The purpose of the referendum was to decide whether Hungary should abolish the fees for certain medical services, namely a daily fee for hospital care and fee for doctors’ consultations and tuition fees for higher education.
Problems and Purpose
The consequences of the Prime Minister’s; Ferenc Gyurcsány’s famous “lie-speech” in which he admitted severe financial problems and fake election campaign promises were felt through 2006-2007. (Ilonszki and Kurtán, 2008). The high political tensions resulted in demonstrations on the street. According to Ilonszki and Kurtán (2008 p. 998)”The main politically – as well as theoretically – the relevant problem of the year was how the connection between parliamentary and direct democracy should evolve”. It explains why the largest opposition party gradually supported extra-parliamentary solutions to gain public support. As a result, the two opposition parties Fidesz (Conservatives) and KDNP (Christian Democratic People’s Party) ran a campaign against the Government’s legislation to introduce reform in healthcare and education through popular referendum (Ilonszki and Kurtán, 2009). The purpose of the referendum was to decide whether Hungary should abolish the fees for certain medical services namely daily fee for hospital care and fee for doctors’ consultations and tuition fee for higher education. The country took to the polling stations on 9th of March in 2008 and abrogated all three fees.
Background History and Context
In 2006, the governing parties (MSZP-Socialist and SZDSZ-Hungarian Liberal Party) ended up in a legitimacy crisis because of Prime Minister's Ferenc Gyurcsány’s ill speech (Ilonszki and Kurtán, 2008). After admitting severe financial troubles and fake campaign promises, riots and strikes erupted on the streets. Due to extreme political polarisation and increasing discontent among social groups towards representative democracy, the largest opposition party, Fidesz Conservatives, gradually supported direct democracy instruments to gain public support. The party's campaign was successful and prevailed by a considerable margin at the local election at that year. Viktor Orbán tried to use this opportunity to remove the government and get an early election. However, the majority government prevailed in parliament and the claims for an early election slowly disappeared.
The referendum proposal was initiated by the two largest opposition parties – Fidesz and KDNP (Christian Democratic People's Party) (Ilonszki and Kurtán, 2008). The proposal initially had seven questions. The parties encouraged the public to propose hundreds of referendum initiatives to pressure the National Election Commission (NEC) and Constitutional Court (CC). ). While the NEC backs the parliament sovereignty over popular sovereignty, the CC could decide in favour to direct initiatives. However, the Hungarian Constitution clearly states that a referendum cannot be conducted on an issue which has budgetary consequences. Surprisingly, the CC accepted three questions out of seven explaining those were targeted to delete fees – those expenditures had already been in the budget. As results, the questions on healthcare and education reforms remained on the proposal. After the decision of the CC, Fidesz and KDNP collected the necessary 200,000 signatures and the Head of State decided the referendum would take place in 2008.
The three remained questions aimed to introduce reforms on healthcare and education (Ilonszki and Kurtán, 2008). Even though the healthcare system has been free for most parts, patients had to pay for a daily fee for hospital care and fee for doctors' consultations. As a result, the referendum would solve social inequalities among patients by removing those fees. The education policy reform would increase the number of students at state-subsidised universities by removing tuition fees.
Organizing, Supporting, and Funding Entities
The referendum proposal originally contained seven issues, and it was initiated by Fidesz (Conservatives) and KDNP (Christian Democratic People's Party) in 23rd of October 2006 (Ilonszki and Kurtán, 2008). After a long legal debate between the National Election Commission and Constitutional Court only three remained in the proposal. The Head of State László Sólyom officially announced it in 22th of January 2007 and it was organised by the majority governing parties; MSZP-Socialist and SZDSZ-Hungarian Liberal Party. The cost of the referenda was estimated at HUF 4 470 million (about £11.8 million as at 5 December 2018). There was no limit on spending on the campaign before the 8th of March 2008. However, it was a short campaign period 45 days which was better suited for the opposition Fidesz because they were campaigning for the referendum for the one and half year. The governing parties did not expect that the referendum proposal would pass by Constitutional Court.
Participant Recruitment and Selection
All Hungarian citizens aged 18 or over were allowed to vote in the referendum (Index, 2008). All voters received a notification by 22nd of March in 2008 regarding at which local council they could cast their votes. Any Hungarian citizen living abroad could vote but had to be registered by 22nd of March at the corresponding Embassy.
