Turkey's Health and Social Expenditures: A Retrospec-tive Comparative Study from the Perspective of Social Work

Yıl 2020, Cilt: 15 Sayı: 1, 185 - 208, 01.04.2020

Ercem Erkul Buğra Yıldırım

https://doi.org/10.17153/oguiibf.494634

Öz

At the beginning of the 1980s, when the state of welfare declined and
liberal economy disguised, so-called neoliberal politics flourished in both
developing and developed countries. Consequently, public and private sector economies
in those countries narrowed; internal and external debts increased; and those
countries remained weak relative to the countries advocating neoliberal
policies. In this context, the year 1980, in which neoliberal policies emerged,
has been chosen as the initial year for the assessment of health and social
expenditures in the case of Turkey. The reason for the selection of health and
social expenditures in the study is to reflect the perspective of social work
on the assessment to be made using OECD data. In this regard, the aim of this
study is to make a retrospective and comparative examination of the health and
social expenditures of Turkey using OECD data from the perspective of social
work.

Anahtar Kelimeler

Neoliberal Policies, Turkey, Health Expenditures, Social Expenditures, Social Work, Social Work Perspective

Türkiye'nin Sağlık ve Sosyal Harcamaları: Sosyal Hizmet Perspektifinden Retrospektif Karşılaştırmalı Bir Çalışma

Öz

1980’li
yılların başında sosyal devlet anlayışının azaldığı ve liberal ekonominin kılık
değiştirerek neoliberal politikalar adı altında hüküm sürdüğü bir süreç, hem
gelişmekte olan hem de gelişmiş ülkeler için başlamış oldu. Bu ülkelerin kamu
ve özel sektör ekonomileri daralmış, iç ve dış borçları artmış ve neoliberal
politikaları savunan ülkeler karşısında adeta onlar zayıf kalmışlardı. Bu bağlamda,
neoliberal politikaların gün yüzüne çıktığı 1980 yılı, Türkiye’ye ilişkin
sağlık ve sosyal harcamaların değerlendirilmesinde başlangıç yılı seçilmiştir.
Öte yandan, çalışmada sağlık ve sosyal harcamaların seçilmesinin nedeni ise
sosyal hizmet bakış açısının Ekonomik Kalkınma ve İşbirliği Örgütü (OECD)
verileri kullanılarak yapılacak olan değerlendirmeye yansıtılmak istenmesidir.
Dolayısıyla bu çalışmanın amacı Türkiye’nin sağlık ve sosyal harcamalarının
sosyal hizmet bakış açısı temelinde OECD verileri kullanılarak retrospektif
karşılaştırmalı şekilde incelenmesidir.

Anahtar Kelimeler

Neoliberal Politikalar, Türkiye, Sağlık Harcamaları, Sosyal Harcamalar, Sosyal Hizmet, Sosyal Hizmet Bakış Açısı

