Extension of Health Services Coverage for Needy in Turkey : From Social Assistance to General Health Insurance

In the beginning of the 1990’s, Turkey started to implement a new free health service scheme named the Green Card program for people with one third of minimum wage income level in a household. The scheme is financed by taxes. This paper examines the Green Card program and it’s effect on health coverage in Turkey. We used Turkey Statistics Institution’s (TURKSTAT) Household Budget Survey, Turkey Life Satisfaction Survey and Social Security Institution’s statistics to examine the Green Card holders special features such as gender, age, income group and employment status. About 13 % of the population was provided health service by having expenses at the rate of 4 per thousand of GDP with the scheme of green card in 2010. More than half of the Green Card holders are children and elderly. We estimated that 80% of the Green Card holders are in the poorest three income groups among ten income groups and almost 80,6% of the Green Card holders are below the poverty limit to entitle a green card from data of TURKSTAT 2009 Household Budget Survey. It can be said that health benefit reached the targeted poor groups of the population with the Green Card scheme. Health contribution for needy has been paid by the state since 1st January 2012In other words, the Green card scheme has continued with various names. 1990’lar n ba nda Türkiye hanedeki geliri asgari ücretin ü te birinden dü ük yoksullar i in ücretsiz sa l k hizmeti sa layan ve vergilerle finanse edilen ye il kart isimli bir program ba latt . Bu al ma ye il kart program n ve onun sa l k güvencesi kapsam üzerine etkisini incelemektedir. al mada ye il kartl lar n, ya , cinsiyet, gelir ve istihdam durumlar n incelemek i in Türkiye statistik Kurumu (Tü K) Hane Halk Büt e Anketi (HHBA), Türkiye Ya am Memnuniyeti Anketi ve Sosyal Güvenlik Kurumu statistikleri kullan lm t r. 2010 y l nda GSY H’n n binde 4’ünü harcayarak nüfusun sa l k sigortas olmayan %13’lük bir k sm na ücretsiz sa l k güvencesi sa lanm t r. Ye il kartl lar n yar s ndan fazlas n ocuklar ve ya l lar olu turmaktad r. al ma ile Tü K HHBA’nden ye il kartl lar n %84’ünün on gelir grubu i inde ilk ü yoksul gelir grubunda bulundu u, %82,6’s n n ise ye il karta sahip olabilmek i in gerekli olan asgari ücretin ü te birinden daha az gelire sahip olma art n yerine getirdi i saptanm t r. Ye il kart uygulamas ile sa l k yard mlar n n büyük l üde hedef gruba ula t s ylenebilir. Halen genel sa l k sigortas kapsam nda yoksullar n primleri devlet taraf ndan denmeye devam etmektedir. Bir ba ka anlat mla ye il kart uygulamas ad de i tire