A recent report by the Confederation of Revolutionary Trade Unions of Turkey Research Center (DİSK-AR) highlights a paradox in Turkey’s healthcare system: while the number of patient applications to private hospitals has steadily decreased since 2012, the Social Security Institution (SGK)’s payments to these hospitals have surged.
In 2012, there were 87.9 million patient visits to private hospitals, but by 2023, this figure had dropped to 68.5 million. Despite the decline in applications, SGK’s per-patient payments to private hospitals increased from 180 TL in 2012 to 801 TL in 2024, marking a 940% increase. In comparison, payments to state second-level hospitals rose from 49 TL to 282 TL (469% increase), and to state third-level hospitals from 91 TL to 564 TL (518% increase). Payments to university hospitals also saw significant growth, from 180 TL to 1,341 TL.
The report reveals that while private hospital applications now account for only 10% of all healthcare applications (down from 22.7% in 2012), these hospitals receive around 16% of SGK’s total healthcare payments. This divergence underscores the financial strain private hospitals place on public resources, with SGK paying three times more per patient to private hospitals than to state second-level hospitals.
The report attributes much of the financial strain to exorbitant pricing policies in private hospitals, which exceed the rates set by the Health Implementation Circular (SUT). Additionally, the rise in SGK payments aligns with the structural changes introduced by the Health Transformation Program in the 2000s, which expanded the role of private hospitals within the healthcare system.
According to DİSK-AR, these practices have left both the SGK and patients in financially vulnerable positions. Despite reforms meant to enhance healthcare access and efficiency, private healthcare providers continue to exert significant pressure on the public health insurance system. The unit payment discrepancy between state and private hospitals has widened since 2012, with SGK payments to private hospitals now reaching 153% of the average payment per patient, compared to 67% for state second-level hospitals.
- 2012: Private hospitals received SGK payments equivalent to 105% of the average payment per patient.
- 2024 (first half): Private hospitals now receive 153% of the average payment, while state secondary hospitals receive only 53%.
