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Equity Finance In Health Care Services

4771 words - 20 pages

1. INTRODUCTIONHealth systems are generally assessed in terms of the degree of achievement of their objectives. These objectives comprise mainly health maximization, efficiency and equity. However, the particular characteristics of the health care market, as discussed in the previous chapter, separate health and health care from other goods and services. These peculiarities shape the objectives in health policies and thereby determine the structure; organization, financing and provision in the health system.In discussing equity, a consideration of the distribution of wealth and income necessarily constitutes a starting point. This would involve the inherited wealth and abilities, training ...view middle of the document...

This capability is an indication of equity in a health system. Therefore, this chapter aims to assess how responsive the health system in Turkey has been to the health care needs of the population.The main objective of the health services is to ensure the availability of an adequate amount of health care to the entire population. The income differences, employment status or residential location (i.e. urban/rural, regional) should not prevent any individual from receiving medical care when needed. Health is thus an individual right for everyone, referred to as such in the constitution of Turkey. However, there are important problems in receiving better health care by the population. This is related not only to the inadequacy of resources in the health sector, but also to their uneven distribution throughout the country, across different geographical regions and urban/rural settlements. These deficiencies are accompanied by differences in income levels and social security coverage, leading to disparities in access to and utilization of health services and hence, variations within the population in terms of health status.Since the early 1990s, enhancement of equity has been one of the main objectives of the reform efforts in the health sector in Turkey. These efforts, however, have focused more on the financial aspects of the health system (T.C. Başbakanlık, 2005), with an underlying view to reducing the financing burden on the government. Despite their continued emphasis on the issue, the reform efforts acutely lacked a clear and comprehensive definition of equity, nor have they ever involved sufficient tools to measure equity against the specified policy preferences.2. EQUITY IN HEALTH SERVICES2.1. Defining Equity in Health ServicesEquity can be evaluated by considering the distribution of the benefits and costs in the health care system. This requires the clarification of simple, but equally fundamental questions as to who gets the health gain and who pays? (Mills and Gilson, 1988). While the former question relates to the provision of health services, the latter is concerned with the financing of them in a country. These questions, in turn, can be answered basing on certain policy preferences generally induced by the political views, social values and cultural traditions in a society. There are varying approaches to the problem of justice which may help us clarify the way we understand equity. These approaches can be classified under Libertarian and Egalitarian view.The Libertarians focus on the willingness and ability to pay of the individuals that would ultimately result in the rationalization of health care. Libertarian view emphasizes the role of private sector in health care and restricts the role of government in providing minimum standard of care to the poor. Hence, their criteria for equity is defined as the extent to which people are free to use the health care that they wish to use. Hence, individual preferences are...

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