Neoliberalization of the health transformation program; the case of university hospitals and privately owned clinics in turkey
Yükleniyor...
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İstanbul Bilgi Üniversitesi
Erişim Hakkı
Attribution-NonCommercial-NoDerivs 3.0 United States
info:eu-repo/semantics/openAccess
info:eu-repo/semantics/openAccess
Özet
Türkiye’nin de içine dahil olduğu neoliberal politika akımı, özellikle 1980’li yıllardan sonra, sağlıkta dönüşüm reformlarını, değişen hükümetlerin ortak ilgi alanı haline getirdi. 1990’lı yıllara gelindiğinde, yeni yönetişim, üçüncü yol söylemleri yayıldıkça, kamu-özel sektör ortaklıkları, ticarileştirme ve özelleştirmeler, reform adıyla yapılan düzenlemelere büyük hız kazandırmış; devletin önceleri sağlık hizmeti üretme olan görevi, söz konusu yıllar içerisinde sağlık hizmeti sağlama görevine dönüştürülmüştür. Bu çalışmada, ilk olarak, AKP hükümetinin 2003 yılında ortaya çıkardığı Sağlıkta Dönüşüm Programı ve onun alt başlıklarından Genel Sağlık Sigortası ele alınmıştır. Daha sonra yapılan görüşmelerde, üniversite hastaneleri ve zincirleşmeye dahil olmayan özel tıp merkezi yetkililerine “sağlık hizmetindeki metalaşmanın hizmet kalitesini arttırıp arttırmadığı” sorulmuştur. Görüşmelerden elde edilen sonuçlar ve başvurulan diğer istatistiklere göre hastane servislerine erişim kolaylaşmış, artmıştır ve fakat servis kalitesinde olumlu bir değişim yaşanmadığı gibi aksine düşüş gözlemlenmiştir. Dahası, bu değişim, hekimler ve sağlık çalışanlarına karşı şiddet olaylarında artışa sebep olmuştur. Netice itibariyle bu araştırmada ortaya çıkan sonuç, “Sağlık alanında her şey iyiye gidiyor” gibi kamu bilincini etkileyen ifadelerle taban taban zıt bir görüntü oluşturmaktadır.
Turkey got involved in the neoliberal political wave, since 1980's. The Health Transformation Reformation has been a common interest of the changing governments since then. After 1990's the reformations in the field gained momentum, the government's responsibility to product health services turned into a responsibility to provide health services only and as the discourses like new governance and third way became spread; public-private partnerships, commercialisation and privatization showed a great increase. In this dissertation, the subtopics of the Health Transformation Program which was started by the JDP government under the name of "reform in the field of health" in 2003, General Health Insurance is discussed in the first place. Then, with the conducted interviews, the service qualities of university hospitals and privately owned medical centers are questioned by asking this in basic terms, ”Did commodification of health services given in the hospitals improve the quality of them?". According to the results, the access to the health services got easy and as the statistics show, the access increased, whereas no improvements were experienced in the quality of services and on the contrary, a decline was witnessed. Moreover, an increase in the violence acts showed against the doctors and health care personnels was observed. These results form an image complitely antipodal to the one created in the public awareness by statements like "Every thing goes well in the field of health."
Turkey got involved in the neoliberal political wave, since 1980's. The Health Transformation Reformation has been a common interest of the changing governments since then. After 1990's the reformations in the field gained momentum, the government's responsibility to product health services turned into a responsibility to provide health services only and as the discourses like new governance and third way became spread; public-private partnerships, commercialisation and privatization showed a great increase. In this dissertation, the subtopics of the Health Transformation Program which was started by the JDP government under the name of "reform in the field of health" in 2003, General Health Insurance is discussed in the first place. Then, with the conducted interviews, the service qualities of university hospitals and privately owned medical centers are questioned by asking this in basic terms, ”Did commodification of health services given in the hospitals improve the quality of them?". According to the results, the access to the health services got easy and as the statistics show, the access increased, whereas no improvements were experienced in the quality of services and on the contrary, a decline was witnessed. Moreover, an increase in the violence acts showed against the doctors and health care personnels was observed. These results form an image complitely antipodal to the one created in the public awareness by statements like "Every thing goes well in the field of health."
