{"id":156235,"date":"2025-01-22T00:16:37","date_gmt":"2025-01-21T21:16:37","guid":{"rendered":"https:\/\/epochtimestr.com\/?p=156235"},"modified":"2025-01-22T00:16:39","modified_gmt":"2025-01-21T21:16:39","slug":"ito-koruyucu-saglikta-ucretli-uygulamalar-halk-sagligina-tehdittir","status":"publish","type":"post","link":"https:\/\/epochtimestr.com\/index.php\/ito-koruyucu-saglikta-ucretli-uygulamalar-halk-sagligina-tehdittir","title":{"rendered":"\u0130TO, \u201cKoruyucu Sa\u011fl\u0131kta \u00dccretli Uygulamalar Halk Sa\u011fl\u0131\u011f\u0131na Tehdittir\u201d\u00a0"},"content":{"rendered":"\n

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\u0130stanbul Tabip Odas\u0131 (\u0130TO), sa\u011fl\u0131k hizmetlerinin piyasala\u015fmas\u0131na kar\u015f\u0131 duyulan endi\u015feleri art\u0131rd\u0131\u011f\u0131n\u0131 dile getirdi.\u00a0<\/h2>\n\n\n\n

\u0130stanbul Tabip Odas\u0131 (\u0130TO), 15 Ocak 2025’te y\u00fcr\u00fcrl\u00fc\u011fe giren Aile Hekimli\u011fi yasas\u0131ndaki de\u011fi\u015fiklikler ve sa\u011fl\u0131k hizmetlerinde artan piyasala\u015ft\u0131rmaya kar\u015f\u0131 bir bas\u0131n a\u00e7\u0131klamas\u0131 d\u00fczenledi. Sosyal Sigortalar ve Genel Sa\u011fl\u0131k Sigortas\u0131 Kanunu ile Baz\u0131 Kanunlarda De\u011fi\u015fiklik Yap\u0131lmas\u0131na Dair Kanun, 15 Ocak 2025 tarihinde Resm\u00ee Gazete\u2019de yay\u0131mland\u0131. Yap\u0131lan d\u00fczenlemelerle daha \u00f6nce t\u00fcm\u00fcyle \u00fccretsiz olan birinci basamak sa\u011fl\u0131k hizmetleri kapsam\u0131ndaki aile hekimli\u011fi uygulamas\u0131nda baz\u0131 hizmetlerden \u00fccret al\u0131nmas\u0131 ba\u015flat\u0131ld\u0131. <\/p>\n\n\n\n

D\u00fczenlemelerle ilgili 21 Ocak 2025 Sal\u0131 g\u00fcn\u00fc, Ca\u011falo\u011flu merkez b\u00fcroda ger\u00e7ekle\u015ftirilen bas\u0131n toplant\u0131s\u0131na T\u00fcrk Tabipleri Birli\u011fi Merkez Konseyi 2. Ba\u015fkan\u0131 Dr. P\u0131nar Saip, \u0130stanbul Tabip Odas\u0131 (\u0130TO) Y\u00f6netim Kurulu Ba\u015fkan\u0131 Dr. Osman K\u00fc\u00e7\u00fckosmano\u011flu, \u0130TO Genel Sekreteri Dr. Ertu\u011frul Oru\u00e7 ve \u0130TO Y\u00f6netim Kurulu \u00fcyesi Dr. Emrah K\u0131r\u0131ml\u0131 kat\u0131ld\u0131.\u00a0<\/p>\n\n\n

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\u201c\u0130ktidar\u0131n g\u00f6z\u00fc halk\u0131m\u0131z\u0131n cebinde”\u00a0<\/strong><\/p>\n\n\n\n

