• Spending overview
• Policy overview
• Diseases overview

Spending overview

Total expenditure on health in Turkey has remained low in comparison with, and has expanded less rapidly than, other OECD countries. According to the OECD, in 1990-2006 healthcare spending increased by 7% a year faster than GDP in Turkey, compared with an average of 29% faster in OECD countries. This probably reflects Turkey's young population, low income levels compared with developed economies and the absence of universal health insurance. According to the OECD, total healthcare spending in Turkey was just under 6% of GDP in 2004-06. It is estimated to have edged up slightly in 2007-09, remaining below other west European countries in 2008.

The gradual introduction of universal coverage, an increase in annual income per head, a growing population, a gradual rise in life expectancy and the size of the elderly population all point to higher expenditure on healthcare in the years ahead. The Economist Intelligence Unit expects total healthcare spending will rise from an estimated US$44bn in 2008 to about US$64bn in 2014, but could be substantially higher if the government fails to control public spending. By 2014 total spending on healthcare in Turkey is forecast at 6.4% of GDP, above that in Romania, more or less in line with that in Poland, but below that in Hungary, Germany and France (the latter two being above 10%).

Policy overview

Turkey’s healthcare system is undergoing a prolonged period of transition under the 2003-13 Health Transformation Programme. The restructuring is being carried out in the context of attempts to reduce the deficits of the social security institutions, which have risen sharply in recent years. To avoid extra public spending (or the need for intolerably high premiums), the range of healthcare services and medicines provided may be circumscribed, fewer people will qualify to receive services as dependants of the insured and more significant user fees are expected to be charged for all services and medicines.

Besides controlling public healthcare expenditure, the main aims identified in the 2003-13 reform are restructuring of the health ministry to enhance its core functions of developing policies, setting standards and ensuring quality; introduction of compulsory health insurance for the entire population; increasing access to healthcare facilities previously reserved exclusively for members of the various social security institutions and their dependants; improving training for doctors, nurses and administrators; and providing incentives for a more even distribution of personnel nationwide. A family practitioner service, which should improve primary care, is also being rolled out across the country, but it will take time to implement in full because of the shortage of trained general practitioners (GPs).

Diseases overview

Although healthcare indicators have improved in recent years, they are still relatively low by west European standards. Life expectancy, for example, was 72.9 years in 2007, up from 56 years in 1970, but still below the EU27 average of 77.3 years.

Turks remain heavy smokers (about 50% of adult males and almost 20% of adult females). According to the Ministry of Health, about 110,000 Turks die of smoking-related illness each year. Owing to awareness campaigns and restrictions on advertising and smoking in public places, consumption has started to fall, at least according to official data. In July 2009 restrictions on smoking in public places were extended to bars, cafes and restaurants. Being a predominantly Muslim country, Turkey's alcohol consumption is considerably lower than the OECD average. As a result, alcohol-related diseases are less frequent. According to the OECD, low alcohol consumption adds about 1.5 years to life expectancy at birth compared with the OECD average.