Kaynakça

• Adams, Robert; Dominelli Lena; Payne Malcolm (2009), Social Work: Themes, Issues And Critical Debates. London: Macmillan.
• Adema, Willem; Ladaique Maxime (2005), Net Social Expenditure, 2005 Edition: More Comprehensive Measures of Social Support. Social, Employment and Migration Working Papers No. 29. Paris: OECD Publishing.
• Agovino, Massimiliano; Parodi Giuliana (2016), "An analysis of Italian regional social expenditure on disability and other social measures: a spatial econometric approach." Applied Spatial Analysis and Policy 9.4: 549-567.
• Ağartan, Tuba (2007), “Sağlıkta Reform Salgını”. Eds.: Çağlar Keyder vd., İçinde: Avrupa’da ve Türkiye’de Sağlık Politikaları: Reformlar, Sorunlar, Tartışmalar (ss. 37-54). İstanbul: İletişim Yayınları.
• Alcock, Pete; Haux Tina; May Margaret; Wright Sharon (2008), The Students Companion to Social Policy. Oxford: Blackwell.
• Alston, Margaret (2007), “Globalisation, Rural Restructuring And Health Service Delivery in Australia: Policy Failure And The Role of Social Work?” Health & Social Care in the Community 15(3): 195-202.
• Álvarez-Gálvez, Javier; Jaime-Castillo Antonio M. (2018), "The impact of social expendi-ture on health inequalities in Europe." Social Science & Medicine 200: 9-18.
• Atun, Rıfat; Aydın Sabahattin; Chakraborty Sarbani; Sümer Safir; Aran Meltem; Gürol İpek; Nazlıoğlu Serpil; Özgülcü Şenay; Aydoğan Ülger; Ayar Banu; Dilmen Uğur; Akdağ Recep (2013), “Universal Health Coverage in Turkey: Enhancement of Equity”. The Lancet 382(9886): 65-99.
• Aydın, M. Kemal; Çakmak Eyüp Ensar (2017), “Sosyal Devletin Temelleri”. Bilgi Sosyal Bilimler Dergisi 34(1): 11-19.
• Becchetti, Leonardo, Conzo Pierluigi; Salustri Francesco (2017), "The impact of health expenditure on the number of chronic diseases." Health Policy 121.9: 955-962.
• Buğra, Ayşe (2015), Kapitalizm, Yoksulluk ve Türkiye’de Sosyal Politika. (7. Baskı), İstanbul: İletişim Yayınları.
• Buğra, Ayşe; Keyder, Çağlar. (2003). “Yeni Yoksulluk ve Türkiye’nin Değişen Refah Rejimi”. Birleşmiş Milletler Kalkınma Programı Proje Raporu. http://www.tr.undp.org/content/dam/turkey/docs/povreddoc/UNDP-TR-new_poverty.pdf (Erişim Tarihi: 28.11.2018).
• Castles, Francis (1986), “Social Expenditure And The Political Right: A Methodological Note”. European Journal of Political Research 14(5‐6): 669-676.
• Castles, Francis, Obinger Herbert (2007), “Social Expenditure And The Politics of Redistribution”. Journal of European Social Policy 17(3): 206-222.
• Cuckler, Gigi; Sisko Andrea; Keehan Sean; Smith Shelia; Madison Andrew; Poisal John; Wolfe Christian; Lizonitz Joseph; Stone Devin (2013), “National Health Expenditure Projections, 2012-22: Slow Growth Until Coverage Expands And Economy Improves”. Health Affairs 32(10): 1820-1831.
• Çınaroğlu, Songül; Şahin Bayram (2016), "Katastrofik Sağlık Harcaması ve Yoksullaştırıcı Etki." Hacettepe Sağlık İdaresi Dergisi 19.1:73-86.
• Dahl, Espen; van der Wel Kjetil A. (2013), “Educational Inequalities in Health in European Welfare States: A Social Expenditure Approach”. Social Science & Medicine 81: 60-69.
• Di Matteo, Livio (2005), “The Macro Determinants of Health Expenditure in The United States And Canada: Assessing The Impact of Income, Age Distribution And Time”. Health Policy 71(1): 23-42.
• Dixon, Anna; Mossialos Elias (2000), “Has The Portuguese NHS Achieved Its Objectives of Equity And Efficiency?”. International Social Security Review 53(4): 49-78.
• Erdem, Nilgün (2010), “Bağımlılığın Yeni Biçimleri Olarak Neoliberal Politikalar: Türkiye Örneği”. Ankara Üniversitesi SBF Dergisi 65(2): 117-135.
• Erençin, Arif; Yolcu Vesim (2008), “Türkiye’de Sağlık Hizmetlerinin Dönüşümü ve Yerinden Yönetim”. Memleket Siyaset Yönetim 3(6): 118-136.
• Erkul, Ercem; Demir-Erkul Fatma (2016), “Enerji Fiyatlarındaki Dalgalanmaların Sosyal Harcamalar Üzerine Etkisi: SHÇEK Özel Örneği”. Eds. İbrahim Cılga vd., İçinde: Sosyal Çalışma ve Sosyal Politika Yazıları (ss. 181-195). Ankara: Bellek Yayınları.
• Erol, Hatice; Özdemir Abdullah (2014), “Türkiye’de Sağlık Reformları ve Sağlık Harcamalarının Değerlendirilmesi”. Sosyal Güvenlik Dergisi 4(1): 9-34.