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Yap\u0131lan d\u00fczenlemeyi vahim bir geli\u015fme olarak nitelendiren Dr. P\u0131nar Saip, \u201c\u0130ktidar\u0131n g\u00f6z\u00fc halk\u0131m\u0131z\u0131n cebinde. Bunun hem halk sa\u011fl\u0131\u011f\u0131na zararl\u0131 yanlar\u0131 var hem de koruyucu hizmet vermesi gereken birinci basamak sa\u011fl\u0131k hizmetlerinin paral\u0131 hale getirilmesinin \u00f6n\u00fcn\u00fcn a\u00e7\u0131lmas\u0131 vahim bir geli\u015fmedir. Bundan bir an \u00f6nce geri d\u00f6n\u00fclmelidir. Bunun d\u0131\u015f\u0131nda \u00e7a\u011f d\u0131\u015f\u0131 y\u00f6ntemlerin s\u0131radan bir hizmet haline getirilmesi \u00fcstelik de \u00fccretli hale getirilmesi ger\u00e7ek anlamda hizmet almay\u0131 da engelleyecektir\u201d dedi.\u00a0<\/p>\n\n\n\n

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“Paral\u0131 hizmetler birinci basama\u011f\u0131n ruhuna ayk\u0131r\u0131d\u0131r\u201d\u00a0<\/strong><\/p>\n\n\n\n

Sa\u011fl\u0131k sisteminde i\u015flerin iyi gitmedi\u011fini vurgulayan Dr. Osman K\u00fc\u00e7\u00fckosmano\u011flu da birinci basamak sa\u011fl\u0131k hizmetlerinde eziyet y\u00f6netmeli\u011finin getirdi\u011fi de\u011fi\u015fiklikleri \u015fu s\u00f6zlerle anlatt\u0131: <\/p>\n\n\n\n

\u201cSanki aile hekimlerinin derdi paraym\u0131\u015f, daha \u00e7ok para istiyorlarm\u0131\u015f gibi kamuoyuna yans\u0131t\u0131larak dendi ki; size baz\u0131 para kazanma olanaklar\u0131 yarataca\u011f\u0131z. Bu para kazanma olanaklar\u0131n\u0131 yaratan bu de\u011fi\u015fiklikler de kamuoyuna sanki aile hekimlerinin isteklerinin bir k\u0131sm\u0131 kar\u015f\u0131lan\u0131yormu\u015f gibi yans\u0131t\u0131ld\u0131. Burada asl\u0131nda \u00e7ok b\u00fcy\u00fck aldatmaca var. Bunun aile hekimlerinin talebi olmad\u0131\u011f\u0131n\u0131 s\u00f6yl\u00fcyoruz. Paral\u0131 hizmetler, koruyucu hekimli\u011fin \u00f6n planda oldu\u011fu birinci basama\u011f\u0131n ruhuna ayk\u0131r\u0131d\u0131r.\u201d\u00a0<\/p>\n\n\n

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“Eme\u011fimizi ve sa\u011fl\u0131k hakk\u0131n\u0131 savunmaya devam edece\u011fiz”\u00a0<\/strong><\/p>\n\n\n\n

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D\u00fczenlemeyle birlikte yabanc\u0131lar\u0131n birinci basamaktan sa\u011fl\u0131k hizmeti alamayaca\u011f\u0131na dikkat \u00e7eken Dr. Emrah K\u0131r\u0131ml\u0131 ise \u201cY\u0131llard\u0131r bizimle beraber olan, bu \u00fclkede do\u011fan, yabanc\u0131 diye kabul edilen ki\u015filer bir anda \u00fccretli hale gerildi. Ekonomik krizin artt\u0131\u011f\u0131 bir ortamda bu durum sa\u011fl\u0131k hizmetlerinin geriye b\u0131rak\u0131lmas\u0131 anlam\u0131na gelir. Zaten \u0131rk\u00e7\u0131l\u0131k, ayr\u0131mc\u0131l\u0131k memleketin \u00f6nemli sorunlar\u0131ndan bir tanesi. Biz eme\u011fimizi, sa\u011fl\u0131k hakk\u0131n\u0131 savunmaya devam edece\u011fiz\u201d diye konu\u015ftu.\u00a0<\/p>\n\n\n

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Bas\u0131n a\u00e7\u0131klamas\u0131n\u0131 Dr. Ertu\u011frul Oru\u00e7 okudu. A\u00e7\u0131klama \u015f\u00f6yle: <\/p>\n\n\n\n

Sa\u011fl\u0131\u011f\u0131n \u00d6l\u00fcm\u00fc; Para, Para, Para! 
Sa\u011fl\u0131k hizmetlerinde paral\u0131 hizmetlere kap\u0131 a\u00e7\u0131l\u0131yor. <\/p>\n\n\n\n

