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Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing

Cilt: 40 Sayı: 4 15 Ekim 2026
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Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing

Öz

Over the past two decades, Türkiye has significantly advanced health system reforms towards universal health coverage, notably expanding non-contributory, government-funded health insurance benefits (Green Card) for low-income households to mitigate inequities in financing, access, and outcomes. This research investigates the association between the Green Card and low-income households' out-of-pocket healthcare expenditures, focusing on physician and hospital costs. Using the Entropy Balancing technique on TurkStat Household Budget Survey data (2005-2018) to balance observed characteristics between Green Card holders and non-holders, the study finds an inverse relationship between Green Card and healthcare costs, especially in regions with enhanced infrastructure. These results are consistent with non-contributory insurance being an important tool for addressing financing inequities for the disadvantaged, and the association between the program and out-of-pocket expenditures varies with the region's health infrastructure.

Anahtar Kelimeler

Green Card Health Insurance, Government-Funded Health Insurance, Healthcare Expenditures, Low-Income Households, Entropy Balancing Method

Etik Beyan

The author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Kaynakça

  1. Acar, Y. (2023). The economic impact of universities: Empirical evidence from Turkish provinces. Applied Economics Letters, 30(19), 2825–2831. https://doi.org/10.1080/13504851.2022.2109572
  2. Alderman, H., Chiappori, P.-A., Haddad, L., Hoddinott, J., & Kanbur, R. (1995). Unitary versus collective models of the household: Is it time to shift the burden of proof? The World Bank Research Observer, 10(1), 1–19. https://doi.org/10.1093/wbro/10.1.1
  3. Aran, M. A., & Hentschel, J. (2012). Protection in good and bad times? The Turkish Green Card health program (Policy Research Working Paper No. 6178). World Bank. https://doi.org/10.1596/1813-9450-6178
  4. Atun, R., Aydın, S., Chakraborty, S., Sümer, S., Aran, M., Gürol, I., Nazlıoğlu, S., Özgülcü, Ş., Aydoğan, Ü., Ayar, B., Dilmen, U., & Akdağ, R. (2013). Universal health coverage in Turkey: Enhancement of equity. The Lancet, 382(9886), 65–99. https://doi.org/10.1016/S0140-6736(13)61051-X
  5. Baird, K. E. (2016). The incidence of high medical expenses by health status in seven developed countries. Health Policy, 120(1), 26–34. https://doi.org/10.1016/j.healthpol.2015.10.004
  6. Bellemare, M. F., & Wichman, C. J. (2020). Elasticities and the inverse hyperbolic sine transformation. Oxford Bulletin of Economics and Statistics, 82(1), 50–61. https://doi.org/10.1111/obes.12325
  7. Caliendo, M., & Kopeinig, S. (2008). Some practical guidance for the implementation of propensity score matching. Journal of Economic Surveys, 22(1), 31–72. https://doi.org/10.1111/j.1467-6419.2007.00527.x
  8. Chiappori, P.-A., & Mazzocco, M. (2017). Static and intertemporal household decisions. Journal of Economic Literature, 55(3), 985–1045. https://doi.org/10.1257/jel.20150715
  9. Erus, B., Yakut-Çakar, B., Cali, S., & Adaman, F. (2015). Health policy for the poor: An exploration on the take-up of means-tested health benefits in Turkey. Social Science & Medicine, 130, 99–106. https://doi.org/10.1016/j.socscimed.2015.02.015
  10. Finkelstein, A., Taubman, S., Wright, B., Bernstein, M., Gruber, J., Newhouse, J. P., Allen, H., Baicker, K., & Oregon Health Study Group. (2012). The Oregon health insurance experiment: Evidence from the first year. The Quarterly Journal of Economics, 127(3), 1057–1106. https://doi.org/10.1093/qje/qjs020

Kaynak Göster

APA
Tirgil, A. (2026). Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing. Trends in Business and Economics, 40(4), 722-738. https://doi.org/10.16951/trendbusecon.1702648
AMA
1.Tirgil A. Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing. Trend Bus Econ. 2026;40(4):722-738. doi:10.16951/trendbusecon.1702648
Chicago
Tirgil, Abdullah. 2026. “Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing”. Trends in Business and Economics 40 (4): 722-38. https://doi.org/10.16951/trendbusecon.1702648.
EndNote
Tirgil A (01 Ekim 2026) Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing. Trends in Business and Economics 40 4 722–738.
IEEE
[1]A. Tirgil, “Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing”, Trend Bus Econ, c. 40, sy 4, ss. 722–738, Eki. 2026, doi: 10.16951/trendbusecon.1702648.
ISNAD
Tirgil, Abdullah. “Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing”. Trends in Business and Economics 40/4 (01 Ekim 2026): 722-738. https://doi.org/10.16951/trendbusecon.1702648.
JAMA
1.Tirgil A. Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing. Trend Bus Econ. 2026;40:722–738.
MLA
Tirgil, Abdullah. “Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing”. Trends in Business and Economics, c. 40, sy 4, Ekim 2026, ss. 722-38, doi:10.16951/trendbusecon.1702648.
Vancouver
1.Abdullah Tirgil. Green Card Health Insurance and Out-of-Pocket Health Expenditures in Türkiye: Evidence from Entropy Balancing. Trend Bus Econ. 01 Ekim 2026;40(4):722-38. doi:10.16951/trendbusecon.1702648