Up to 284 percent increase in examination participation fees: Pharmacists warn

The last-minute changes made by the Social Security Institution (SGK) to the Health Implementation Communiqué (SUT) resulted in a decision that directly affects citizens' hospital expenses. According to the new regulation, a significant increase was made to the examination participation fees collected in state, university, and private hospitals. The mentioned increase rates reached up to 284 percent in some hospital types, causing citizens to fall under a serious economic burden. This decision, which was published in the Official Gazette and entered into force, poses the risk of making access to healthcare difficult, especially for low and middle-income families. 22. Region Malatya Pharmacists' Chamber President Ebru Sönmez, who made statements regarding the issue, strikingly brought up the negative effects that the new practice will have on the public.

Pharmacists' Chamber President Ebru Sönmez, speaking about the hike, clarified an important detail that is widely misunderstood by a large segment of society. Emphasizing that citizens pay their examination participation fees at pharmacies but this money does not stay with the pharmacists, Sönmez stated that pharmacies merely assume the role of a collector in this process. She transparently explained the operation of the process by stating that this fee collected from the patient is recouped from the pharmacies by the state at the end of the month. Therefore, she advised that citizens should not show their high bills as a reaction towards the pharmacies. Sönmez's statements aim to prevent the public's rightful anger from being directed at the wrong address.

Along with the new Health Implementation Communiqué, radical changes were made in the pricing system according to the tiers of the hospitals. Accordingly, the examination participation fee in second-tier state hospitals, which was previously 26 TL, was increased to 50 TL with a 92.3 percent hike. The fee applied in training, research, and state university hospitals rose to 90 TL with a massive jump of 246.2 percent in the same period. The places with the highest increase were foundation universities and private hospitals; the participation fee paid in these institutions reached a level of 100 TL from 26 TL with a 284.6 percent increase. These figures require serious budget planning, especially for citizens with chronic conditions who have to go to the hospital frequently.

It appears that the primary motivation underlying these price increases is the state's desire to restructure the healthcare system. The primary goal of the authorities is interpreted as easing the patient burden on crowded and busy hospitals and directing people to family physicians. In this context, examinations in family health centers, which are primary healthcare institutions, continue to be offered completely free of charge. For citizens who prefer to go to second or third-tier hospitals by obtaining a referral from a family physician within the system, an incentivizing practice such as a 50 percent discount on the participation fee has been introduced. For example, the second-tier state hospital examination fee, which is normally 50 TL, can be reduced to 25 TL with a referral document from a family physician.

Despite all these practical and economic regulations, the applied high increase rates continue to be criticized by non-governmental organizations and citizens. Reminding of the requirements of being a social state, Malatya Pharmacists' Chamber President Ebru Sönmez argued that public access to medicine and basic healthcare services must be facilitated under all circumstances. She emphasized that while the goal of reducing congestion in hospitals is extremely legitimate and correct, different methods could be preferred instead of using staggering hike rates ranging between 92 and 284 percent to achieve this. Sönmez also addressed the citizens once again, adding that the high amounts they pay upon prescription issuance should not exhaust the pharmacists, and that pharmacies are merely a tool of the state's collection mechanism. What long-term effects this new era, which directly concerns millions of Social Security Institution patients across Turkey, will have on public health expenditures will become clearer in the coming days.