{"id":3421,"date":"2018-01-08T11:00:08","date_gmt":"2018-01-08T08:00:08","guid":{"rendered":"http:\/\/www.bastasdanismanlik.com.tr\/2018\/01\/yayinlarimiz\/haber\/genel-saglik-sigortasi-uygulamalarina-toplu-bakis-mahmut-esen-e-mulkiye-mufettisi\/"},"modified":"2018-01-08T11:00:08","modified_gmt":"2018-01-08T08:00:08","slug":"genel-saglik-sigortasi-uygulamalarina-toplu-bakis-mahmut-esen-e-mulkiye-mufettisi","status":"publish","type":"post","link":"https:\/\/www.bastasdanismanlik.com.tr\/2018\/01\/yayinlarimiz\/makale\/genel-saglik-sigortasi-uygulamalarina-toplu-bakis-mahmut-esen-e-mulkiye-mufettisi\/","title":{"rendered":"Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131na Toplu Bak\u0131\u015f &#8211; Mahmut ESEN, E. M\u00fclkiye M\u00fcfetti\u015fi"},"content":{"rendered":"<p><strong>Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131na Toplu Bak\u0131\u015f<\/strong><\/p>\n<p> <span class=\"quote-arrow\" style=\"border-left-color:;\"><\/span><strong>Mahmut ESEN<\/strong><br \/> Emekli M\u00fclkiye Ba\u015fm\u00fcfetti\u015fi<br \/> mahmutesen@gmail.com <\/p>\n<p><strong><em>\u00d6z\u00fc:<\/em><\/strong><em> \u00dclke n\u00fcfusunun t\u00fcm\u00fcn\u00fc kapsamas\u0131 gereken, 2012 y\u0131l\u0131ndan itibaren zorunlu hale gelen ve sa\u011fl\u0131k giderlerinin tek elden yap\u0131lmas\u0131n\u0131 \u00f6ng\u00f6ren genel sa\u011fl\u0131k sigortas\u0131 \u00a0(GSS) sisteminde ula\u015f\u0131lm\u0131\u015f son a\u015fama; <u>milletvekilleri ile y\u00fcksek yarg\u0131 organlar\u0131 ba\u015fkan ve \u00fcyeleri i\u00e7in getirilmi\u015f istisnalar, GSS uygulamalar\u0131nda resmi\u00a0 ve \u00f6zel sa\u011fl\u0131k kurum\/kurulu\u015flar\u0131 a\u00e7\u0131s\u0131ndan tespit edilmi\u015f aksakl\u0131klar,<\/u> GSS konusunda al\u0131nmas\u0131 gerekli g\u00f6r\u00fclen baz\u0131 tedbirler; <\/em><\/p>\n<p><em>Emekli\/deneyimli denetim eleman\u0131 g\u00f6z\u00fc ile, olabildi\u011fince nesnel \u00f6l\u00e7\u00fctler i\u00e7erisinde \u00a0kamuoyunu ve yetkileri ayd\u0131nlatmak amac\u0131yla taraf\u0131mdan haz\u0131rlanm\u0131\u015f, <u>(GSS sistemi konusunda bilgi notu niteli\u011findeki<\/u>) \u00a0bu raporda a\u00e7\u0131klanmaya \u00e7al\u0131\u015f\u0131lm\u0131\u015ft\u0131r. <\/em><\/p>\n<p><strong>I-GENEL SA\u011eLIK S\u0130GORTASI<\/strong><\/p>\n<p><strong>1<\/strong>-2006 y\u0131l\u0131nda (<strong><span style=\"text-decoration: underline;\">5510<\/span><\/strong> ve <strong><span style=\"text-decoration: underline;\">5502<\/span> <\/strong>say\u0131l\u0131 