SGK – the ups and downs

SGK Turkish Social InsuranceBlimey! Wherever you look just lately – Facebook; forums; you name it – there are folks getting themselves into a right old pickle about the SGK (Sosyal Güvenlik Kurumu) and the compulsory health insurance issue.

As someone who has been ‘in the system’ for some while I can assure you that it works. I can also assure you that from my own experiences the hospital/clinic treatment that you get here in Turkey makes the UK’s NHS look like a broken down, third-world shambles. Has it all been plain-sailing? No! There has been the odd glitch, but nothing to get overly stressed by.

J and I mostly choose to attend a local private hospital because we know the staff, they know us, it’s convenient and we get escorted and helped at every stage and we get seen instantly (well, almost). They also have state-of-the-art equipment, which is reassuring at our age! For all this we pay a very modest additional sum  directly to the hospital. Essentially it is the difference between what the SGK pays and the hospital’s displayed scale of charges. There are loads of Turks of modest means in our area who do the same – so you can see that the extra is not much and the service is popular.

The current issues around compulsion/private/state aside, I can tell you that J and I are more than happy and very reassured to be part of Turkish Health Insurance system. ‘So,’ I hear you ask, ‘is there a downside?’ I’m not going to lie to you . . . Yes!

Paying the monthly premium!

Some of you will have Turkish bank accounts and you’ll probably be able to pay by standing order/direct debit – Good luck! Based on a good many years of experience, both personal and second/third hand, I wouldn’t let a Turkish bank anywhere near a standing order of mine, let alone any of my money, ever again! We’ve been burnt once too often!

The trade off is that J and I have to pay directly at a branch of Ziraat Bank (the only one authorised to take cash payments for SGK) each month. If the gods are feeling benign towards us the branch will be quiet and we’ll get to a teller fairly stressed outquickly – if they are doubly benign we’ll get the same teller as last month and they won’t have to vanish on a half-hour training course again in order to deal with us. If the gods are triply benign the computer system won’t be malfunctioning and we won’t have sat there, clutching our ticket, for an hour, willing the display to click on a few more customers, and all to no avail, as we did today! Oh! and don’t even think of nipping out for a quick coffee or to pop to the supermarket whilst you wait – you may well have another sixty punters ahead of you and you may very well only be gone for five minutes, but I guarantee, based on bitter experience, that when you get back that display will have clicked on and you’ll need to get a new ticket and start over!

Anyway, if I’m going to be stressed out and lining myself up for a heart attack, I’d much rather be here in Turkey, where I’ll get sorted quickly and professionally, than in the UK where there’s a three week waiting list to see the doctor (I think I’m dying, doc! – Have you made an appointment? Sorry!) and a couple of months wait before the test results come back! Just like the climate, the scenery and the people, there are some things here in Turkey that leave us utterly spoilt.

Alan Fenn, Okçular Köyü

'Burası Türkiye!' 'This is Turkey!'

Drug Trials

Recently J and I joined the Turkish SGK health insurance scheme; we’d heard good reports from others and our existing private insurance couldn’t be upgraded because of our ages. The Turkish scheme takes you whatever your age and regardless of any pre-existing conditions and it will cover your prescriptions – seemed like a pretty reasonable deal to us. If you use the state hospitals and clinics there are no hidden extras, if you go private you just cough up any difference between what the state pays for and the private institution’s bill.

Anyway, J and I were getting short on a few of the pills and potions we use to put off using the body-washing and wrapping service provided by the local authorities, so we went to see our new ‘family doctor’. He wrote out our prescriptions but told us there were several of the drugs that required a report by the specialist at the hospital before the pharmacist would supply them. Daft thing is that if you are paying with cash you can get just about anything over the counter with no prescription and no check ups.

We were duly seen and issued with several bits of paper covered with stamps, signatures and assorted stickies. Back to the pharmacist where we discovered that these bits of paper were not ‘reports’ and we needed ‘reports’. So, back to the hospital – now, I could go on in great detail because this routine was repeated a couple more times, but I won’t!

It seems that the doctors will issue prescriptions based on the blood tests we had but if we want the state to pick up the tab (which we do) then we have to be properly examined. The twist in all this is that, in my case, some of my blood readings were slightly out and so because of my age I got my prescriptions free. J, on the other hand, because her drugs had her under control (I should be that lucky) and she was within every one of her limits was deemed by the system to not qualify! Can you believe this? This is how the system works (or doesn’t in J’s case), the fact that she is stabilised because she takes certain drugs disqualifies her from getting those  drugs supplied free.

We put it to the doctor that perhaps both of us should knock off taking our stuff for a week prior to our next examination to ensure we weren’t too healthy when we were examined! He laughed but then sort of shrugged in agreement. I mean, what do they do with someone who is, for example, a paranoid schizophrenic with delusions of being Jack the Ripper – ‘Sorry mate, can’t help you. Come back in a couple of weeks when Jack’s around and we’ll see what we can do.’ This is a system created, set up and run by bureaucrats for bureaucrats who, apparently change the rules several times a day, and the doctors admit that their hands and feet are tied along with their prescription pads.

So, renewing our prescriptions actually took from 10 in the morning until nearly 5 in the afternoon; we were both hacked off and pretty knackered by it all. The final bit that had to be done was for J to be examined by a doc to get her hormone replacement prescription – she disappeared for about half an hour and when she came back it was a good news-bad news thing; the bad news was that after all that buggering about she couldn’t have the drug because it wasn’t on the list; the good news? The lady ‘ladies’ doctor was wonderfully efficient and J got a full ‘ladies check up’ thrown in for free, and the cream on the cake (if I can call it that)? everything is tickety-bo! Not such a wasted day after all.

Oh! by the way, so many foreign residents have elected to join this system and such is the chaos this has added to that which is already inherent in this system ‘of  bureaucrats, by bureaucrats, for bureaucrats’ that they have had to suspend any further enrollments, so, if you’re not in yet – ‘tough tittie’ you could well die of something before you get to share in the frustration.

Alan Fenn, Okçular Köyü