• Esping-Andersen, Gosta (1990), The Three Worlds of Welfare Capitalism. Oxford: Polity Press.
• Esping-Andersen, Gosta (2002), “Towards The Good Society, Once Again?” Ed: G. Esping-Andersen. İçinde: Why We Need A New Welfare State? (First published, 1-25). New York: Oxford University Press.
• Etiler, Nilay (2011), “Neoliberal Politikalar ve Sağlık Emekgücü Üzerindeki Etkileri”. Türk Tabipler Birliği Mesleki Sağlık ve Güven Dergisi Ekim-Kasım-Aralık: 2-11.
• Ferguson, Lain; Lavalette Micheal (2006), “Globalization And Global Justice: Towards A Social Work of Resistance”. International Social Work 49(3): 309-318.
• Ferrera, Maurizio (1996), “The Southern Model of Welfare in Social Europe”. Journal of European Social Policy 6(1): 17-37.
• Ferrera, Maurizio; Hemerijck, Anton; Rhodes, Martin (2000), “Recasting European Welfare States For The 21st century”. European Review 8(3): 427-446.
• Gökbunar, Ramazan; Özdemir Harun; Uğur Alparslan (2008), “Küreselleşme Kıskacındaki Refah Devletinde Sosyal Refah Harcamaları”. Doğuş Üniversitesi Dergisi 9(2): 158-173.
• Görg, Holger; Molana Hassan; Montagna Catia (2009), “Foreign Direct Investment, Tax Competition And Social Expenditure”. International Review of Economics & Finance 18(1): 31-37.
• Hahn, Sangjin; McCabe Angus (2006), “Welfare‐to‐Work And The Emerging Third Sector in South Korea: Korea's Third Way?”. International Journal of Social Welfare 15(4): 314-320.
• Hitiris, Theo (1997), “Health Care Expenditure And Integration in The Countries of The European Union”. Applied Economics 29(1): 1-6.
• Hugman, Richard (2003), “Professional Values And Ethics in Social Work: Reconsidering Postmodernism?”. British Journal of Social Work 33(8): 1025-1041.
• Jaime-Castillo, Antonio M.; Marqués-Perales Ildefonso; Álvarez-Gálvez Javier (2016), "The impact of social expenditure on attitudes towards immigration in Europe." Social Indicators Research 126.3: 1089-1108.
• Jones, Chris (2001), “Voices From The Front Line: State Social Workers And New Labour”. British Journal of Social Work 31(4): 547-562.
• Kazgan, Gülten (2013), Tanzimat’tan 21. Yüzyıla Türkiye Ekonomisi. (5. Baskı), İstanbul: Bilgi Üniversitesi Yayınları.
• Kemshall, Hazel (2010), “Risk Rationalities in Contemporary Social Work Policy And Practice”. British Journal of Social Work 40(4): 1247-1262.
• Kittel, Bernhard; Obinger Herbert (2003), “Political Parties, Institutions, And The Dynamics of Social Expenditure in Times of Austerity”. Journal of European Public Policy 10(1): 20-45.
• Koray, Meryem (2008), Sosyal Politika. (3. Baskı), Ankara: İmge Kitapevi.
• Kurt, Serdar (2015), “Government Health Expenditures And Economic Growth: A FederRam Approach For The Case of Turkey”. International Journal of Economics And Financial Issues 5(2): 441-447.
• Leibfried, Stephan (2000), “National Welfare States, European Integration And Globalization: A Perspective For The Next Century”. Social Policy & Administration 34(1): 44-63.
• Liang, Li-Lin; Tussing A. Dale (2018), "The cyclicality of government health expenditure and its effects on population health." Health Policy: Baskıda (https://doi.org/10.1016/j.healthpol.2018.11.004).
• López, G. Casasnovas; Mosterín A. Höpping (2008), "Health expenditure in the context of social expenditure. A generational analysis of tendencies in Spain in the context of demographic aging. 2008 SESPAS Report." Gaceta sanitaria 22: 43-52.
• Lora, Eduardo; Olivera Mauricio (2007), “Public Debt And Social Expenditure: Friends Or Foes?”. Emerging Markets Review 8(4): 299-310.
• Mishra, Ramesh (1999), Globalization And The Welfare State. UK: Edward Elgar Publishing.
• Moscone, Francesco; Knapp Martin; Tosetti Elisa (2007), “Mental Health Expenditure in England: A Spatial Panel Approach”. Journal of Health Economics 26(4): 842-864.
• Moscone, Francesco; Tosetti Elisa (2010), “Health Expenditure And Income in The United States”. Health Economics 19(12): 1385-1403.
• Mullaly, Robert (1997), Structural Social Work: Ideology, Theory, And Practice. (2nd edition), Toronto: Oxford University Press.
