The New Politics of Healthcare in Turkey

Yılmaz, Volkan

doi:10.1007/978-3-319-53667-5_1

Cited by 5 publications

(13 citation statements)

References 52 publications

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“…In the 2002 general elections, the AK Party won by a majority and “ended a decade of poorly functioning coalition governments” ( 19 ). While the party adopted a neo-liberal approach to the economy, it had a clear preference to keep the role of the state intact on social and healthcare policy ( 4 ). The AK Party had seven main components in its party programme, one of which was dedicated to social policies, which included healthcare.…”

Section: Resultsmentioning

confidence: 99%

“…Consequently, when the AK Party came into power on a populist mandate, in order to appeal to its significant voter base of rural poor and urban slum dwellers, it focused on a pro-poor narrative. Yilmaz ( 4 ) finds that “Healthcare was key in the AKP's quest for power, and that the AKP used healthcare to influence people.” Yilmaz argues that the AK Party focused on social policies and healthcare reform specifically to distance itself from the Political Islamist movement it had emerged out of, as all parties affiliated to the movement had been shut down.…”

Section: Resultsmentioning

confidence: 99%

“…Health reforms, in the form of the Health Transformation Plan (HTP) implemented well, resulted in electoral success for the AK party over the years; in turn continuing the priority to healthcare, through which the party was able to leverage greater political legitimacy. Over a ten-year period, the percentage of the population satisfied with the healthcare system in Turkey increased from 39.5% in 2003 to 74.7% in 2013 ( 4 , 19 ). Public opinion surveys indicated that the general public considered healthcare reforms as the party's most successful achievement ( 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Over a ten-year period, the percentage of the population satisfied with the healthcare system in Turkey increased from 39.5% in 2003 to 74.7% in 2013 ( 4 , 19 ). Public opinion surveys indicated that the general public considered healthcare reforms as the party's most successful achievement ( 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…Patton ( 42 ) argues that the party was able to push for reforms and deliver successfully on them due to a combination of factors including “a more stable government staffed by an AK Party majority in 2002, better fiscal management, and a demand for better healthcare from working class constituents in rapidly expanding urban areas.” The World Bank provided technical and financial assistance in introducing the reforms, with the relations between the Turkish government and the World Bank strengthened with the AK Party. Yilmaz ( 4 ) argues that the release of the World Bank's report on Turkey's healthcare system in 2003 was “influential in setting the main parameters of the political debates on Turkey's health- care system” and served as a reference point for the AK Party which was already motivated to reform the country's healthcare system.…”

Section: Resultsmentioning

confidence: 99%

See 4 more Smart Citations

Political motivation as a key driver for universal health coverage

Venkateswaran

Slaria²,

Mukherjee³

2022

Front. Public Health

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Variation in public investments to health, health outcomes, and progress toward universal health coverage across countries is vast and neither economic status nor the knowledge on solutions have borne out to be binding constraints to health improvements. The drivers for universal health coverage go beyond the macro-economic context of a nation, and as pointed out by scholars, are deeply linked with the extent of political prioritization of healthcare. Low public investments to health in India and slow movement toward universal health coverage underline the need for more attention to the political priority accorded to health in the country. While the role of politics in policy reforms has been established by several scholars, this paper seeks to identify the intrinsic motivations or incentives that drive political priority. Drawing on the experience of nine countries, the paper attempts to inform the analysis for countries such as India (where progress toward universal health coverage remains slow), on the political incentives for prioritization of healthcare, and how these may be shaped or strengthened. The analysis finds that health care reforms happen in (at least) two stages: the existence and recognition of a national context and a problem, followed by political opportunities and motivations which lead political leaders to address the identified problem. The paper separates motivation as a distinct factor for analysis because, in the absence of strong incentives, not every political opportunity may lead to attention to an issue, and finds that reforms were motivated by a need to gain political legitimacy by an incoming regime, or by its political ideology, or a combination of both. Importantly, political motivation does not always take root in itself, but often driven by external factors and stakeholders who contribute to creating or strengthening incentives for political attention. A greater role from citizens and other actors such as elected representatives, questioning status quo and highlighting the schisms in the social contract between a political regime and citizens may contribute to shifting the source of legitimacy for leaders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Political motivation as a key driver for universal health coverage

Venkateswaran

Slaria²,

Mukherjee³

2022

Front. Public Health

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Gendered familialism in a Mediterranean context: women’s labor market participation and early childhood education and care in Turkey

Akkan,

Buğra,

Knijn

2023

New Perspect. Turk.

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This article explores the relationship between women’s labor market participation and early childhood education and care (ECEC) in Turkey within a broader Mediterranean context. Since the 1990s, there have been significant changes in the familialist models in the Mediterranean region driven by women’s increased labor market participation and the expansion of ECEC services. The transformations in the region have unveiled a significant link between the expansion of preschool education and an increase in women’s labor market participation. Turkey missed this critical juncture in the 1990s, as indicated by the low employment rates of women and below-the-Organisation for Economic Co-operation and Development (OECD)-average preschool enrolment. Through a comparative perspective that examines the slow progress in both areas in Turkey as well as the gendered feature of its familialist model, the article emphasizes the need for closer analysis of the link between ECEC and the low labor force participation of women. Given that the expansion of ECEC in the 2000s has taken place through market-driven services, the article concludes that the link between ECEC and women’s labor market participation exhibits a class dimension. Thereby, women from lower socio-economic groups are increasingly experiencing the impact of the gendered characteristics inherent in the familialist regime in Turkey.

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Pay-for-performance in healthcare provision: the role of discretion in policy implementation in Turkey

Aktas

Hammond

Richardson

2023

IJPSM

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PurposeNew Public Management-informed pay-for-performance policies are common in public sectors internationally but can be controversial with delivery agents. More attention is needed on contingent forms of bottom-up implementation of challenging policies, in emerging market economies, for professionals who face tensions between policies and their codes of practice. Street-level bureaucrats (SLBs) mediate policy implementation through discretionary practices; health professionals have enhanced space for discretion based on autonomy derived from professional status. The authors explore policy implementation, adaptation and resistance by physicians, focusing on payments for health workers in Turkey.Design/methodology/approachThe researchers conducted semi-structured qualitative interviews with 12 physicians in Turkish hospitals and thematic analysis of interview transcripts, using a blended (deductive and inductive) approach.FindingsThe policy fostered discretionary behaviours such as cherry-picking (high volume, low risk procedures) and pro-social rule-breaking (e.g. “upcoding”), highlighting clinical autonomy to navigate within policy restrictions. Respondents described damage to relationships with patients and colleagues, and dissonance between professional practice and perverse policy incentives, sometimes leading to disengagement from clinical work. Policymakers were perceived to be detached from the realities experienced by SLBs. Tensions between the policy and professional values risked alienating physicians.Research limitations/implicationsThis study utilises participant self-reported perceptions of discretionary behaviours. Further work may adopt alternative methods to explore the relationship between self-reporting and observed practice.Originality/valueThe authors contribute to research on differentiated, contingent roles of groups with high scope for discretion in bottom-up implementation, pointing to the potential for policy-professional role conflicts between top-down P4P policies, and the values and codes of practice of professional SLBs.

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The New Politics of Healthcare in Turkey

Cited by 5 publications

References 52 publications

Political motivation as a key driver for universal health coverage

Political motivation as a key driver for universal health coverage

Gendered familialism in a Mediterranean context: women’s labor market participation and early childhood education and care in Turkey

Pay-for-performance in healthcare provision: the role of discretion in policy implementation in Turkey

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