Financial burden of health care expenditures in Turkey: 2002-2003

Sulku, Seher Nur and Bernard, Didem M. (2009): Financial burden of health care expenditures in Turkey: 2002-2003.

Abstract

We examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to “The Health Transformation Programme” (HTP) for the non elderly population. We measure health care burdens as the share of out of pocket health care expenditures within family income. We define high burdens as expenses above 10 and 20 percent of income. We find that 19 percent of the nonelderly population were living in families spending more than 10 percent of family income and that 14 percent of the nonelderly population were living in families spending more than 20 percent of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. More significantly, we find that the risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period.

• Item Type: MPRA Paper
• Language: English
• Keywords: Out of Pocket Expenditures, Financial Burden, Health Care Reform, Turkey
• Subjects: G - Financial Economics > G2 - Financial Institutions and Services > G22 - Insurance ; Insurance Companies ; Actuarial Studies; I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health; I - Health, Education, and Welfare > I1 - Health > I10 - General

References

[1] Future for Turkish health sector under 21 aims. (21 hedefte Türkiye sağlıkta gelecek).Ankara, Turkey: Ministry of Health and Refik Saydam Hygiene Center School of Public Health; 2007.

[2] OECD. OECD Reviews of health systems Turkey, OECD and the International Bank for Reconstruction and Development, The World Bank; 2009.

[3] Organisation for Economic Co-operation and Development (OECD) health data 2008: statistics and indicators for 30 countries. Paris, France: OECD; 2008.

[4] Health 2006. (Sağlık 2006). Ankara, Turkey: Ministry of Health; 2006.

[5] Tatar MH, Ozgen B, Sahin PB, Berman P. Informal payments in the health sector: a case study from Turkey. Health Affairs 2007; 26: 1029-39.

[6] Savas, SB, Karahan Ö, Saka Ö. Health care systems in transition: Turkey. In: Thomson S,and Mossialos E, editors. Copenhagen, European Observatory on Health Care Systems; 4(4) 2002.

[7] World Bank. Turkey: reforming the health sector for improved access and efficiency. Volume 1 and 2, report no. 24358-TU.2003. Washington DC: International Bank for Reconstruction and Development, The World Bank; 2003.

[8] Social Security Institution. 2007 Activity report. (2007 Yılı Faaliyet Raporu). Social Security Institution; 2008. Available at http://www.sgk.gov.tr/wps/wcm/connect/2c354400 4c1667138480846156da2d6a/2007FaaliyetRaporu.pdf?MOD=AJPERES.

[9] Banthin JS, Bernard DM. Changes in financial burdens for health care national estimates for the population younger than 65 years, 1996 to 2003. Journal of the American Medical Association 2006; 22: 2712-9.

[10] Banthin JS, Cunningham P, Bernard DM. Financial burden of health care, 2001-2004. Health Affairs 2008, 27: 188- 95.

[11] Aran M, Hentschel J. Household level health expenditures and health ınsurance coverage of the poor in Turkey. Washington DC: World Bank; forthcoming.