Date of Award


Document Type

Masters Thesis

Degree Name


Organizational Unit

College of Arts Humanities and Social Sciences, Economics

First Advisor

Yavuz Yaşar


Turkey, Health care, Universal health care, Health insurance


In 2008, Turkey introduced a new health system reform called Health Transformation Project (HTP) with universal health coverage. HTP aims equity in financing healthcare and distribution as well as sustainability, efficiency and quality within the healthcare system. There are claims that HTP has significantly increased the fairness in financing with better protection, eventually enhancing equity (Atun et. al. 2013). In this study, we investigate the accuracy of this claim by examining the share of out-of-pocket and health insurance payments in the households‘ ability to pay. We use Turkish Household Budget Surveys between 2003 and 2013 in order to assess the progressivity of the healthcare system before and after the reform. The results suggest that there is an absolute improvement in that the share of healthcare expenditures within the households‘ ability to pay has been declining. However, the poor segments of the population still pay a higher portion of their income for healthcare expenditures in the form of out-of-pocket payments. As a result, relative inequalities in healthcare payment still remain; and this leads to vertical inequity because population segments with different ability to pay have to bear inappropriate and unequal shares of healthcare payment.

Publication Statement

Copyright is held by the author. This work may only be accessed by members of the University of Denver community. The work is provided by permission of the author for individual research purposes only and may not be further copied or distributed. User is responsible for all copyright compliance.

Rights Holder

Mete Can Özçörekçi


Received from author

File Format




File Size

65 pgs