Universal Health Care Reform

The BU Health Law Association recently hosted this great event last week and I wrote up a summary for the BU website- figured I should share on the blog, too! The original piece can be found here: http://www.bu.edu/law/news/akdag.shtml


Universal Health Care Reform in Turkey: Overcoming Legal and Political Barriers

bu law students recep akdagOn October 22nd, BU School of Law hosted Turkish Member of Parliament and former Minister of Health Prof. Recep Akdağ, who discussed the implementation of his ground-breaking health care reform in Turkey.

Akdağ traveled throughout his country when he first became minister of health in 2002, and was struck by the lack of access to quality medical care. Realizing that a new national health care system was desperately needed, he visited countries around the world to examine different reform strategies.

During his visit to the United States, Akdağ noted the advantages of patient privacy in American hospitals. Upon his return to Turkey, he decreed that media should not have free access to hospital rooms. Political opponents, however, attacked his decision, and he received intense backlash. It was the first obstacle of many.

In the face of opposition by members of his own department, Akdağ assembled an informal advisory group of doctors, lawyers and politicians to design a workable health care system. They worked 80- to 90-hour weeks for years, trying to increase access to quality medical care while decreasing costs to citizens. There was “no blueprint” to follow; instead, they had to use their experiences in the field and observations of other countries to achieve a system palatable to doctors, hospitals, insurance companies, drug companies, and the public. A close relationship with the finance minister, Akdağ explained, was a must.

As Akdağ frankly discussed the continuous obstacles – from political opposition to budgetary constraints – he faced, he noted that many aspects of the Health Transformation Program were ultimately challenged in legal battles in the nation’s highest courts. Dr. Furkan Burak, one of the organizers of the event, explained that “lawyers and legal professionals” played a “key role” in achieving “humanistic, accessible, affordable health care and legal regulations” in Turkey. Akdağ emphasized how members of the legal field played a critical role in the process, from the high court judges who blocked reforms to his legal advisors who helped him shape the Health Transformation Program. Eventually he was able to establish a system that is, according to Dr. Burak, “a successful and real health care reform.”

Today, thanks to his program, primary care in Turkey is free, and access to care has greatly improved. Life expectancy has increased, and both maternal and infant mortality have drastically decreased.

The presentation was followed by a Q&A session, in which students asked the former minister about the details of his reform program, including insurance options, payment structures, and doctor incentives.

recep akdag sena celik burak furkap burakOne student’s question began a discussion about the differences between the United States and Turkey in terms of barriers to health care reform. Akdağ noted that the political influence of drug companies is much greater in the United States, and that many aspects of medical care, including drug prices, are much more expensive in the United States than in Turkey. Akdağ also pointed out cultural differences shaping public opinion: while Americans are vocal in challenging health care policy decisions and can be quick to voice negative opinions about universal health care, there is minimal backlash in Turkey.

“I thought it was interesting that the challenges were not the same kind you would expect in the United States,” said Nick Falcone (’15), who is working toward a dual J.D./MPH degree. “The presentation really highlighted the cultural differences.”

In addition to being trained as a pediatrician, Akdağ is a professor at the Medical Faculty of Ataturk University and has recently spent time in Boston as a senior leadership fellow in the Division of Policy Translation & Leadership Development at Harvard School of Public Health. He is also an honorary member of the expert research group and advisory board of the Ministerial Health Leaders’ Forum, held by Harvard School of Public Health and Harvard Kennedy School of Government.

The program was organized by Sena Celik Burak (LL.M. ’14) and her husband Dr. Furkan Burak in collaboration with the BU Health Law Association.


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