Web-economic-crisis-health-systems-and-health-web

Turkey
Salih Mollahaliloglu and Mehtap Tatar
Economic trends
• Real per capita GDP in Turkey declined in 2009 by 4.0%, although
growth surpassed pre-crisis levels the following year. The budget deficit in
2009 increased to 7% of GDP, as the government share of GDP increased.
• The unemployment rate increased in 2009, but has since returned to
European mean levels.
• Health spending as a share of government expenditure remained stable
between 2008 and 2011. Although OOP expenditure per capita decreased
slightly in 2009 by 1.8%, public expenditure per capita increased
throughout the 2008 to 2011 period (Turkey: Figs 1 and 2).
Policy responses
Changes to public funding for the health system
• The budget of the Ministry of Health increased between 2008 and 2011.
• Payment of SHI contributions for government employees and their dependants
was transferred from the Ministry of Finance to the Social Security Institution
(2010); expenditure for Green Card holders was transferred from the Ministry
of Health to the Social Security Institution (2012).
Population (entitlement)
• No response reported.
The benefits package
• No response reported.
User charges
• Reimbursement rate for branded drugs without a generic option increased
(from 32.5% to 41% of the ex-factory price) (2011).
• Reduction of the reimbursement rate for drugs in the reference price system
from 15% to 10% of the price of the cheapest drug (2011).
• Reduction of the reimbursement rate for branded drugs with a generic option
(from 28% to 20.5%) and for generics (from 28% to 20.5%) (2011).
• Introduction of a new co-payment for prescriptions (TL 3 for up to three items
and TL 1 for each additional item) (2012).