IN DEFENSE OF TIPPING PHYSICIANS
IN DEFENSE OF TIPPING PHYSICIANS

Summary/Abstract: In recent years the practice in Hungary of routinely tipping physicians has come under much deserved criticism. The so-called “hálapénz rendszer,” or “gratitude money system” (though it is hardly sufficiently codified to merit the word “system”), originated under communism as a means of compensating for the modest wages physicians were paid by the state. While it has been more than twenty years since the change of regime, the practice has been slow to change, in part because physicians in Hungary are still poorly paid, at least in comparison with the salaries of doctors in other European Union countries, and no doubt in part because many physicians are loathe to abandon a practice from which they have profited for years or decades. Change is clearly inevitable and necessary, but it might be prudent, as consumers and policy makers weigh the advantages and disadvantages of different approaches to financing health care, to consider (wistfully and with some measure of irony) the merits of the practice of tipping. I should be explicit: the point is not so much to defend tipping as to consider potential inadequacies and risks of other approaches to the funding of health care, in particular the introduction of private insurance, a solution proposed several times between 2000 and 2008, but also the suggestion (made for instance by István Mikola in an interview with Nick Thorpe in the January 2011 edition of Hungarian Review) that physicians negotiate independent contracts with health care providers (in simple terms, hospitals).

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