olanlar ba\u015fta olmak \u00fczere) sosyal g\u00fcvenlik ve sosyal sigortalar alan\u0131nda reform niteli\u011finde yasal d\u00fczenlemeler yap\u0131lm\u0131\u015ft\u0131r. SSK, Ba\u011f-Kur ve T.C. Emekli Sand\u0131\u011f\u0131 kurulu\u015f kanunlar\u0131 y\u00fcr\u00fcrl\u00fckten kald\u0131r\u0131lm\u0131\u015f, bunlar taraf\u0131ndan verilmekte olan hizmetler\u00a0 yeni kurulmu\u015f olan SGK Ba\u015fkanl\u0131\u011f\u0131 b\u00fcnyesinde birle\u015ftirilmi\u015ftir.<\/p>\n<p>Bu arada ki\u015filerin sa\u011fl\u0131klar\u0131n\u0131n korunmas\u0131, sa\u011fl\u0131k riskleri ile kar\u015f\u0131la\u015fmalar\u0131 halinde de olu\u015fan harcamalar\u0131n finansman\u0131 i\u00e7in genel sa\u011fl\u0131k sigortas\u0131 (GSS) ihdas edilmi\u015ftir<strong>. <\/strong>Sigortal\u0131lara\u00a0 sa\u011fl\u0131k yard\u0131mlar\u0131n\u0131n SGK arac\u0131l\u0131\u011f\u0131yla tek elden yap\u0131lmas\u0131, toplumun t\u00fcm\u00a0 bireylerinin GSS olmas\u0131 kabul edilmi\u015ftir.<\/p>\n<p><strong>Bu ba\u011flamda;<\/strong><\/p>\n<p>\u0130lk olarak (4\/1-a) SSK, 4-1\/b (Ba\u011f-Kur ), 4\/1-c (Emekli Sand\u0131\u011f\u0131) ve iste\u011fe ba\u011fl\u0131 sigortal\u0131lar ile bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc olduklar\u0131\u00a0 ki\u015filer\u00a0 (toplam 67,8 milyon) ile aile i\u00e7indeki geliri ki\u015fi ba\u015f\u0131na d\u00fc\u015fen ayl\u0131k tutar\u0131 asgari \u00fccretin \u00fc\u00e7te birinden az olan (toplam 6,7 milyon) vatanda\u015f\u0131m\u0131z <em>(Eski ye\u015fil kartl\u0131lar, <strong><span style=\"text-decoration: underline;\">2022 s.k<\/span><\/strong>. kapsam\u0131nda ayl\u0131k alan ya\u015fl\u0131\/\u00f6z\u00fcrl\u00fc vb.<\/em>) GSS kapsam\u0131na al\u0131nm\u0131\u015ft\u0131r. <em>(Yeterli gelire sahip olmayan vatanda\u015flar\u0131m\u0131z\u0131n GSS primleri Devlet (ASPB) taraf\u0131ndan kar\u015f\u0131lanmaktad\u0131r. Bu ama\u00e7la 2016 y\u0131l\u0131nda 7 milyar TL\u00a0 prim \u00f6demesi yap\u0131lm\u0131\u015ft\u0131r.<\/em>)<\/p>\n<div class=\"alignleft\" style=\"margin-right: 15px;\"> \/\/ < ![CDATA[ \/\/ < ![CDATA[ (adsbygoogle = window.adsbygoogle || []).push({}); \/\/ ]]&gt;<\/div>\n<p><strong>2-<\/strong>GSS kapsam\u0131 d\u0131\u015f\u0131nda kalan TSK b\u00fcnyesindeki er\/erba\u015f, yedek subay okulu \u00f6\u011frencileri; 506 say\u0131l\u0131 SSK kanununun ge\u00e7ici 20 maddesi kapsam\u0131ndaki\u00a0 <em>(TCMB\/ TMSF \/\u0130LKSAN\/OYAK\/Banka Yard\u0131mla\u015fma Sand\u0131klar\u0131 vb.)