T\u00fcrkiye\u2019de 24 Ocak 1980 kararlar\u0131yla ba\u015flayan, 12 Eyl\u00fcl darbesi ile devam eden s\u00fcrecin devam\u0131nda, d\u00fcnya ile benzer \u015fekilde, \u00f6ncesinde devletin \u00fccretsiz olarak ve nitelikli \u015fekilde sundu\u011fu pek \u00e7ok hizmet, ad\u0131m ad\u0131m piyasala\u015ft\u0131r\u0131ld\u0131-\u00f6zelle\u015ftirildi; \u00f6zelle\u015fmedi\u011fi durumda ise hizmetin niteli\u011fi d\u00fc\u015f\u00fcr\u00fclerek paral\u0131 hale getirildi. Bundan sa\u011fl\u0131k alan\u0131 da nasibini ald\u0131. 90\u2019lar\u0131n ba\u015f\u0131ndan itibaren D\u00fcnya Bankas\u0131 gibi kurulu\u015flar\u0131n verdi\u011fi kredilerin de deste\u011fiyle sa\u011fl\u0131k hizmetleri piyasala\u015ft\u0131r\u0131ld\u0131. Ancak seyri yava\u015f oldu. Bunda 90\u2019lar boyunca kamu emek\u00e7ilerinin sendikala\u015fma m\u00fccadelesinin canl\u0131l\u0131\u011f\u0131 ve T\u00fcrk Tabipleri Birli\u011fi\u2019nin (TTB) muhalefeti etkili olmu\u015ftu.\u00a0<\/p>\n\n\n\n

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T\u00fcrkiye\u2019de sa\u011fl\u0131kta piyasala\u015ft\u0131rma ve \u00f6zelle\u015ftirmeye dair at\u0131lan en b\u00fcy\u00fck ad\u0131m 2003 y\u0131l\u0131nda AKP iktidar\u0131n\u0131n ba\u015flatt\u0131\u011f\u0131 \u201cSa\u011fl\u0131kta D\u00f6n\u00fc\u015f\u00fcm Program\u0131 (SDP)\u201dd\u0131r. SDP\u2019nin ilk icraatlar\u0131ndan biri 2005 y\u0131l\u0131nda, Sa\u011fl\u0131k Ocaklar\u0131 sistemi yerine Aile Hekimli\u011fi sistemine ge\u00e7i\u015fti. Bu sistemle beraber Aile Sa\u011fl\u0131\u011f\u0131 Merkezlerinde (ASM) \u00e7al\u0131\u015facak hekimler ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 s\u00f6zle\u015fmeli olmu\u015f, Sa\u011fl\u0131k Ocaklar\u0131nda \u00e7al\u0131\u015fan ekip da\u011f\u0131t\u0131larak her bir hekime yaln\u0131zca bir sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131 tan\u0131mlanm\u0131\u015f, bina ve demirba\u015flardan kamu deste\u011fi \u00e7ekilmi\u015f, tedavi edici hizmetlerin \u00f6ncelendi\u011fi bir birinci basamak kurulmu\u015ftu.\u00a0<\/p>\n\n\n\n

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15 Ocak 2025\u2019te Aile Hekimli\u011fi yasas\u0131nda yap\u0131lan de\u011fi\u015fiklikle \u0130l Sa\u011fl\u0131k M\u00fcd\u00fcrl\u00fckleri b\u00fcnyesinde d\u00f6ner sermaye i\u015fletmeleri kurularak birinci basamak sa\u011fl\u0131k hizmetlerinin paral\u0131 hale getirilmesi kurumsalla\u015fm\u0131\u015f oldu. D\u00f6ner sermaye i\u015fletmesinde toplanacak paran\u0131n b\u00f6l\u00fc\u015f\u00fcm mekanizmas\u0131 ise mu\u011fl\u00e2k b\u0131rak\u0131ld\u0131. Ayr\u0131ca \u00e7\u0131kan yasayla Aile Hekimleri\u2019nin verebildi\u011fi baz\u0131 raporlar da (ehliyet, spor yapabilir vb.) art\u0131k paral\u0131 hale gelecek.\u00a0<\/p>\n\n\n\n

