Self-employed and informal sector employees in social health insurance: Situations in developing countries and the case of Türkiye
The Future of Universal Health Insurance, NOVA Publications , ss.75-98, 2024
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2024
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.75-98
- Anahtar Kelimeler: Healthcare access, Informal sector, Self-employed, Social health insurance, Türkiye
- Boğaziçi Üniversitesi Adresli: Evet
Özet
Social health insurance schemes have functioned as the central instrument in several countries to accomplish universal coverage. A good deal of these schemes almagamated subsidies with means-testing mechanisms towards people with low incomes, while also collecting premiums from others. Whereas a major issue has been experienced in urging self-employed people and those informally employed to pay the insurance premiums, resulting in incomplete population coverage. Instead, some countries relied on tax-based financing, especially for people not employed in formal sectors. Nevertheless, this approach faced its own challenges, particularly with the increase of healthcare costs over time. This chapter aims to investigate the mechanisms that developing countries utilize to provide coverage for the self-employed and those employed in informal sectors. To attain this, a selective literature review is conducted to scrutinize the mechanisms in different developing countries. The chapter then addresses the system in Türkiye, with a focus on developments in the 2000s. Finally, it assesses the impact of the system on private health expenditures and inability to access healthcare, especially investigating a policy change that eased access to public hospitals for those with premium debt. It is observed that the mandatory health insurance system has resulted in difficulties in accessing healthcare.