Sosyal Güvenlik Kurumu (SGK)
Country of Operation
- Ministry of HealthGovernment
Target income level
- Bottom 20%
- Lower-middle income (20-40%)
- Middle-income (40-60%)
- Higher middle-income (60-80%)
- High-income (80-100%)
SummaryIn 2003, the newly-elected Government of Turkey launched the Health Transformation Program that reformed the fragmented system from multiple parallel public payers to a single payer into the national payer Sosyal Güvenlik Kurumu (SGK), and all citizens were entitled to the same benefits package.
Key program components
The Ministry of Health remains the system steward and continues to retain a strong role in provision, managing public hospitals and the family medicine program through its regional offices. The Ministry of Labor and Social Security has oversight of the national payer, SGK.
Enrollment in SGK is mandatory except for those electing private insurance. All beneficiaries are entitled to the same comprehensive benefits package. The integration of benefits packages across population segments occurred in a step-wise fashion, with the goal of first deepening all packages to the level of the Government Retirement Fund (that had the deepest package pre-reform), and second, adding additional services to the deepened package.
A newly-created Reimbursement Commission is responsible for setting prices and modulating the benefits package. Initially few changes were made to the old, fragmented fee-for-service model. In 2007, the SGK created a bundled price for outpatient and inpatient services.
The Turkish health system is principally funded through payroll taxation, with a small contribution from co-payments. For SGK, contributions are set at 12.5% of taxable income, 7.5% of which comes from employers and 5% from beneficiaries. The government pays the contribution of the disabled, refugees, Olympic champions, veterans, and children in social services. The poor formerly covered by the Green Card program are exempt from premia payment on a means-tested basis, and the government covers the premia.