<\/em> kurulu\u015f mensuplar\u0131\u00a0 vb.nin GSS ge\u00e7i\u015fleri i\u00e7in s\u00fcreler belirlenmi\u015ftir.<\/p>\n<p>01.01.2012 tarihinden itibaren GSS tabi olmak zorunlu hale gelmi\u015ftir.\u00a0 Bu suretle do\u011frudan\/dolayl\u0131\u00a0 sosyal g\u00fcvencesi olmayanlar ile 5510 say\u0131l\u0131 Kanun kapsam\u0131 d\u0131\u015f\u0131nda olanlar ( Sigorta primleri ASPB yat\u0131r\u0131lanlar dahil 10,2 milyon ki\u015fi)\u00a0 GSS kapsam\u0131na al\u0131nm\u0131\u015ft\u0131r.<\/p>\n<p>Say\u0131\u015ftay Ba\u015fkanl\u0131\u011f\u0131nca yap\u0131lan denetimler sonucu baz\u0131\u00a0 raporlar da GSS sistemine ili\u015fkin baz\u0131 ayk\u0131r\u0131l\u0131klar tespit edilmi\u015f, Kanun kapsam\u0131ndaki idarelerin b\u00fct\u00e7elerinden tedavi ve ila\u00e7 \u00f6demesi uygulamas\u0131na son verilmesi istenmi\u015ftir. <em>(Say\u0131\u015ftay, 2013) <\/em><\/p>\n<p><strong>3<\/strong>-06.01.2017 g\u00fcnl\u00fc R.G. yay\u0131mlanm\u0131\u015f olan 681 say\u0131l\u0131 KHK ile, askerlik g\u00f6revini yapan er\/erba\u015flar\/ ile yedek subay okulu \u00f6\u011frencileri (yakla\u015f\u0131k 350 bin personel) GSS kapsam\u0131na al\u0131nm\u0131\u015ft\u0131r.<\/p>\n<p>Ge\u00e7ici 20 madde kapsam\u0131ndaki kurulu\u015f mensuplar\u0131n\u0131n GSS kapsam\u0131na al\u0131nmas\u0131na y\u00f6nelik \u00e7al\u0131\u015fmalar devam ise etmektedir. Bunlar\u0131n kapsama al\u0131nmalar\u0131 i\u00e7in\u00a0 belirlenmi\u015f s\u00fcrelerin dolmas\u0131 \u00fczerine,\u00a0 yap\u0131lm\u0131\u015f yasal bir d\u00fczenleme ile\u00a0\u00a0 GSS ge\u00e7i\u015f tarihlerini belirleme konusunda Bakanlar Kurulu yetkilendirilmi\u015ftir.<\/p>\n<p>Ceza infaz kurumlar\u0131 ile tutukevleri b\u00fcnyesinde bulunan h\u00fck\u00fcml\u00fc ve tutuklular\u0131n GSS kapsam\u0131na al\u0131nmas\u0131na y\u00f6nelik sorunlar hen\u00fcz \u00e7\u00f6z\u00fcmlenemedi\u011fi anla\u015f\u0131lmaktad\u0131r.<\/p>\n<p><strong>4-<\/strong>Sonu\u00e7 itibar\u0131yla, SGK Ba\u015fkanl\u0131\u011f\u0131n\u0131n 2016 y\u0131l\u0131 istatistikleri g\u00f6re, halen 78 milyon vatanda\u015f\u0131m\u0131z GSS olarak tescil edilmi\u015ftir. <strong>N\u00fcfusumuzun asgari\u00a0 %97,7 sinin GSS oldu\u011fu g\u00f6r\u00fclmektedir<em>. <\/em><\/strong><em>(SGK, 2016)<\/em>\u00a0 Ancak SGK\u2019n\u0131n y\u0131ll\u0131k istatistiklerindeki <em>(2022 Say\u0131l\u0131 Kanun kapsam\u0131nda ayl\u0131k alan 65 ya\u015f\u0131n\u0131 doldurmu\u015f ki\u015filerin 5510 say\u0131l\u0131 Kanunun 60-c\/4 maddesine