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Changing Origins of Inequalities in Access to Health Care Services in Turkey: From Occupational Status to Income

Published online by Cambridge University Press:  05 March 2015

Volkan Yilmaz
Volkan Yilmaz*
Affiliation:
PhD Candidate, the School of Politics and International Studies, University of Leeds, Social Sciences Building, Leeds, LS2 9JT, United Kingdom, Research Coordinator, Civil Society Studies Centre-Youth Studies, İstanbul Bilgi University, İstanbul, Turkey, ptvy@leeds.ac.uk
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Abstract

Health care reforms have always been critical political arenas within which the parameters of citizens' access to health care services and thus the new terms of social bargain that backs social policies are negotiated. Despite the relative success of Turkey in establishing public health insurance schemes and developing a public capacity for health care service delivery since the late 1940s, Turkey's health care system has largely failed to institute equality of access to health care services. With the promise of abolishing the inequalities, the ruling Justice and Development Party (AKP) launched Turkey's Health Transformation Program in 2003. Since then, Turkey's health care system has been undergoing a significant transformation. On the one hand, with the unification of all public health insurance schemes under a compulsory universal health insurance scheme and the equalization of benefit packages for all publicly insured, the program has succeeded in abolishing the occupational status-based inequalities in access to health care services. On the other, this article suggests that the program has changed the main origin of inequalities in service access from occupational status to income. As the country suffers from an uneven distribution of income, it is argued that these incomebased inequalities in access pose a significant threat to the realization of the social citizenship ideal in Turkey.

Keywords

Health care policyhealth care reforminequalityaccessTurkey
Type
Articles
Information
New Perspectives on Turkey , Volume 48 , Spring 2013 , pp. 55 - 77
Copyright
Copyright © New Perspectives on Turkey 2013

