Financial burden of health care expenditures in Turkey: 2002-2003

We examine whether and to what extent the health insurance system in Turkey provided adequate protection against high out of pocket expenditures in the period prior to “The Health Transformation Programme” (HTP) for the non elderly population. We measure health care burdens as the share of out of pocket health care expenditures within family income. We define high burdens as expenses above 10 and 20 percent of income. We find that 19 percent of the nonelderly population were living in families spending more than 10 percent of family income and that 14 percent of the nonelderly population were living in families spending more than 20 percent of family income on health care. Furthermore, the poor and those living in economically less developed regions had the greatest risk of high out of pocket burdens. More significantly, we find that the risk of high financial burdens varied by the type of insurance among the insured due to differences in benefits among the five separate public schemes that provided health insurance in the pre-reform period.