Methods and Tools Used
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What Went On: Process, Interaction, and Participation
Given the short campaign period, the referendum was not deliberated meaningfully by either opposition. The opposition party Fidesz run an active campaign in favour of yes (see below), but they were gathering support for the next general election (Ilonszki and Kurtán, 2009; Terestyéni, 2008). They capitalised on the government legitimacy crisis and promoted votes for yes would be a legitimate way to express the “anger of the people” (Edelényi et all, 2008). They tried to blend passion and interest in the voters’ eyes. The governing coalition was aware it had a minimal chance to win the popular vote, hence hoped for a low turnout. A quarter of the electorate had to vote in the same way for referenda to be valid.
Fidesz was the most active during the referenda campaign (Terestyéni, 2008). The party had a strong dominance concerning newspaper and radio adverts. It shows that MSZP did not invest significantly in fighting back at media platforms. The party argued for reforms in healthcare and education, but they wanted to push through their reform package in the parliament; "New Hungary Development plan". They could not regain the public trust. SZDSZ frequently ran television advert throughout the whole campaign; promoting rationality. They argued that the healthcare and education system would need those incomes to function properly. Fidesz did not run campaign ad on television until 25th of February; hence their campaign was better focused and intensive right before the referendum. Furthermore, the President of the party, Viktor Orbán, toured the country to generate further support with the slogan of “The future begin with a yes” (Edelényi et all, 2008). He rallied nongovernmental organisation and trade unions because argued by deleting fees would enhance their social well-being.
On the day of the referendum – 8th of March 2008- the polling stations were open from 7 am till 7 pm, and ballots asked the voters to respond "Yes" or "No" to the three questions (Ilonszki and Kurtán, 2009 p.1)
‘Do you agree that in-patient care should be exempt from daily hospital fees with effect from 1 January in the year after the referendum is held on the present issue?
Do you agree that family doctor care, dentistry care and special outpatient care should be exempt from consultation fees with effect from 1 January in the year after the referendum is held on the present issue?
Do you agree that students in state-subsidised higher education should be exempt from tuition fees?’
The voter turnout was 50.5 % (4061015), an all-time high for a referendum in Hungary. It had higher participation than the NATO or the EU referendums (46 % and 49 % respectively) (Ilonszki and Kurtán, 2009). As many as 84.4 % of those who participated in the referendum voted against daily hospital fees, a total of 82.4% voted to delete doctor consultation fees while 82.2 voted to remove higher education fees.
Examining the results regarding distributions we can observe key differences (Edelényi et all, 2008). The rural areas had a higher participation rate while the cities proved to be more supportive of the government’s reform package. The country's wealthier western counties had a higher turnout rate than the poorer eastern counties.
Influence, Outcomes, and Effects
Even though the referendum was not technically legally binding but it would not be wise for the government not following through the results. The outcome of the referendum was clear “yes” over 80 % of the participant voted to delete those fees (Ilonszki and Kurtán, 2009). Hence, the night of the referendum, the government declared that it would immediately delete co-payment schemes.
The outcome of the referenda represented the failure of the Government, MSZP (Socialist) and SZDSZ (Hungarian Liberal Democrat), and raised questions about the future of reforms initiatives and also about the future of the parties (Ilonszki and Kurtán, 2009). Their proposed reform attempts came and faded away. SZDSZ left the coalition because it was dissatisfied with the MSZP's achievement in healthcare and tax reduction reforms. The Socialist had to govern as a minority. The popularity of MSZP dropped from 40 % to 26 % by the end of 2008 while Fidesz reached a record of 60 % rating.
The government implemented the decisions endorsed by the referendum. Accordingly, they deleted the fee for daily care and the fee for doctors' consultations. The estimation of the withdrawal of the fees would imply a cutback in resources of HUF 20 billion (about £53 thousand at 5 December 2018) a year for healthcare institutions (Edelényi et all, 2008). Consequently, health spending as a share of GDP has dropped from 8.0 % in 2005 to 7.1 % in 2015 (OECD, 2015). Moreover, the public of healthcare expenditure decreased from 71 % in 2005 to 67 % in 2015. It is the sixth lowest in the European Union.