ayk\u0131r\u0131 olarak -ve yap\u0131lm\u0131\u015f uyar\u0131m\u0131za kar\u015f\u0131n- GSS olarak kabul edilmemesi, ayn\u0131 sayfada dahi g\u00f6r\u00fclen maddi tutars\u0131zl\u0131klar vb. <\/em>) baz\u0131 hatalar\u0131n elimine edilmesi;\u00a0 2017 y\u0131l\u0131nda kapsama al\u0131nan TSK b\u00fcnyesindeki er\/erba\u015flar vb. dahil edilmesi halinde halinde GSS lilerin toplam n\u00fcfusa oran\u0131n\u0131n daha da artaca\u011f\u0131 a\u00e7\u0131kt\u0131r.<\/p>\n<p><strong>5-<\/strong>Devlet taraf\u0131ndan yap\u0131lan tedavi giderlerinin parasal tutarlar\u0131 hakk\u0131nda bilgilerin tazelenmesi ba\u011flam\u0131nda\u00a0 \u00a02016 y\u0131l\u0131nda ger\u00e7ekle\u015fmi\u015f sa\u011fl\u0131k giderlerini g\u00f6sterir bir tablo a\u015fa\u011f\u0131ya \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r. (Milyon TL)<\/p>\n<table>\n<tbody>\n<tr>\n<th width=\"103\">Gider B\u00fct\u00e7esin T\u00fcr\u00fc<\/th>\n<th width=\"57\">Tedavi<\/th>\n<th width=\"57\">\u0130la\u00e7<\/th>\n<th width=\"60\">Toplam<\/th>\n<\/tr>\n<tr>\n<td width=\"103\">Merkezi Y\u00f6netim<\/td>\n<td width=\"57\">277<\/td>\n<td width=\"57\">101<\/td>\n<td width=\"60\">378<\/td>\n<\/tr>\n<tr>\n<td width=\"103\">SGK<\/td>\n<td width=\"57\">46.457<\/td>\n<td width=\"57\">21.592<\/td>\n<td width=\"60\">68.048<\/td>\n<\/tr>\n<tr>\n<td width=\"103\">Aile Hekimli\u011fi<\/td>\n<td width=\"57\"><\/td>\n<td width=\"57\"><\/td>\n<td width=\"60\">5.573<\/td>\n<\/tr>\n<tr>\n<td width=\"103\">Genel TOPLAM<\/td>\n<td width=\"57\">46.734<\/td>\n<td width=\"57\">21.693<\/td>\n<td width=\"60\">73.999<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Kaynak<\/strong>: Maliye Bakanl\u0131\u011f\u0131 2018 Y\u0131l\u0131 B\u00fct\u00e7e Gerek\u00e7esi<\/p>\n<p>2017 y\u0131l\u0131nda ise sa\u011fl\u0131k giderleri toplam\u0131\u00a0 83,9 milyar TL olarak tahmin edilmektedir.<\/p>\n<p><strong>A- Cumhurbakan\u0131&#8217;nca\u00a0 GSS\u00a0 \u0130li\u015fkin Yap\u0131lm\u0131\u015f Bir De\u011ferlendirme<\/strong><\/p>\n<p><strong>6-<\/strong> <u>17.01.2017 tarihinde<\/u> SGK Ba\u015fkanl\u0131\u011f\u0131na ba\u011fl\u0131 tesislerin toplu a\u00e7\u0131l\u0131\u015f t\u00f6reninde konu\u015fan Cumhurba\u015fkan\u0131 Erdo\u011fan taraf\u0131nda GSS y\u00f6nelik olarak<strong>:<\/strong><\/p>\n<p><em>\u201c&#8230;.<strong>\u00dclkemizde uygulanan genel sa\u011fl\u0131k sigortas\u0131 belki de d\u00fcnyadaki tek \u00f6rnektir. Bu modelin dar bir \u00f6rne\u011fini ABD uygulamaya kalkt\u0131, ba\u015faramad\u0131lar, vazge\u00e7tiler.