The Effects of the 2008 Health Reform on Out-of-Pocket Health Expenditures in Turkey

University Faculty of Economics & Administrative Sciences (Akdeniz İ.İ.B.F. Dergisi ), 36, 71-102, 2017

32 Pages Posted: 1 Jul 2019

See all articles by Eleftherios Giovanis

Eleftherios Giovanis

Manchester Metropolitan University-Business School, Department of Economics, Policy and International Business; Aydin Adnan Menderes University, Nazilli Faculty of Economics and Administrative Sciences

Oznur Ozdamar

Aydın Adnan Menderes University

Date Written: November 20, 2017

Abstract

The Turkish health care system has been subject to significant and critical changes and reforms since 2003. One of the most important reforms has been implemented in 2008 where the Green Card holders are entitled to the same services, without any fee, as those with public health insurance, such as the Emekli Sandığı, BAĞKUR, SSK. This study initially examines the characteristics of health insurance schemes, determinants of holding one of the health insurance schemes (public, private, green card, no-insurance) in Turkey. It further analyses the effect of 2008 reform on out of pocket expenditures (OOPEs). The study will be the first in the related literature analysing the effect of this reform especially on the OOPEs of green card holders. The analysis relies on a detailed micro-data level survey, TUİK Household Budget Survey, over the period 2002-2011 and employs a difference-in-difference approach using a pseudo-panel based on propensity score matching. Initial results show that individuals who have public insurance are less inclined to face out-of-pocket health expenditures compared to those without health insurance and the Green Card holders. However, the difference of the OOPEs between the public health insurees and green card holders is reduced after the implementation of the 2008 reform.

Keywords: Difference-in-Difference Approach, Health Insurance Schemes, Health Reforms, Out-of-Pocket Expenditures, Propensity Score Matching Method, Pseudo-Panel Data, Turkey

JEL Classification: I13, I14

Suggested Citation

Giovanis, Eleftherios and Ozdamar, Oznur, The Effects of the 2008 Health Reform on Out-of-Pocket Health Expenditures in Turkey (November 20, 2017). University Faculty of Economics & Administrative Sciences (Akdeniz İ.İ.B.F. Dergisi ), 36, 71-102, 2017. Available at SSRN: https://ssrn.com/abstract=3411581

Eleftherios Giovanis (Contact Author)

Manchester Metropolitan University-Business School, Department of Economics, Policy and International Business ( email )

Business School
All Saints Campus
Manchester, M15 6BH
United Kingdom

Aydin Adnan Menderes University, Nazilli Faculty of Economics and Administrative Sciences ( email )

Nazilli IIBF
Sumer Kampusu
Aydin, Nazilli 09800
Turkey

Oznur Ozdamar

Aydın Adnan Menderes University ( email )

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