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De\u011fi\u015ftirilen yasayla \u201cikamet izni olan yabanc\u0131lar\u201d i\u00e7in tedavi edici hizmetler \u00fccretli hale gelmi\u015f oldu. \u00dclkemizde kesin say\u0131 net olmamakla birlikte milyonlarca g\u00f6\u00e7men ya\u015famaktad\u0131r. H\u00fck\u00fcmet, Avrupa \u00fclkeleriyle yapt\u0131\u011f\u0131 anla\u015fmalar yoluyla a\u00e7\u0131k \u015fekilde, ucuz i\u015fg\u00fcc\u00fc olmalar\u0131 nedeniyle \u00fclkeye g\u00f6\u00e7men gelmesini ise \u00f6rt\u00fck bi\u00e7imde desteklemektedir. \u0130\u015f, g\u00f6\u00e7menler \u00fczerinden para kazanmaya gelince g\u00f6\u00e7menler \u201ciyi\u201d, \u00fclke olarak sorumluluklar\u0131 yerine getirmeye gelince g\u00f6\u00e7menler \u201ck\u00f6t\u00fc\u201d olmaktad\u0131r. T\u00fcrkiye\u2019nin planl\u0131 bir g\u00f6\u00e7men politikas\u0131 bulunmamaktad\u0131r. Elbette her insan gibi, g\u00f6\u00e7menlerin de sa\u011fl\u0131\u011fa eri\u015fimi hakt\u0131r ve uluslararas\u0131 s\u00f6zle\u015fmelerle d\u00fczenlenmi\u015ftir. Bu uygulama insan haklar\u0131na ayk\u0131r\u0131 oldu\u011fu ve birinci basamak hizmetlerini paral\u0131 hale getirdi\u011fi i\u00e7in kabul edilemez, geri \u00e7ekilmelidir.\u00a0<\/p>\n\n\n

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Sa\u011fl\u0131k hizmetlerinde \u201cGeleneksel ve Tamamlay\u0131c\u0131 T\u0131p (GETAT)\u201d ad\u0131 alt\u0131nda yap\u0131lan uygulamalar, AKP iktidar\u0131n\u0131n hep g\u00f6zdesi olageldi. Bilimsel a\u00e7\u0131dan ge\u00e7erlilikleri \u015f\u00fcpheli, sa\u011fl\u0131\u011fa yararl\u0131 olmay\u0131 bir tarafa b\u0131rakal\u0131m sa\u011fl\u0131\u011fa zarar verebilen bu uygulamalar yeni yasa de\u011fi\u015fikli\u011fiyle beraber akupunktur ve fitoterapi uygulamas\u0131yla Aile Hekimli\u011fi sistemine girmi\u015f olacak. Yasada bu GETAT hizmetlerinin mesai d\u0131\u015f\u0131 saatlerde, \u00fccretli olarak verilece\u011fi belirtiliyor. San\u0131r\u0131z h\u00fck\u00fcmet Eziyet Y\u00f6netmeli\u011fi ile Aile Hekimlerinin maa\u015flar\u0131nda yaratt\u0131\u011f\u0131 erimeyi, bu \u015fekilde telafi etmek istiyor. Aile Hekimli\u011fi\u2019nde mesai d\u0131\u015f\u0131 \u00e7al\u0131\u015fman\u0131n kap\u0131s\u0131n\u0131 a\u00e7mas\u0131, bilimsel a\u00e7\u0131dan ge\u00e7erlili\u011fi \u015f\u00fcpheli uygulamalar olmas\u0131 ve paral\u0131 \u015fekilde verilecek olmas\u0131 nedeniyle bu maddenin de geri \u00e7ekilmesi gerekmektedir.\u00a0<\/p>\n\n\n\n