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References

“450 bin Yeşil Kart İptal.” Sabah. January 14, 2012.Google Scholar
Adaman, Fikret, “Study on the Social Protection Systems in Turkey.” In Entry for the Report Study on the Social Protection Systems in the 13 Applicant Countries. European Commission, 2003.Google Scholar
Ağartan, Tuba I., “Turkish Health Policy in a Globalizing World: The case of ‘Transformation of Health’ Program.” Paper presented at the ISA Research Committee 19th Annual Academic Conference. Florence: 2007.Google Scholar
Ağartan, Tuba I., “Turkish Health System in Transition: Historical Background and Reform Experience.” PhD Dissertation. State University of New York, 2008.Google Scholar
Ağartan, Tuba I., “Marketization and Universalism: Crafting the right balance in the Turkish healthcare system.” Current Sociology 60, no. 4 (2012): 456–471.Google Scholar
Alkan, Hüseyin, “AKP’nin Sağlık Kozu.” BBC Türkçe, (une 1, 20u. Andreotti, Alberta and others.“Does a Southern European Model Exist?” Journal of Contemporary European Studies 9, no. 1 (2001): 43–62.Google Scholar
Arrow, Kenneth Joseph, “Uncertainty and the Welfare Economics of Medical Care.” The American Economic Review 53, no. 5 (1963): 941–973.Google Scholar
Bambra, Clare, “Worlds of Welfare and the Health Care Discrepancy.” Social Policy el Society 4, no. 1 (2005): 31–41.Google Scholar
Bambra, Clare, “Health status and the worlds of welfare.” Social Policy and Society 5, no. 1 (2005): 53–62.Google Scholar
Barış, Enis, and others. “Healthcare in Turkey: From Laggard to Leader.” British Medical journal 342, C7456 (2011).Google Scholar
Barrientos, Armando, and Peter, Lloyd-Sherlock. “Reforming Health Insurance in Argentina and Chile.” Health Policy and Planning 15, no. 4 (2000): 417–423.Google Scholar
Blank, Robert H., and Viola, Burau Comparative Health Policy. Hampshire: Palgrave Macmillan, 2010.Google Scholar
Buğra, Ayşe, and Ayşen, Candaş. “Change and Continuity under an Eclectic Social Security Regime: The Case of Turkey.” Middle Eastern Studies 47, no. 3 (2011): 515–528.Google Scholar
Buğra, Ayşe, and Keyder, Çağlar. “The Turkish Welfare Regime in Transformation.” Journal of European Social Policy 16, no. 3 (2006): 211–228.Google Scholar
Buğra, Ayşe, and Keyder, Çağlar. New Poverty and Changing Welfare Regime of Turkey. Ankara: UNDP Turkey, 2003.Google Scholar
Buğra, Ayşe, and Volkan, Yılmaz “Sağlıkta Alınan Yol ve Ortaya Çıkan Tehlikeler” [Advances and Threats in Health]. Bağımsız İletişim Ağı (BİANET). August 8, 2011.Google Scholar
Burau, Viola, and Blank, Robert H. “Comparing Health Policy: An Assessment of Typologies of Health Systems.” Journal of Comparative Policy Analysis. 8, no. 1 (2006): 63–76.Google Scholar
Çarkoğlu, Ali, and Kalaycıoğlu, Ersin. Türkiye’de Sağlık: Toplumbilimsel bir Değerlendirme, İstanbul: Koç University and Sabancı University, 2012.Google Scholar
Civaner, Murat, “Transforming Our Health by Privatisation-Response to Baris et al.,” British Medical Journal (2011).CrossRefGoogle Scholar
Dannreuther, Charles, and Gideon, Jasmine. “Entitled to Health? Social Protection in Chile’s Plan AUGE.” Development and Change 39, no. 5 (2008): 845–864.Google Scholar
Demirci, Bengi, “Transformation in the Organizational and Financial Set-up of the Health Care System in Turkey: Its Repercussions and Similarities with the English Model.” PhD Dissertation, Middle East Technical University 2012.Google Scholar
Ersoy, Tolga, Türkiye Tıp Tarihi İçin Materyalist Notlar. İstanbul: Sorun Yayınları, 1998.Google Scholar
Erus, Burçay, and Nazlı, Aktakke. “Impact of healthcare reforms on out-of-pocket health expenditures in Turkey for public insurees.” The European Journal of Health Economics 13, no. 3 (2012): 337–346.Google Scholar
Esping-Andersen, Gesta, The Three Worlds of Welfare Capitalism. Cambridge and Princeton: Polity Press and Princeton University Press, 1990.Google Scholar
Ferrera, Maurizio, “Welfare States and Social Safety Nets in Southern Europe: An Introduction.” In Welfare State Reform in Southern Europe, ed. Maurizio, Ferrera. London: Routledge, 2005.CrossRefGoogle Scholar
Hassenteufel, Patrick, and Palier, Bruno. “Towards Neo-Bismarckian Health Care States? Comparing Health Insurance Reforms in Bismarckian Welfare Systems.” Social Policy d Administration 41, no. 6 (2007): 574–596.Google Scholar
Karadeniz, Oğuz, “Annual National Report 2009-Pensions, Health and Long-term Care.” In Analytical Support on the Socto-Economic Impact of Social Protection Systems. European Commission DG Employment, Social Affairs and Equal Opportunities, 2009.Google Scholar
Keyder, Çağlar, “Giriş,” in Avrupa’da ve Türkiye’de Sağlık Politikaları, edited by Çağlar, Keyder, Nazan, Üstündağ, Tuba, Ağartan and Yoltar, Çağrı. İstanbul: İletişim, 2007.Google Scholar
Kılıç, Azer, Osman, Savaşkan, and Çağrı, Yoltar. “Yeşil Kartın Vatandaşlık Rejimi.” Radikalİki. November 10, 2008.Google Scholar
Kısa, Adnan, and Younis, Mustafa Z. “Financing Health Care for the Poor in Turkey: Is a Temporary Solution Becoming a Permanent Scheme?” Public Health Reports 121, no. 6 (2006): 764–768.CrossRefGoogle ScholarPubMed