• Musgrove, Philip; Zeramdini Riadh; Carrin Guy (2002), “Basic Patterns in National Health Expenditure”. Bulletin of The World Health Organization 80(2): 134-146.
• Neuman, W. Lawrence (2012), Toplumsal Araştırma Yöntemleri: Nitel ve Nicel Yaklaşımlar. 2. Çev. Sedef Özge. (Beşinci Basım), Ankara: Yayınodası.
• Nixon, John; Ulmann Philippe (2006), “The Relationship Between Health Care Expenditure And Health Outcomes”. The European Journal of Health Economics 7(1): 7-18.
• Oğuz, Şebnem (2012), “Türkiye’de Kapitalizmin Küreselleşmesi ve Neoliberal Otoriter Devletin İnşası”. Türk Tabipler Birliği Mesleki Sağlık ve Güven Dergisi Temmuz-Aralık: 2-15.
• Otto, Adeline (2018), "Social expenditure, social rights, and benefit receipt as indicators of welfare state generosity: Three peas in a pod, or a different kettle of fish altogether?" International Journal of Sociology and Social Policy 38.9/10: 851-867.
• Parton, Nigel (1994), “Problematics of Government: (Post) Modernity And Social Work”. British Journal of Social Work 24(1): 9-32.
• Pearson, Mark A.; Martin John P (2005), “Should We Extend The Role of Private Social Expenditure?”. IZA Discussion Paper, No: 1544. https://ssrn.com/abstract=695241 (Erişim Tarihi: 23.11.2018).
• Pollack, Shoshana (2010), “Labelling Clients ‘Risky’: Social Work And The Neo-Liberal Welfare State”. British Journal of Social Work 40(4): 1263-1278.
• Quintal, Carlota; Lopes Jose (2016), “Equity in Health Care Financing in Portugal: Findings From The Household Budget Survey 2010/2011”. Health Economics, Policy and Law 11(3): 233-252.
• Rezapour, Aziz; Vahedi Sajad; Khiavi Farzad Faraji; Esmaeilzadeh Firooz; Javan-Noughabi Javad; Rajabi Abdolhalim (2017), "Catastrophic health expenditure of chronic diseases: Evidence from Hamadan, Iran." International Journal of Preventive Medicine 8:1-8.
• Seshamani, Meena; Gray Alastair (2004), “Time to Death And Health Expenditure: An Improved Model For The Impact of Demographic Change on Health Care Costs”. Age and Ageing 33(6): 556-561.
• Sharland, Elaine (2006), “Young People, Risk Taking And Risk Making: Some Thoughts For Social Work”. British Journal of Social Work 36(2): 247-265.
• Siskou, Olga; Kaitelidou Daphne; Papakonstantinou Vasiliki; Liaropoulos Lycourgos (2008), “Private Health Expenditure in The Greek Health Care System: Where Truth Ends And The Myth Begins”. Health Policy 88(2-3): 282-293.
• Song, Eun-Cheol; Shin Young-Jeon (2014), “The Effect of Catastrophic Health Expenditure on The Transition to And Persistence of Poverty in South Korea: Analysis of The Korea Welfare Panel Study Data, 2007-2012”. Health Policy and Management 24(3): 242-253.
• Toprak, Düriye (2015), “Uygulamada Ortaya Çıkan Farklı Refah Devleti Modelleri Üzerine Bir İnceleme”. Süleyman Demirel Üniversitesi Sosyal Bilimler Enstitüsü Dergisi 21(1): 151-175.
• Xu, Ke; Saksena Priyanka; Jowett Matthew; Indikadahena Chandika; Kutzin Joe; Evans B. David (2010), “Exploring The Thresholds of Health Expenditure For Protection Against Financial Risk”. World Health Report Background Paper, No: 19. http://www.who.int/healthsystems/topics/financing/healthreport/19THE-thresv2.pdf (Erişim Tarihi: 23.11.2018).
• Xu, Yongjian; Wu Na; Fan Xiaojing; Zhang Tao; Zhou Zhongliang; Gao Jianmin; Ren Jianping; Chen Gang; (2018), "Catastrophic health expenditure in households with chronic disease patients: A pre-post comparison of the New Health Care Reform in Shaanxi Province, China." PloS one 13.3: e0194539. https://doi.org/10.1371/journal.pone.0194539
• Yamatani, Hide; Feit Marvin (2013), “Contemporary Social Policy Analysis Methods: An Incorporation of Ethical Principals And Implementation Processes”. Journal of Human Behavior in The Social Environment 23(7): 817-823.
• Yardim, Mahmut Saadi; Cilingiroglu Nesrin; Yardim Nazan (2010), “Catastrophic Health Expenditure and Impoverishment in Turkey”. Health Policy 94(1): 26-33.
• Yıldırım, Buğra (2016), “Sağlıkta Hizmet Dönüşümü Bünyesinde Harcamaların Hak Temeli”. Eds. İbrahim Cılga vd., İçinde: Sosyal Çalışma ve Sosyal Politika Yazıları (ss. 165-180). Ankara: Bellek Yayınları.
• Yıldız, Özkan (2008), “Küreselleşme, Sağlık ve Toplum”. Gaziantep Tıp Dergisi 14(1): 30-34.