AMME IDARESI DERGISI, vol.44, no.2, pp.71-98, 2011 (SSCI)
Health expenditures have shown an upward trend due to a range of factors. Increasing of the expenditures constitutes serious pressures on countries' scarce health financing resources. User charges have recently been used widely in various densities in order to shift the financial burden from public to private, gain additional revenue, avoid unnecessary demand and contain expenditures in health systems funded by general taxes and compulsory social contributions. On the one hand, within the health transformation program and social security reform, Turkey has been trying to ensure universal coverage establishing general health insurance scheme by merging all public social security programs under one roof on the other hand, paradoxically, has widely been using user charges, which reduces the depth of coverage, in various densities within the coverage of the same reforms. Since user charges have both benefits and harms inherently, protection mechanisms must be employed effectively and powerfully for the poor and other vulnerable segments of the population in order to get expected benefits from user charges and minimize the negative effects of them.