<\/strong> \u00d6n\u00fcm\u00fcz\u00fc kesmeye \u00e7al\u0131\u015ft\u0131lar, y\u0131lba\u015f\u0131 itibariyle 5 y\u0131l geride kald\u0131, sistem t\u0131k\u0131r t\u0131k\u0131r i\u015fliyor. Biz insan\u0131 ya\u015fat ki devlet ya\u015fas\u0131n dedik. Bu anlay\u0131\u015f\u0131m\u0131z\u0131n en somut tezah\u00fcrlerinden biri olan bu uygulamay\u0131 incelemek i\u00e7in d\u00fcnyan\u0131n her yerinden heyetler geliyor.<\/em><\/p>\n<p><em>Sultanahmet Camisi&#8217;nde cuma namaz\u0131 k\u0131ld\u0131k, ABD&#8217;de g\u00fcndemde. ABD&#8217;li turist grup arkada duruyor, hepsi i\u015faretler falan. Orada konu\u015ftuk, &#8216;Genel sa\u011fl\u0131k sigortas\u0131n\u0131 nas\u0131l halletiniz. Obama arkada\u015f\u0131n\u0131z ona da s\u00f6ylesenize&#8217; dediler. Ama i\u015fte hallolmad\u0131. Bu toplumu haz\u0131rlama noktas\u0131nda da maharet istiyor. Biz halk\u0131m\u0131zla, STK&#8217;lar\u0131m\u0131zla el ele vermek suretiyle ba\u015fard\u0131k. 14 y\u0131l \u00f6nce bu \u00fclkede her kamu kurulu\u015funun ayr\u0131 hastanesi vard\u0131<\/em>&#8230;\u201d \u015feklinde a\u00e7\u0131klamalarda bulunmu\u015ftur. <em>(Haberler, 2017)<\/em><\/p>\n<p><strong>B)- GSS Sigortal\u0131lar\u0131na Sa\u011flanan Sa\u011fl\u0131k Yard\u0131mlar\u0131<\/strong><\/p>\n<p><strong>7<\/strong>-\u00dclke n\u00fcfusunun tamam\u0131na yak\u0131n\u0131 kapsayan GSS kapsam\u0131ndaki sigortal\u0131lara sa\u011fl\u0131k yard\u0131mlar\u0131 SGK taraf\u0131ndan\u00a0 sa\u011fl\u0131k kurum\/kurulu\u015flar\u0131ndan hizmet al\u0131m\u0131 yap\u0131lmas\u0131 suretiyle kar\u015f\u0131lanmaktad\u0131r. Yap\u0131lacak sa\u011fl\u0131k yard\u0131mlar\u0131n\u0131n usul ve esaslar\u0131, sigortal\u0131lardan al\u0131nacak kat\u0131l\u0131m paylar\u0131, \u00f6zel sa\u011fl\u0131k kurulu\u015flar\u0131na \u00f6denecek ek \u00fccretler, sa\u011fl\u0131k hizmetlerinin bedellerinin tespit edilmesi vb. konular;\u00a0 5510 say\u0131l\u0131 Kanun, konuya ili\u015fkin y\u00f6netmelik ile\u00a0 SGK taraf\u0131ndan \u00e7\u0131kar\u0131lm\u0131\u015f Sa\u011fl\u0131k Uygulama Talimat\u0131nda (SUT) ayr\u0131nt\u0131l\u0131 olarak belirtilmi\u015ftir.<\/p>\n<p>SGK taraf\u0131ndan\u00a0 sa\u011fl\u0131k giderlerinin \u00f6denmesinde SUT h\u00fck\u00fcmlerine titizlikle ba\u011fl\u0131 kal\u0131nd\u0131\u011f\u0131, sigortal\u0131lara yap\u0131lacak sa\u011fl\u0131k giderlerinin asgari d\u00fczeyde tutulmas\u0131 gayreti i\u00e7erisinde oldu\u011fu g\u00f6r\u00fclmektedir. <em>(\u00d6zel sa\u011fl\u0131k kurumlar\u0131nca sigortal\u0131lardan al\u0131nan\u00a0 ek \u00fccretler konusunda ayn\u0131 duyarl\u0131\u011f\u0131n g\u00f6sterilmedi\u011fi bilinmektedir.)