelemben-tobb-intezkedes-is-a-kormany-elott-859418
  • [HVG] 2,5 milliárdot kapott a vagyonvisszaszerzési hivatal — https://hvg.hu/gazdasag/20260831_vagyonvisszaszerzesi-hivatal-koltsegvetes-sztfh
  • [24.hu] 2,48 milliárd forintból működik majd a Nemzeti Vagyonvisszaszerzési és Vagyonvédelmi Hivatal — https://24.hu/belfold/2026/08/31/nvvh-248-milliard-mukodes-forras-breaking/
  • [HVG] A kormány döntött a Wekerle Lakásépítési Programról — https://hvg.hu/itthon/20260901_a-kormany-dontott-a-wekerle-lakasepitesi-programrol
  • [Népszava] Láthatóan kezd lecsengeni a kormányváltási eufória, vége a mézesheteknek a gazdaságban (title-level reference only) — https://nepszava.hu/

Knowledge base references (literature):

  • 📖 International Monetary Fund: Fiscal Monitor — Health Spending
  • 📖 OECD: Health at a Glance — Europe 2024
  • 📖 International Monetary Fund: World Economic Outlook 2025

MIAK internal materials:

  • MIAK policy area: Economy (programme points; programme point ID: G1, G23, G21, G15, G20)
  • MIAK policy area: Healthcare (programme points; programme point ID: E3)
  • MIAK policy area: Transparency and anti-corruption policy (programme points; programme point ID: A1)
  • MIAK press monitor, 1 September 2026 — topic 2, score: 93/100

Supplementary public data sources:

  • Hungarian Central Statistical Office — national accounts and general government data
  • Fiscal Council — its opinions on budget proposals
  • State Audit Office — budgetary opinion
  • Eurostat — data reporting linked to the excessive deficit procedure

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