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Bu yasa de\u011fi\u015fikli\u011fi Aile Hekimli\u011fi sisteminde; Aile Hekimlerinin, Aile Sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131n\u0131n ve halk\u0131n zarar\u0131na piyasac\u0131 bir gedik a\u00e7m\u0131\u015ft\u0131r. Bug\u00fcn bu gedikten neyin ne kadar ge\u00e7ti\u011finden \u00e7ok esas \u00f6nemli olan bu gedi\u011fin a\u00e7\u0131lmas\u0131d\u0131r. SDP\u2019nin ge\u00e7mi\u015f tecr\u00fcbesi bize, bu gedi\u011fin b\u00fcy\u00fcyerek devam edece\u011fini g\u00f6stermektedir. \u0130TO olarak ikinci ve \u00fc\u00e7\u00fcnc\u00fc basamakta d\u00f6ner sermaye ve performans-te\u015fvik uygulamalar\u0131na, \u00f6zel hastanelerde hastalardan al\u0131nan \u00f6nce Sa\u011fl\u0131k Uygulama Tebli\u011f (SUT) fiyat\u0131n\u0131n %30\u2019u ile ba\u015flay\u0131p %200\u2019e kadar artt\u0131r\u0131lan, bug\u00fcn i\u00e7in fiilen \u00fcst s\u0131n\u0131r\u0131 belli olmayan kat\u0131l\u0131m paylar\u0131na kar\u015f\u0131 \u00e7\u0131karken \u015fimdi Aile Hekimlikleri benzer bir s\u00fcrece sokulmu\u015f oldu. Biz bu kitab\u0131 daha \u00f6nce okuduk, sonu iyi bitmedi.\u00a0<\/p>\n\n\n\n

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\u201cSa\u011fl\u0131kta reform\u201d slogan\u0131 ile ba\u015flayan SDP y\u00fcz\u00fcnden sa\u011fl\u0131k hizmetleri art\u0131k sa\u011fl\u0131ks\u0131zl\u0131k \u00fcretmektedir. Sa\u011fl\u0131k sistemi \u00e7eteler yaratmakta, halk\u0131n sa\u011fl\u0131\u011f\u0131 yerine paray\u0131 \u00f6ncelemektedir. Bir anlamda \u201csa\u011fl\u0131k \u00f6lm\u00fc\u015ft\u00fcr\u201d. SDP\u2019nin art\u0131k tarihin \u00e7\u00f6p sepetine at\u0131lmas\u0131 gerekmektedir. Bu da ancak \u00f6rg\u00fctl\u00fc m\u00fccadeleyle olabilir.\u00a0<\/p>\n\n\n\n

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Aile Hekimlerimizin ve Aile Sa\u011fl\u0131\u011f\u0131 \u00e7al\u0131\u015fanlar\u0131m\u0131z\u0131n \u00f6zl\u00fck haklar\u0131n\u0131 ve \u00e7al\u0131\u015fma ko\u015fullar\u0131n\u0131 k\u00f6t\u00fcle\u015ftiren, halk\u0131n ASM\u2019lerden sa\u011fl\u0131k hizmeti almas\u0131n\u0131 g\u00fc\u00e7le\u015ftiren \u201cEziyet Y\u00f6netmeli\u011fi\u201dnin geri \u00e7ektirilmesi i\u00e7in m\u00fccadeleleri 2024 Kas\u0131m ay\u0131ndan beridir devam etmekte. Biz \u0130TO olarak, bu m\u00fccadeleye yeni \u00e7\u0131kan yasa maddelerini de ekleyip Aile Hekimli\u011fi\u2019nin ve toptan bir sa\u011fl\u0131k sisteminin paral\u0131 hale getirilmesine kar\u015f\u0131 m\u00fccadelemize devam edece\u011fiz.\u00a0<\/p>\n\n\n\n

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\ud83c\udf99\ufe0f Birinci Basamak Sa\u011fl\u0131k Hizmetlerinin Paral\u0131 Hale Getirilmesine Kar\u015f\u0131 Bas\u0131n Toplant\u0131s\u0131 D\u00fczenledik.

Sa\u011fl\u0131\u011f\u0131n \u00d6l\u00fcm\u00fc; Para, Para, Para!

\ud83d\udc47https:\/\/t.co\/bhO6H6ZmDy<\/a> pic.twitter.com\/S05ZWUZIcC<\/a><\/p>— \u0130stanbul Tabip Odas\u0131 (@istabip) January 21, 2025<\/a><\/blockquote>