<\/em><\/p>\n<p>Nitekim,\u00a0 SUT \u00a0ile belirlenmi\u015f olan sa\u011fl\u0131k hizmeti \u00a0bedellerinin b\u00fcy\u00fck b\u00f6l\u00fcm\u00fc 2013 y\u0131l\u0131ndan beri g\u00fcncellenmemi\u015ftir. <strong>\u00d6rne\u011fin\u00a0 \u00f6zel hastanede ayaktan tedavi s\u0131ras\u0131nda\u00a0 KBB muayenesi i\u00e7in\u00a0 SGK\u2019n\u0131n \u00f6zel sa\u011fl\u0131k kurulu\u015funa \u00f6deyece\u011fi rakam\u00a0 (KDV dahil) 25,92 TL dir.\u00a0 Yine SUT h\u00fck\u00fcmlerine g\u00f6re \u00f6zel sa\u011fl\u0131k kurulu\u015flar\u0131n\u0131n sigortal\u0131dan alaca\u011f\u0131 ek ilave \u00fccret ise bu rakam\u0131n iki kat\u0131 olan 51,84 TL yi ge\u00e7memesi gerekmektedir.<\/strong><\/p>\n<p>Bu durumun kamu hastaneleri ba\u015fta olmak \u00fczere sa\u011fl\u0131k kurum\/kurulu\u015flar\u0131nda yol a\u00e7t\u0131\u011f\u0131 olumsuzluklar kurumlar itibar\u0131yla a\u015fa\u011f\u0131ya \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r.<\/p>\n<p><strong>a)-Resmi Sa\u011fl\u0131k Kurum ve Kurulu\u015flar\u0131<\/strong><\/p>\n<p><strong>8-Resmi sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131ndaki GSS uygulamas\u0131ndan kaynaklanan olumsuzluklara ili\u015fkin medyada yay\u0131mlanm\u0131\u015f baz\u0131 haberlerin \u00f6zetleri a\u015fa\u011f\u0131ya \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r.<\/strong><\/p>\n<p>\u0130.\u00dc. T\u0131p Fak\u00fcltesi\u00a0 \u00d6\u011fretim \u00dcyesi Prof. Dr. Erbu\u011f Keskin bir yaz\u0131s\u0131nda g\u00f6revli oldu\u011fu \u00c7apa Hastanesinin durumu a\u015fa\u011f\u0131daki \u015fekilde a\u00e7\u0131klam\u0131\u015ft\u0131r<strong>:<\/strong><\/p>\n<p><em>\u201c&#8230;\u00c7apa zor durumda..<\/em><\/p>\n<p><em>\u00c7apa \u00e7ok zor durumda..<\/em><\/p>\n<p><em>Bor\u00e7 bata\u011f\u0131nda..<\/em><\/p>\n<p><strong><em>Bor\u00e7lar\u0131n\u0131 36 ay geriden zar zor \u00f6deyebiliyor..<\/em><\/strong><\/p>\n<p><em>\u0130\u015fin en ac\u0131s\u0131 ne biliyor musunuz?<\/em><\/p>\n<p><strong><em>\u00c7al\u0131\u015fmad\u0131\u011f\u0131m\u0131z i\u00e7in de\u011fil.. \u00c7al\u0131\u015ft\u0131\u011f\u0131m\u0131z i\u00e7in bat\u0131yoruz.<\/em><\/strong><\/p>\n<p><strong><em>Bir safra kesesi ameliyat\u0131 yapt\u0131\u011f\u0131m\u0131zda devletin hastaneye \u00f6dedi\u011fi para 1100 Tl.. Ama o ameliyat bize en iyimser \u015fartlarda 1800 Tl ye mal oluyor.. Yani derdinden kurtard\u0131\u011f\u0131m\u0131z her hasta da 700Tl zarar ediyoruz.