From Deficit Risk to Surplus Strength: A Revenue-Centered Analysis of Türkiye’s General Health Insurance 2015-2024
Author(s)
OZNUR SEYHUN, BSc, MFE, MSc1, Yusuf Çelik, Prof. Dr.2, Guvenc Kockaya, MSc, PhD, MD3.
1Department of Healthcare Management, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey, 2Department of Healthcare Management, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey, 3Econix Research, Samsun, Turkey.
1Department of Healthcare Management, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey, 2Department of Healthcare Management, Institute of Health Sciences, Acibadem Mehmet Ali Aydinlar University, İstanbul, Turkey, 3Econix Research, Samsun, Turkey.
OBJECTIVES: This study aims to examine the financial balance of Türkiye’s General Health Insurance (GSS) system between 2015 and 2024, focusing on trends in premium revenues, hospital and prescription invoice expenditures, and overall spending dynamics. The analysis evaluates the sustainability of the system by comparing income and expenditures over time, with emphasis on structural shifts and the effects of the COVID-19 pandemic.
METHODS: A retrospective analysis was conducted using official figures on GSS premium revenues, hospital (application and prescription) expenditures, total health spending, and the annual GSS budget margin. Data were analyzed year by year, and percentage changes in expenditures, income, and fiscal surplus or deficit were calculated. The 2020-2022 period was interpreted in light of the pandemic's economic and health service effects.
RESULTS: Between 2015 and 2024, GSS premium revenues increased from ₺57.3 billion to ₺940 billion. Total healthcare expenditures also rose substantially, from ₺54.4 billion to ₺735.1 billion. The difference between income and spending—reflecting the financial balance—was positive throughout the period, although the surplus margin varied. The highest surplus (₺204.9 billion) was observed in 2024, while the lowest (₺−148.3 million) occurred in 2016. The GSS profit margin ranged from 0.24% in 2016 to 21.8% in 2024, with a notable peak of 21.15% in 2020. This increase coincided with lower-than-usual healthcare service utilization during the COVID-19 pandemic. The most significant expenditure growth occurred after 2021, as hospital bills and prescription costs rose sharply with the normalization of healthcare services.
CONCLUSIONS: Türkiye’s GSS system demonstrated increasing fiscal strength between 2015 and 2024. Despite the shock of the pandemic, the system maintained a positive income-expenditure balance, especially in the post-pandemic recovery years. These findings highlight the financial resilience of Türkiye’s universal health insurance framework and offer key insights for long-term fiscal planning and health policy reforms.
METHODS: A retrospective analysis was conducted using official figures on GSS premium revenues, hospital (application and prescription) expenditures, total health spending, and the annual GSS budget margin. Data were analyzed year by year, and percentage changes in expenditures, income, and fiscal surplus or deficit were calculated. The 2020-2022 period was interpreted in light of the pandemic's economic and health service effects.
RESULTS: Between 2015 and 2024, GSS premium revenues increased from ₺57.3 billion to ₺940 billion. Total healthcare expenditures also rose substantially, from ₺54.4 billion to ₺735.1 billion. The difference between income and spending—reflecting the financial balance—was positive throughout the period, although the surplus margin varied. The highest surplus (₺204.9 billion) was observed in 2024, while the lowest (₺−148.3 million) occurred in 2016. The GSS profit margin ranged from 0.24% in 2016 to 21.8% in 2024, with a notable peak of 21.15% in 2020. This increase coincided with lower-than-usual healthcare service utilization during the COVID-19 pandemic. The most significant expenditure growth occurred after 2021, as hospital bills and prescription costs rose sharply with the normalization of healthcare services.
CONCLUSIONS: Türkiye’s GSS system demonstrated increasing fiscal strength between 2015 and 2024. Despite the shock of the pandemic, the system maintained a positive income-expenditure balance, especially in the post-pandemic recovery years. These findings highlight the financial resilience of Türkiye’s universal health insurance framework and offer key insights for long-term fiscal planning and health policy reforms.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
HPR102
Topic
Health Policy & Regulatory
Topic Subcategory
Insurance Systems & National Health Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas