Assessing the Health-economic Crisis: The Case of Turkey

Abstract

With the transition to neoliberalism, health has tended to be less regarded as a social obligation and become instead an individual responsibility. Hence, the issue of healthcare has gained a “health-economic” character by increasingly integrating health systems into the existing economic situation and market dynamics. Introduced in the 2000s, the Health Transformation Program (HTP) represents such an approach in Turkey. This article reports on field research carried out in Istanbul into the consequences of the HTP through a survey focusing on healthcare facility preferences and perceptions of the most critical problems of the healthcare system. The survey was carried out in 2019 with 5002 participants aged 25-65 using the face-to-face technique and frequency and Pearson chi-square analyses to summarise the findings. The privatisation trend is shown by public-to-private comparisons of health expenditures, hospital beds and admissions to hospitals, while the shift toward private hospitals is mitigated by participant preferences for the public healthcare schema, which remains the central pillar of the system. This preference is mainly based on the economical services provided in public hospitals, while the shift to the private system is argued to be largely impelled by increased patient density in the public system resulting from the neoliberal logic of the HTP. In conclusion, the need for a new reform program that will invest in the public nature of the Turkish health system is identified and addressed.