The Politics of Healthcare Reform in Turkey

Yılmaz, Volkan

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

Cited by 48 publications

(55 citation statements)

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“…Provincial health directorates served as the coordinating agencies for the MoH and implement policies in cities and rural areas. At the macro-level, stakeholders, such as the professional associations representing physicians, dentists and nurses or unions representing other health professions and social workers, had a 'restricted role in policymaking', participating mostly in a consultative capacity (Tatar et al 2011: 8; see also Yılmaz 2017). Thus, physicians had a limited role in planning and regulation of healthcare services such as deciding on the suitability and economic efficiency of medical services and diagnostic tools that would be included in the publicly provided benefits package (Wendt et al 2013).…”

Section: Populism and The Justice And Development Partymentioning

confidence: 99%

New public management, physicians and populism: Turkey's experience with health reforms

Agartan

Kuhlmann

2019

Sociology Health & Illness

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Recent debates on the rise of right‐wing or neoliberal populism globally have prompted public health and health systems researchers to explore its implications in the healthcare systems. This case study of Turkey's recent health reform initiative, the Health Transformation Program, aims to contribute to this debate by examining the nexus among populism, professionalism and the contemporary market and managerial reforms, often described as New Public Management (NPM). Building on document analysis and secondary sources, this article introduces a framework to explore whether and how populist agendas grow up in the shadow of NPM policies. We aim to deepen our understanding of the governance settings that might be used in different ways by right‐wing populist leaders to advance their agendas. Our research reveals that the NPM reforms in Turkey have opened a ‘backdoor’ through which right‐wing populist agendas were supported and the position of the medical profession as an important stakeholder in the institutional settings was weakened. However, what mattered most in the reform process was not the policies themselves but the ways new managerialist policies were implemented. Our analysis makes blind spots of the NPM reforms and healthcare governance research visible and calls for greater attention to implementation processes.

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Section: Populism and The Justice And Development Partymentioning

confidence: 99%

New public management, physicians and populism: Turkey's experience with health reforms

Agartan

Kuhlmann

2019

Sociology Health & Illness

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“…This is clearly illustrated by Volkan Yılmaz's () study on developments in Turkey's healthcare system. The Health Transformation Programme which was introduced in 2003 retained the former health‐financing model based on contributions from employers and employees, with the self‐employed having to pay their own contributions.…”

Section: Social Policy Developments In Turkey: Market Reforms With Exmentioning

confidence: 96%

“…In the new system, redesigned according to the basic tenets of market rationality, out‐of‐pocket payments have become increasingly important for public hospital visits and medication. Additional patient contributory payments are required for visits to private hospitals which accept payment through public insurance (Ağartan, ; Yılmaz, ). Although anyone who has public insurance can in theory use privately provided health services (Yılmaz, : 210), contributory payments are set at a level that effectively limits the access of low‐income groups to these private hospitals.…”

Section: Social Policy Developments In Turkey: Market Reforms With Exmentioning

confidence: 99%

“…Additional patient contributory payments are required for visits to private hospitals which accept payment through public insurance (Ağartan, ; Yılmaz, ). Although anyone who has public insurance can in theory use privately provided health services (Yılmaz, : 210), contributory payments are set at a level that effectively limits the access of low‐income groups to these private hospitals. A private supplementary health insurance scheme was introduced to cover the required patient contributory payments, but it aims to appeal to middle class patients (Yılmaz, ).…”

Section: Social Policy Developments In Turkey: Market Reforms With Exmentioning

confidence: 99%

“…Since the unification of the three social security organizations under a single Social Security Institution with expanded coverage had a real inclusionary aspect, the market‐oriented reforms of the pension and health systems could proceed with considerable popular support. Through the implementation of the Health Transformation Programme, for example, the resistance of the Medical Association against the trend toward the privatization of health services and the business administration techniques introduced in hospital management could be dismissed without much difficulty by presenting it to the public as the doctors’ attempt to defend their own interests, and a reflection of their reluctance to serve the popular masses who now had the opportunity to have access to health services on equal terms with the privileged elite (Yılmaz, : 167–93).…”

Section: Politics Of Social Policymentioning

confidence: 99%

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Buğra¹

2020

Development and Change

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This article approaches social policy as an integral component of a capitalist society and, by drawing on the notion of the double movement introduced by Karl Polanyi, argues that social policy intervention both limits and contributes to market expansion. While this argument could be generally applied to recent social policy changes in the current context of economic globalization, these changes were shaped against different histories of social policy development in early and late industrializing countries. This article examines the increasing importance of social policy in late industrializing countries by focusing on the case of Turkey. It is argued that social policy transformation in Turkey has involved the expansion of social security coverage along with the privatization and marketization of health and pension systems. A new system of labour market regulation has contributed to the commodification of labour while the ‘state‐supported familialism’, which forms an important aspect of current trends in the area of social care, has served to integrate women in the prevailing flexible employment relations by simultaneously sustaining their position in the gender division of roles within traditional family relations. The populist strategy of polarization pursued by the ruling government is discussed to show how opposition to these trends toward privatization, marketization and labour commodification has been isolated.

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Physician perspectives on the implications of the diagnosis‐related groups for medical practice in Turkey: A qualitative study

Aktas

2022

Health Planning & Management

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Hospital reimbursement models might have unintended consequences for medical practice. In Turkey, a mixed reimbursement scheme, based on the diagnosis-related group (DRG) model and global budget, was gradually introduced as part of the country's 2003 healthcare reforms. This article examines the impacts of the DRG model on medical practice in Turkey, as perceived by physicians working in public and private hospitals. This study draws on an analysis of 14 interviews with physicians. The findings reveal that the implementation of the DRG has transformed medical practice into a process of cost-benefit optimisation which involves balancing the income and expenses of hospitals against patients' medical needs. To mitigate the negative effects of the DRG, the current model may need to be reformed, particularly to grant exemptions from the standard reimbursement structure for patients who are experiencing complications and/or multiple health conditions.

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The Politics of Healthcare Reform in Turkey

Cited by 48 publications

References 0 publications

New public management, physicians and populism: Turkey's experience with health reforms

New public management, physicians and populism: Turkey's experience with health reforms

Politics of Social Policy in a Late Industrializing Country: The Case of Turkey

Physician perspectives on the implications of the diagnosis‐related groups for medical practice in Turkey: A qualitative study

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