Reduction of healthcare expenditures had a significant impact on performance, accessibility and affordability. The OECD report (2015) stated that Hungary rated the fifth highest rate of amenable mortality. The rate was around the double than the European Union average for both men and women. Furthermore, the most significant barrier to access medical care was income, 6.8 % of people with low income reported unmet needs while only 0.8 % among the highest income group. Moreover, out of pockets payments (direct payments) accounted for 29 % of all health spending in Hungary. It was nearly twice as high as the European Union average. Hence, 7.4 % of all Hungarian households have faced horrific out of pocket payments. This percentage reached over 25 % of low-income household.
Analysis and Lesson Learned
The outcome of the referendum could be seen as a victory for participatory democracy. The referenda engaged a record number of citizens with a 50.5 % voter turnout rate which showed a relative success of democratic engagement (Ilonszki and Kurtán, 2009). It was an improvement comparing the last two referendums, the NATO and the European Union referendums 46 % and 49 % respectively. However, a large proportion of the public was not included and presented in the referendum. The parties hardly engaged half of the voting population.
Smith (2009) set out key democratic factors to determine a legitimate process; inclusiveness, popular control, considered judgement, transparency. The 2008 Hungarian Referendum did not fulfil those requirements. It has been criticised concerning purpose, originating, deliberation and outcomes. There is no conclusive evidence whether it was passions or interests decided the referendum results (Ilonszki and Kurtán, 2009). The ruling parties' legitimacy crisis played a sentiment in the results. The public had been disillusioned by the Prime Minister, Ferenc Gyurcsány. Although the opposition party, Fidesz- Conservatives- argued that the referendum would solve in-built social inequalities in the healthcare system, their real intentions were to weaken the coalition. The citizen did not have the popular control; they were not given a fair campaign and proper information on both outcomes (Terestyéni, 2008). The ruling government realised they could not win the popular vote; therefore they aimed to create a low turnout rate. They ran an insignificant campaign in favour to say "no". On the other hand, Fidesz combined the referendum questions with their intention for the next general election. They campaigned a ballot for "yes" was a vote for the future. Even though, the set of questions had been transparent and accountable they created a huge budgetary deficit in the healthcare system. It had a significant negative impact on the healthcare system concerning performance, accessibility and affordability (OECD, 2015).
Some lesson can be learned from the 2008 Hungarian Referendum. For instance, it showed the danger of using a direct democratic instrument. The public was disillusioned by the representative democracy and the opposition parties used the momentum to pressure further the legitimacy crisis (Ilonszki and Kurtán, 2009). They stopped the ruling government reform initiatives and put the decision into the voters’ hand. People are not inclined to pay for services particularly if the services had been free. Hence, Hungary has been facing serious healthcare problems (OECD, 2015). Furthermore, MSZP couldn’t recover from its existential crisis ever since. Fidesz won the 2010 election with two-thirds of the seats and was able to modify the Constitution (Wilkin, 2018). It served them to build an authoritarian regime. Wilkin characterised the Hungarian politics as intolerant, illiberal, and ethnic-nationalist. In conclusion, we say that the 2008 referendum was a turning point in the Hungarian political world. It had consequences beyond the healthcare and education reforms. Hence, it reshaped the political power in the country.
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Ilonszki, G. & Kurtán, S. (2009). Hungary. European Journal of Political Research 48(7–8): 973–979.
Index (2008) Március 9-én lesz a népszavazás [(Referendum will be on 9th of March (In Hungarian)] Available from https://index.hu/belfold/nepszav4280/ [Accessed 5 December 2018].
OECD/European Observatory on Health Systems and Policies (2017), Hungary: Country Health Profile 2017, State of Health in the EU, OECD Publishing, Paris/European Observatory on Health Systems and Policies, Brussels
Smith, G (2009) Democratic Innovations. Cambridge University Press
Terestyéni T. (2008) A pártok politikai hirdetései a 2008. március 9-ei népszavazás kampányában [The parties political advertisements for the referendum campaign 9th of March in 2008 (In Hungarian)] Médiakutató Available fromhttps://mediakutato.hu/cikk/2008_03_osz/04_part_politika_hirdetes [Accessed 5 December 2018].
Wilkin, P. (2018) The Rise of ‘Illiberal’ Democracy: The Orbánization of Hungarian Political Culture. Journal of World-Systems Research, 24 (1), 5-42.
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