Principal health reforms

Abstract

Health care reform has been given the utmost importance on Turkey’s policy agenda since the late 1980s. In 1989, the SPO’s Master Plan Study (SPO, 1990), which was developed through a World Bank loan, introduced new concepts to the Turkish health care system. The Plan suggested splitting the functions of purchasing and provision, developing an internal market, implementing general health insurance, formulating a family medicine system at the primary health care level and giving autonomy to state hospitals. From 1990 to 1993, intensive efforts were undertaken to reshape the health care system in a way that reflected global trends and approaches. The World Bank had an important role in developing this process. The National Health Policy (Ministry of Health, 1993) presented the first comprehensive analysis of priority health care policies and also set out future strategies. However, a decade of political and economic instability (1993–2003) led to reform proposals that remained as blueprints with no concrete steps for implementation.