If the wallet is empty, treatment is also difficult!

Healthcare has been one of the areas most affected by the AKP 's Health Transformation and regime-focused health policies. Public healthcare has been rapidly destroyed, and privatization, private hospitals affiliated with religious sects, and practices that increasingly usurp the rights of physicians and healthcare professionals have made access to healthcare increasingly difficult.

Citizens are forced to pay for every step of the way—medication, prescriptions, copayments, test difference fees, and the difference for generic drugs—and this has further exacerbated the hole in their pockets. Medical chambers have stated, "An ID card should actually be sufficient for healthcare. Citizens shouldn't have to pay extra for healthcare because their Social Security premiums are sufficient, but unfortunately, citizens are being charged for every step."

PATIENT VICTIM

For 23 years, every regulation introduced in the healthcare sector has further impeded citizens, especially physicians, and all healthcare professionals. Neoliberal policies in healthcare have also led to increased healthcare spending. Patients are finding it harder to find appointments with public providers, and paying for every step has exacerbated the situation. This situation is also reflected in the Ministry of Health's Statistical Yearbook. According to the most recently released 2023 data, the real amount of money citizens spend on healthcare has increased by 146 percent in 15 years. While real out-of-pocket healthcare spending per capita was 1,053 TL in 2023, this figure rose to 2,589 TL in 2023. The data also reflects an increase in the amount paid to private hospitals. Citizens said, "Copayments are making our lives miserable. The prevailing mentality of health is as important as your money." Dr. Fahri Yüce Ayhan, President of the Izmir Medical Chamber, reacted to the daily increase in citizens' out-of-pocket healthcare expenses, stating that these figures are steadily increasing with the Health Transformation Program. Ayhan said, "The Health Transformation Program is actually a World Bank project. Physicians, healthcare professionals, and citizens are bearing the brunt of this program." Recalling that healthcare is one of the most fundamental human rights, Ayhan commented, "However, healthcare should be provided equally and accessible to everyone by the state. This is the requirement of a social state."

IDEOLOGICAL TRANSFORMATION

Ayhan stated, "The Health Transformation actually reflects an ideological transformation," adding, "Many parameters demonstrate where the Health Transformation has brought Türkiye. Health is a fundamental human right, and its financing should be handled by the public. However, the Ministry of Health has begun to act more like a broker, an intermediary institution, managing the finances of the healthcare market, rather than a public service provider. In other words, it simply determines where the funding will be allocated. It takes from citizens and gives it to private hospitals. It cuts from public healthcare facilities and gives it to private hospitals. It puts university hospitals in a financial bind. Therefore, this approach lies at the core of many problems in the healthcare sector. This is why we will see more frequent abuses like newborn gangs and counterfeit formula prescriptions. These are perhaps just the tip of the iceberg."

Ayhan summarized the following: "The essence of the system is based on transferring a financial resource to a specific segment. With the money paid annually to city hospitals, the state could have built 33 new public hospitals. The deactivation of university hospitals, the deprivation of adequate equipment in public hospitals, and the funding of private hospitals from public funds are all consequences of this ideological transformation. Furthermore, as of January 2025, the co-payment for public and private hospitals increased by 233 percent, and for training and research hospitals by 542 percent. In short, the state is saying, 'If you want to benefit from healthcare, you must contribute to its financing.' In other words, out-of-pocket expenses have increased even further in the last two years. This has not yet been reflected in TÜİK (Turkish Statistical Institute) data. The question citizens should be asking is, 'Why am I paying extra to access the right to healthcare?' For treatment, every citizen should have only an ID card, but now they also need a wallet."

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THEY DON'T TAKE THEIR MEDICATIONS EVERY DAY TO AVOID RUNNING OUT

Turkish Medical Association (TTB) Central Council President Prof. Dr. Alpay Azap, reminding the public that every aspect of healthcare has become costly, summarized the situation by saying, "Citizens are charged for numerous items, such as prescription co-pays, medication co-pays, and examination co-pays. Furthermore, when patients go to private hospitals, they can be charged an additional fee of up to 200%. Sometimes, for example, it's necessary to make another payment to reschedule imaging appointments at university hospitals."

Azap, noting that patients unable to find an appointment at public hospitals may be forced to resort to private hospitals, said: "It's all about the cost. In short, as the Turkish Medical Association (TTB), we're saying this: A person must have an ID card to access healthcare services. The premiums collected by the Social Security Institution (SGK) are sufficient for healthcare expenses. There's no need to collect any additional money from citizens. This can lead to serious problems with access to healthcare. For example, with high blood pressure, known as the silent killer and a leading cause of death worldwide, patients are taking their medications every two or three days to avoid running out of medication packs, even though they should be taking them regularly every day due to their co-payments. This is something that actually summarizes the current situation."

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Private hospital record

• During the AKP era, the public share of healthcare has gradually diminished. Citizens have been confined to private healthcare. Out-of-pocket expenses have increased.

• Of the 1,555 hospitals across the country, 572 are private, 915 belong to the ministry and 68 are university hospitals.

• Only 164 of the private hospitals are in Istanbul.

• While 18 percent of Türkiye's population is in Istanbul, it is noteworthy that only 6 percent of public hospitals are in Istanbul.

• While 59 percent of hospitals in Türkiye are Ministry of Health hospitals, the private sector's share is 37 percent.