Turkey's Economic Tightrope: Balancing Populism and Neoliberalism in Healthcare
"An in-depth look at how Turkey's AKP navigates the complexities of pharmaceutical policy, economic pressures, and political priorities."
Since November 2002, Turkey has been governed by the Justice and Development Party (AKP), a period often characterized by significant 'neoliberal restructuring.' Indeed, the early 2000s brought widespread privatization, reduced income tax rates, and flexible labor markets.
However, Turkey’s economic policies under the AKP have never fit neatly into a box. Its commitment to free market principles is regularly tempered by its conservative ideology and a strong desire to maintain support among both everyday citizens and powerful elites. This balancing act is visible in the expansion of social programs and the state’s continued role in housing.
A common thread in discussions of Turkish politics is the idea that the AKP is both neoliberal and populist. Drawing from studies of 'neoliberal populism' in Latin America, scholars have examined how the AKP combines these seemingly contradictory elements. This analysis is complex, given that 'populism' can refer to both redistribution policies and a political style centered on mass appeal and anti-establishment rhetoric.
The 2009 Healthcare Reform: A Clash of Ideologies
In September 2009, Turkey initiated a major reform in its pharmaceutical expenditure and pricing policies. By introducing a global budget, the country saved approximately 20 billion TL in public pharmaceutical spending between 2010 and 2012. This substantial reduction was mainly achieved through stricter price controls on pharmaceutical producers and distributors—a populist solution.
- Electoral Considerations: The AKP's leadership recognized the importance of public health services to their voter base. Substantially reducing access could have triggered significant political backlash.
- Limited Business Influence: There was a notable absence of strong business interests advocating for high medicine prices. This reduced potential opposition to price control measures.
- Lack of Industrial Policy: The government lacked a developmentalist commitment to using pharmaceutical policy as a tool for broader industrial strategy. This removed another potential argument against price controls.
Lessons for Turkish Politics
The evidence from this particular case of pharmaceutical policy reform supports several more general conclusions regarding the political dynamics that have underpinned the economic and social policy making of the AKP government. First, it appears that the "social face" of the AKP is of a mostly instrumental nature. The strict regulation of prices and profits in the pharmaceutical sector that was implemented after September 2009 needs to be viewed as a redistributive, pro-poor reform. Yet the reform was merely the unintended consequence of other political dynamics.