<\/em><\/strong><\/p>\n<p><strong><em>Devletin her hizmet i\u00e7in hastaneye \u00f6dedi\u011fi bir fiyat var ve bu fiyatlar y\u0131llard\u0131r de\u011fi\u015fmedi. Oysa kulland\u0131\u011f\u0131m\u0131z malzemelerin fiyat\u0131 defalarca katlad\u0131..<\/em><\/strong><\/p>\n<p><em>Yani devlet bize diyor ki;<\/em><\/p>\n<p><em>Pahal\u0131 tedavileri sak\u0131n uygulama..<\/em><\/p>\n<p><em>Sak\u0131n ameliyat yapma.. yapmak zorunda kal\u0131rsan il\u00e7e devlet hastanelerinde bile yap\u0131labilen basit ameliyatlar\u0131 kabul et..<\/em><\/p>\n<p><em>Sadece muayene yap.. h\u0131zl\u0131 h\u0131zl\u0131.. fazla tetkik isteme.. fak\u00fcltenin ayakta kalabilmesinin belki de tek yolu muayene yapmak..<\/em><\/p>\n<p><em>Hastaya bir faydas\u0131 yok ama zarar ettirmiyor..<\/em><\/p>\n<p><em>Ne kadar \u00e7ok muayene yaparsan, ne kadar az tetkik istersen o kadar kazan\u0131rs\u0131n diyor devlet..\u201d<\/em><\/p>\n<p><em>( T24, 2017)<\/em><\/p>\n<p><strong>9-\u201c<\/strong><em>Hastaneler hasta. \u0130stanbul\u2019da Okmeydan\u0131, \u015ei\u015fli Etfal, Kartal Dr. L\u00fctfi K\u0131rdar ile Marmara \u00dcniversitesi Pendik E\u011fitim ve Ara\u015ft\u0131rma hastanelerini gezdik. Uzun kuyruklar, aylar sonras\u0131na verilen tahlil-tetkik s\u0131ras\u0131, hijyen olmayan ortam gibi bilindik manzaralar bir kez daha kar\u015f\u0131m\u0131za \u00e7\u0131kt\u0131. Hastalar ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 mutsuz.Hastaneler Hasta\u201d<\/em> ba\u015fl\u0131\u011f\u0131 verilmi\u015f\u00a0\u00a0 g\u00fcncel bir haberde de :<\/p>\n<p><em>\u201c&#8230;.Kamu hastanelerinden sa\u011fl\u0131k hizmeti almak isteyen yurtta\u015flar uzun kuyruklar, ameliyat, tahlil-tetkik gibi i\u015flemler i\u00e7in aylar sonras\u0131n\u0131 bekliyor. Yurtta\u015flar binalar\u0131n bak\u0131ms\u0131zl\u0131\u011f\u0131, hijyen sorunu, 14 kaleme varan alanda al\u0131nan katk\u0131-kat\u0131l\u0131m pay\u0131 gibi durumlarla kar\u015f\u0131 kar\u015f\u0131ya kal\u0131yor. <strong>Paras\u0131 olan \u00f6zel hastanelere giderken, olmayan yurtta\u015flar bu \u00e7ileye katlanmak zorunda kal\u0131yor..<\/strong>.