Turkish flag with pills and ballot box symbolizing healthcare policy.

The Populist Prescription: How Politics and Economics Shape Healthcare in Turkey

Reese Marlowe in Politics & Policy June 2025 • 3 min read.

"Decoding Turkey's Pharmaceutical Policy Paradox: A Blend of Populism and Pragmatism"

Turkey's political landscape presents a fascinating case study in the interplay between economic policy and social welfare. Since November 2002, the Justice and Development Party (AKP) has navigated the complexities of governance, often characterized by what many scholars describe as "neoliberal restructuring." This has involved privatization, tax reforms, and labor market adjustments.

However, Turkey's path hasn't been one of strict neoliberal orthodoxy. The AKP's commitment to market principles is tempered by its conservative ideology and a keen awareness of popular and elite support. This balancing act manifests in various ways, from expanding social assistance programs to maintaining a significant state role in housing.

This article delves into one specific area where this dynamic is particularly evident: pharmaceutical policy. By examining the major reforms of September 2009, we can gain insights into the forces shaping Turkey's economic and social direction. This was when the government implemented a stringent pharmaceutical expenditure and pricing overhaul.

The 2009 Pharmaceutical Policy Shift: A Closer Look

Turkish flag with pills and ballot box symbolizing healthcare policy.

In September 2009, Turkey initiated a significant reform in its pharmaceutical expenditure and price policy. By introducing a global budget, the government saved approximately 20 billion TL in public pharmaceutical expenditure between 2010 and 2012. The major portion of these savings came from strict price controls reducing the profit margins of pharmaceutical producers and distributors — a populist policy choice. This was in contrast to raising out-of-pocket payments by the citizens (the neoliberal policy solution).

This decision presents a puzzle. The AKP government usually favors lenient, business-friendly regulation. So, why the sudden shift? The answer lies in a combination of factors:

Electoral Interests: The AKP's leadership recognized the importance of public health services to its voter base.
Business Interests: Absence of strong lobby groups defending higher medicine prices.
Industrial Policy: A lack of commitment to using pharmaceutical policy as a tool for industrial development.

This case study reveals that the AKP's economic and social policies are shaped by the interests of its core constituencies: lower-class voters and "Anatolian capital." Internally, policy decisions are influenced by two main groups: neoliberal-minded technocrats and election-focused party leaders.

Lessons for Understanding Turkish Politics

The 2009 pharmaceutical policy shift offers valuable lessons about the dynamics of Turkish politics under the AKP. It demonstrates that the party's "social face" is often instrumental, driven by political calculations and electoral considerations. While the AKP is capable of implementing pro-poor policies, it does so strategically, balancing the interests of its key constituencies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1017/npt.2016.23, Alternate LINK

Title: The Akp Between Populism And Neoliberalism: Lessons From Pharmaceutical Policy

Subject: Economics and Econometrics

Journal: New Perspectives on Turkey

Publisher: Cambridge University Press (CUP)

Authors: Tim Dorlach

Published: 2016-11-01

Everything You Need To Know

How has the Justice and Development Party (AKP) balanced neoliberal economic policies with social welfare commitments in Turkey?

In Turkey's political and economic context, the Justice and Development Party (AKP) governs with a blend of neoliberal restructuring, including privatization and tax reforms, and a commitment to social welfare programs. This balance is influenced by the need to maintain popular support while adhering to market principles.

What specific changes were introduced during the September 2009 pharmaceutical policy shift in Turkey, and what was their main impact?

The September 2009 pharmaceutical policy shift involved the introduction of a global budget, which led to substantial savings in public pharmaceutical expenditure. This was achieved through strict price controls on pharmaceutical producers and distributors, rather than increasing out-of-pocket payments for citizens.

What factors contributed to the Justice and Development Party's (AKP) decision to implement strict price controls in the pharmaceutical sector in 2009?

The electoral interests of the Justice and Development Party (AKP), the absence of strong lobby groups advocating for higher medicine prices, and a lack of emphasis on pharmaceutical policy as an industrial development tool were key factors. These elements collectively influenced the decision to implement strict price controls in the pharmaceutical sector.

Who are the key constituencies and internal groups that shape the Justice and Development Party's (AKP) economic and social policies?

The Justice and Development Party's (AKP) economic and social policies are influenced by the interests of its core constituencies, specifically lower-class voters and "Anatolian capital." Internally, policy decisions are shaped by neoliberal-minded technocrats and election-focused party leaders, who often balance economic considerations with electoral strategies.

What does the 2009 pharmaceutical policy shift reveal about the dynamics of Turkish politics and the Justice and Development Party's (AKP) approach to governance?

The 2009 pharmaceutical policy shift highlights that the Justice and Development Party's (AKP) "social face" is instrumental and driven by political calculations and electoral considerations. While the AKP can implement pro-poor policies, it does so strategically, balancing the interests of its key constituencies, showcasing the complex interplay between populism and pragmatism in Turkish governance. One should also note that other policies related to healthcare access, such as the expansion of health insurance coverage, also play a significant role but were not discussed.