Intensive care services are the most expensive medical services, and if a patient cannot afford the treatment, the cost is covered by the state insurance scheme. There have been numerous reports of private hospitals abusing the system by putting patients in ICUs unnecessarily and on a large scale and charging the public for the costs. But what appears to be an investment strategy that fosters corruption has ironically helped Turkey provide effective care to COVID-19 patients.
We should also look at city-level inequalities in the health care system. National numbers can be misleading because the pandemic has not affected the country evenly, with major cities being its epicenters. In the case of Türkiye, both health services and health spending are concentrated in Istanbul. This is a feature of Turkey’s health care system and has been harshly criticized as a symbol of unequal access to health care. This fact also unintentionally became one of the strengths of Turkey’s response to the pandemic. Like New York City, Istanbul is Turkey’s most important international hub and therefore has a disproportionate share of infections. In fact, compared to other Western countries, Turkey has fewer globally connected cities.
Finally, doctors who were used to working under stress for long hours on a daily basis did not seem to be overwhelmed by the new wave of patients brought in by the epidemic. Many people were infected and many respected doctors lost their lives. However, the number of highly qualified, dedicated and highly educated health workers gradually increased in numbers, working in Turkey’s favor and positively impacting the fatality rate. Finally, Dr. Alpay Azad, a member of the Scientific Council of Turkey, recently stated in an interview that Turkish health care workers begin aggressive treatment and medication much earlier than their Western counterparts. He said this suggests Turkey’s treatment protocols are more flexible compared to Western countries. Countries. This has also led to criticism of the government for curbing certain side effects of certain drugs.
Multiple elements, multiple routes
Immediate questions regarding the pandemic in Türkiye were well taken care of. Why do countries identified as examples of declining state capacity, deinstitutionalization, and low levels of trust have lower fatality rates than “exemplary” countries? How has a country where the central government continues to fight with local authorities to hinder their ability to provide services to vulnerable populations (so that they don’t get political credit) succeed in reducing the number of deaths? Would you?
This number is truly counterintuitive. However, criticism of Türkiye’s lethality rate reflected implicit bias. The immediate answer was a lack of transparency, with analysts rushing to claim that the numbers were so counterintuitive that they couldn’t be true. This figure was accused of being misreported. So these numbers have become the new battleground. Under these circumstances, reporters and analysts were unable to investigate factors that might explain the discrepancy in the numbers. This could have provided a different perspective on the comparative results between Turkey and Western European countries.
We argued that what was seen as a simple question of transparency may hide a more complex explanation. Turkey’s crisis management system benefited greatly from a number of negative externalities that would be considered disadvantageous under normal circumstances. The Turkish case shows that success in each individual case is related to multiple factors that interact with the country’s unique social characteristics. Demographics interacted with politics. Social structure influenced outcomes in uncertain ways. Timing, population density were all very important.
But the most important lesson we should take from this crisis is that emergencies like this require trusted governments and elites. Comprehensive and widespread medical care is needed not only in response to this crisis, but also in normal situations as well. We need to take better care of vulnerable people so that they can better survive in times of crisis. Close global cooperation is needed to prevent the rapid spread of the disease. Early detection and monitoring systems are needed. Doctors should report new viruses to international organizations rather than their own governments without fear of prosecution.
We don’t know which groups will be affected and how the next pandemic will affect us. We cannot predict what the next crisis will be. Crisis should not be our guide to the future. We need to improve the inclusiveness of our society in peacetime.
Copyright : Yasin AKGUL / AFP