Mapfre, Genel Sigorta. “Tamamlayıcı Sağlık Sigortası.” (2012) http://www.farkyoksigortasi.com/.Google Scholar
Marx, Karl, Capital. Oxford: Oxford University Press, 2008.Google Scholar
Normand, Charles, “Health Insurance: A Solution to the Financing Gap?” In Marketizing Education and Health in Developing Countries: Miracle or Mirage?, edited by Christopher, Colclough. Oxford: Clarendon Press, 1997.Google Scholar
Normand, Charles, “Özel Hastanede Farka Dikkat!” Habertürk Ekonomi. March 18, 2012.Google Scholar
Pala, Kayıhan, “Türkiye Sağlık Sistemi Nereye Gidiyor?” Toplum ve Hekim 22, no. 1-2 (2007): 62–69.Google Scholar
Rhodes, Martin, “Southern European Welfare States: Identity, Problems and Prospects for Reform.” South European Society and Politics 1, no. 3 (1996): 1–22.Google Scholar
Rothgang, Heinz, Mirella, Cacace, Simone, Grimmeisen, and Wendt, Claus. “The Changing Role of the State in Healthcare Systems.” European Review 13, no. 1 (2005): 187–212.Google Scholar
Sağlık, Bakanlığı. Sağlık İstatistikleri Yıllığı 2010. Ankara: Sağlık Bakanlığı, 2011.Google Scholar
“Sağlıkta Parmak izi Dönemi.” Milli Gazete. December 9, 2005.Google Scholar
Salter, Brian, The New Politics of Medicine. New York: Palgrave Macmillan, 2004.Google Scholar
Sexton, Sarah, “Trading Healthcare Away: The WTO’s General Agreement on Trade in Services (GATS).” In Restructuring Health Services: Changing Contexts Comparative Perspectives, edited by Kasturi, Sen. London: Zed Books, 2003.Google Scholar
Sönmez, Mustafa, Paran Kadar Sağlık: Türkiye’de Sağlığın Ticarileşmesi. İstanbul: Yordam Kitap, 2011.Google Scholar
Sosyal, Güvenlik Kurumu. Primsiz Ödemeler Cenel Müdürlüğü Eylül Ayı İstatistik Bülteni. Directorate General of Non-contributory Payments September Statistics Bulletin. Ankara, 2010.Google Scholar
Sosyal, Güvenlik Kurumu. Sağlık istatistikleri (Health Statistics). Ankara: 2012.Google Scholar
Sosyal, Güvenlik Kurumu. Sosyal Güvenlik Kurumu Sağlık Uygulama Tebliğinde Değişiklik Yapılmasına Dair Tebliğ. adopted on February 29, 2012.Google Scholar
Sosyal, Güvenlik Kurumu. Tamamlayıcı ya da Destekleyici Sağlık Sigortası Uygulamaları Genelgesi. No. 2012/25. Issued on June 28, 2012.Google Scholar
Soyer, Ata., Bir Muhalefet Odağı Olarak Tabip Eylemleri, Bir Eylem Biçimi Olarak Beyaz Eylemler. İstanbul: Sorun Yayınları, 2005.Google Scholar
Sulku, Seher Nur, and Bernard, Didem Minbay. “Financial Burden of Health Care Expenditures in Turkey: 2002–2003.” Working Paper No: 28968. Munich: Agency for Healthcare Research and Quality, 2009, http://mpra.ub.uni-muenchen.de/37404/.Google Scholar
Tatar, Mehtap, et al. “Informal Payments in the Health Sector: A Case Study from Turkey.” Health Affairs 26, no. 4 (2007): 1029–1039.Google Scholar
Tatar, Mehtap, et al. “Tedavi Giderleri Arttı, ilaç Giderleri Sabit Kaldı.” Medimagazin. March 28, 2011.Google Scholar
Teksöz, Tuncay, et al. “Sağlık Reformunun Sonuçları İtibariyle Değerlendirmesi.” Türkiye Ekonomi Politikaları Araştırma Vakfı, 2009.Google Scholar
The Ministry of Health of Turkey. Turkey National Health Accounts 1999–2000. Ankara: The Ministry of Health of Turkey, Refik Saydam School of Public Health, 2004.Google Scholar
Türk Sanayicileri ve işadamları Derneği (TÜSİAD). Chartingthe Way Forward: Health Care Reform in Turkey. İstanbul: TÜSİAD Publications, 2005.Google Scholar
Türk, Tabipleri Birliği. “AKP Sağlık Politikası: Yalanlar ve Gerçekler.” Bağımsız iletişim Ağı (BİANET). May 25, 2011.Google Scholar
Türkiye, İstatistik Kurumu. Yaşam Memnuniyeti Araştırması 2010. Ankara: Türkiye İstatistik Kurumu, 2011.Google Scholar
Türkiye, Sigorta Birliği, istatistikler. (2012).Google Scholar
Uçku, Reyhan, and Çınar Elçi., Ömür “Turkey.” in Comparative Health Systems: Global Perspectives, edited by Johnson, James A. and Stoskopf, Carleen H. Boston: Johns and Bartlett Publishers, 2010.Google Scholar
Üstündağ, Nazan, and Çağrı, Yoltar. “Türkiye’de Sağlık Sisteminin Dönüşümü: Bir Devlet Etnografisi.” In Avrupa’da ve Türkiye’de Sağlık Politikaları, edited by Çağlar, Keyder, Nazan, Üstündağ, Ağartan, Tuba, and Yoltar, Çağrı. İstanbul: iletişim, 2007.Google Scholar
Wall, Ann., “Conclusion.” In Health Care Systems in Liberal Democracies, edited by Ann, Wall London: Routledge, 1996.Google Scholar
Wendt, Claus, Claus, Wendt, Lorraine, Frisina, and Rothgang, Heinz. “Healthcare System Types: A Conceptual Framework for Comparison.” Social Policy of Administration 43, no. 1 (2009): 70–90.Google Scholar
World Bank. Turkey Joint Poverty Assesment Report Volume I. Ankara: Human Development Sector Unit Europe and Central Asia Region and State Institute of Statistics of Turkey, 2005.Google Scholar
World Health Organization. “Health Systems: Improving Performance.” In The World Health Report. Geneva: World Health Organization, 2000.Google Scholar
Yenimahalleli Yaşar, Gülbiye, and Uğurluoğlu., Ece“Can Turkey’s general health insurance system achieve universal coverage?” International Journal of Health Planning and Management 26, no. 3 (2011): 282–295.Google ScholarPubMed
Yenimahalleli Yaşar, Gülbiye, and Uğurluoğlu., Ece“Review: ’Health transformation programme’ in Turkey: an assessment.” International Journal of Health Planning and Management 26, no. 3 (2011): 110–133.Google Scholar