Healthcare financing reform in Turkey: context and salient features

The health field is characterised by high uncertainties which can lead to large expenditures. One way to manage these uncertainties is to develop collectively-financed health care systems. Some countries create this collective financing through general taxes, whereas others rely on premiums set up through compulsory social health insurance. Turkey, a middle-income country, has historically used several mechanisms to extend health care to its population. However, inadequate financing and poor service quality have plagued this health care system.

Recently, a transition from a system of multiple insurance schemes that cover only about two-thirds of the population to a single-payer system aiming to achieve universal coverage has been under way to overcome problems in the fragmented health financing system and ensure universal coverage. With the enactment of the General Health Insurance Scheme Law in 2006, the Turkish health care system has embarked on one of its most radical and far-reaching reforms since the socialization attempt of the 1960s.

This paper focuses on the health care financing reform in Turkey, concentrating on its salient features in terms of financing functions and policies and explores the main differences between the old and new systems. The care and coverage aspects are also dealt with. Our results suggest that if well implemented, the GHIS reform can be a powerful engine for achieving universal coverage and enhancing equity and solidarity in the Turkish health care system. However, to reach this end, a transition process is required, as the success of the GHIS will depend on its ability to manage challenges during the implementation process.

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