Universal health coverage in Turkey: enhancement of equity

Atun, Rifat; Aydın, Sabahattin; Chakraborty, Sarbani; Sümer, Safir; Aran, Meltem A.; Gurol, Ipek; Nazlıoğlu, Serpil; Özgülcü, Şenay; Aydoğan, Ülger; Ayar, Banu; Dilmen, Uğur; Akdağ, Recep

doi:10.1016/s0140-6736(13)61051-x

Cited by 318 publications

(350 citation statements)

References 24 publications

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“…Both Turkish and French experiences demonstrate the importance of investing in the public sector, in terms of enhancing working conditions, accountability, and professional development opportunities in luring physicians back to full-time practice. 35,36 The Greek example illustrates that increases in physicians' salaries alone do not necessarily improve their performance or alter their incentives as long as their performance is not evaluated against service standards and their payments are not related to their performance. Specifically, we suggest that reforms be accompanied by (1) an initiative to improve nonfinancial incentives and human resource management tools, such as appreciation, supportive supervision, performance appraisal, career development, feedback from the community, and training opportunities; (2) initiatives to improve workplace conditions, including availability of equipment and medications; and (3) performance-based payment modalities (or pilots), such as performance-based financing, as an incremental step toward eventual provider payment reform moving away from central, historical budgeting.…”

Section: Incentivize Health Workersmentioning

confidence: 99%

To Ban or Not to Ban? Regulating Dual Practice in Palestine

Alaref

Awwad²,

Araújo

et al. 2017

Health Systems & Reform

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Section: Incentivize Health Workersmentioning

confidence: 99%

To Ban or Not to Ban? Regulating Dual Practice in Palestine

Alaref

Awwad²,

Araújo

et al. 2017

Health Systems & Reform

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“…14 Some countries such as Turkey, [15][16][17] South Korea, 18,19 Brazil, Thailand, Ghana, Peru, 20 Estonia, Lithuania, 21 and Indonesia [22][23][24] have adopted this policy to expand the size of the risk pool, and to improve the equity, efficiency, and redistribution of cross-subsidization throughout the entire health insurance system.…”

Section: Policy Contextmentioning

confidence: 99%

“…This integration may or may not involve the Armed Forces Medical Insurance scheme. 15,16,31 Creating two (or three) large health insurance organizations with a full risk pooling within each scheme, and developing an effective oversight framework can address most of problems originating from fragmentation. It is worth highlighting that even though consolidation of health insurance funds is a necessary step for the development of an equitable and efficient health system, it is not enough by itself.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Bazyar¹,

Rashidian²,

Kane³

et al. 2016

Int J Health Policy Manag

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There are fragmentations in Iran's health insurance system. Multiple health insurance funds exist, without adequate provisions for transfer or redistribution of cross subsidy among them. Multiple risk pools, including several private secondary insurance schemes, have resulted in a tiered health insurance system with inequitable benefit packages for different segments of the population. Also fragmentation might have contributed to inefficiency in the health insurance systems, a low financial protection against healthcare expenditures for the insured persons, high coinsurance rates, a notable rate of insurance coverage duplication, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and reliable data and statistics for policy-making. We have conducted a policy analysis study, including qualitative interviews of key informants and document analysis. As a result we introduce three policy options: keeping the existing structural fragmentations of social health insurance (SHI) schemes but implementing a comprehensive "policy integration" strategy; consolidation of existing health insurance funds and creating a single national health insurance scheme; and reducing fragmentation by merging minor well-resourced funds together and creating two or three large insurance funds under the umbrella of the existing organizations. These policy options with their advantages and disadvantages are explained in the paper.

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“…4 However, this generalization requires a strong emphasis on 'context and receptivity of change'. 5 This is because every country has its own particular characteristics. Although the principles and targets are shared, the means for achieving them depend on initial positions and other factors.…”

Section: Uhc: Is It Affordable?mentioning

confidence: 99%

“…My experience is mainly related to a 'remarkable transformation in health' that occurred in a developing country during its ten-year journey from a 'low-middle-income' nation to joining the 'high-middle-income' group. [5][6][7][8][9] During this period, Turkey accomplished great success regarding the three core "outcome goals" for a health system, which are defined in the influential book Getting Health Reform Right: 10 1. Turkey's health status improved significantly.…”

Section: Uhc: Is It Affordable?mentioning

confidence: 99%

Lessons from Health Transformation in Turkey: Leadership and Challenges

Akdağ

2015

Health Systems & Reform

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Abstract-Universal Health Coverage (UHC) is a feasible but difficult goal. It requires an outcome-oriented transformation program plus the strong commitment and leadership of high-level politicians. It also necessitates attention to context and receptivity to change, which are crucial for strategy development and delivery. Any health minister should acknowledge that it is very difficult to achieve success without public support, which also translates into support for the prime minister or president of the country. It is possible to achieve major improvements to health system performance in a relatively short period of time under the right conditions. Turkey made remarkable progress in health status, patient satisfaction and financial risk protection with its ten-year Health Transformation Program. Based on Turkey's transf-ormational experience, nine guiding principles are proposed. These principles are invaluable to transformational leadership and overcoming challenges: assuring deep commitment to bring change, using a two-pronged action approach, gaining the public's support as a shield, developing a comprehensive program, achieving a balance between the public and private sectors, obtaining and sustaining the financial protection of citizens, learning from mistakes, not being blinded by short-term success, and focusing on outcomes.

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Universal health coverage in Turkey: enhancement of equity

Cited by 318 publications

References 24 publications

To Ban or Not to Ban? Regulating Dual Practice in Palestine

To Ban or Not to Ban? Regulating Dual Practice in Palestine

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

Lessons from Health Transformation in Turkey: Leadership and Challenges

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