Access to healthcare: Lessons from Turkey

Abstract

Background The concept of financial protection as part of healthcare has received increasing attention in the health systems of the world. Thus, national governments and international organisations such as the World Bank and other agencies of the United Nations have focused on the risk that high health expenditures pose to the financial security of poor and vulnerable populations such as women and children. The purpose of this paper is to describe the healthcare financing scheme for the poor in Turkey, known as the Green Card system. Methods A systematic review of published and unpublished literature was used to describe the Green Card system. In addition, this study provides information on the general climate of healthcare in Turkey, with special focus on the lack of insurance coverage as it relates to poverty and to health problems in the country. Results This study discussed how the Turkish poor currently gain access to medical care, and presents implications for policy changes toward increasing service utilisation. Approximately 14 per cent of the Turkish population are using the Green Card system to access medical care, and these numbers are increasing due to the recent economic crises in Turkey. The Green Card model has many successes, in addition to problems arising from legal and budgetary restrictions and incomplete coverage. Conclusions The Green Card implementation was a temporary solution at the beginning, but now the system is becoming a permanent scheme for the poor. Thus government officials should try to identity new financial sources for the scheme although the country is currently suffering from a heavy load of increased taxes and premiums.