\u201d <\/em>\u015feklinde bir de\u011ferlendirme yer alm\u0131\u015ft\u0131r. <em>(Cumhuriyet, 2017)<\/em><\/p>\n<p><strong>10-<\/strong><strong> \u201c\u00dcniversite hastanesi 250 milyon liral\u0131k bor\u00e7 nedeniyle faaliyetlerini durdurmak \u00fczere\u201d<\/strong> ba\u015fl\u0131kl\u0131 bir haberde:<\/p>\n<p><em>\u201cY\u00fcz ve kol nakilleriyle ismini d\u00fcnyaya duyuran Akdeniz \u00dcniversitesi (A\u00dc)Hastanesi, medikal firmalara olan 250 milyon liral\u0131k bor\u00e7 nedeniyle faaliyetlerini durdurmak \u00fczere. Ba\u015fhekimi Prof. Dr. B\u00fclent Ayd\u0131nl\u0131, \u201cOlay ger\u00e7ekten son noktaya geldi. Bu durum b\u00f6yle devam ederse bir\u00e7ok malzemeyi bulamay\u0131z ve belki de bir\u00e7ok \u00f6nemli ameliyat\u0131 da yapamayaca\u011f\u0131z<\/em>\u201d\u00a0 \u015feklinde bir a\u00e7\u0131klama yer alm\u0131\u015ft\u0131r.\u00a0 (<em>Cumhuriyet, 2018) <\/em><\/p>\n<p><strong>b)- \u00d6zel Sa\u011fl\u0131k Kurum\/Kurulu\u015flar\u0131<\/strong><\/p>\n<p><strong>11-<\/strong>SGK; sa\u011fl\u0131k hizmetlerinin b\u00fcy\u00fck b\u00f6l\u00fcm\u00fcn\u00fc, sa\u011fl\u0131k hizmet sunucular\u0131 ile yap\u0131lan s\u00f6zle\u015fmeler yoluyla hizmet sat\u0131n al\u0131nmas\u0131 suretiyle sa\u011flamaktad\u0131r. Sa\u011fl\u0131k hizmetlerinden sigortal\u0131lar\u0131n yararlanma usul ve esaslar\u0131, sa\u011fl\u0131k hizmet sunucular\u0131na \u00f6denecek bedeller vb. konular SGK Sa\u011fl\u0131k Uygulama Tebli\u011finde (SUT) ayr\u0131nt\u0131l\u0131 olarak d\u00fczenlenmi\u015ftir.<\/p>\n<p>SUT\u2019 ta s\u00f6zle\u015fmeli vak\u0131f \u00fcniversiteleri ile \u00f6zel sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131ndan al\u0131nacak sa\u011fl\u0131k hizmet bedellerine ili\u015fkin ayr\u0131cal\u0131kl\u0131 h\u00fck\u00fcmler bulunmaktad\u0131r. <strong>Bu ba\u011flamda \u00f6zel sa\u011fl\u0131k kurulu\u015flar\u0131na, resmi sa\u011fl\u0131k kurulu\u015flar\u0131ndan farkl\u0131 olarak, SUT\u2019 ta belirlenmi\u015f tutarlar \u00fczerinden \u00f6denen hizmet bedellerine ek olarak ayr\u0131ca ilave \u00fccret \u00f6denmesi olana\u011f\u0131 getirilmi\u015ftir.<\/strong><\/p>\n<p>S\u00f6zle\u015fmeli \u00f6zel sa\u011fl\u0131k kurulu\u015flar\u0131nca verilmi\u015f olan sa\u011fl\u0131k hizmet bedellerinin; esas\u0131 SGK\u2019 ya, ilave \u00fccretleri de sigortal\u0131ya, fatura edilmektedir. <strong>Sigortal\u0131 taraf\u0131ndan \u00f6denecek ilave \u00fccretlerin, SGK taraf\u0131ndan belirlenmi\u015f bedelin (istisnai sa\u011fl\u0131k hizmetleri d\u0131\u015f\u0131nda) iki kat\u0131n\u0131 ge\u00e7memesi gerekmektedir<\/strong>. Bu kurala uyulmas\u0131 ko\u015fulu ile \u00f6zel sa\u011fl\u0131k kurulu\u015flar\u0131 alacaklar\u0131 ilave \u00fccret oranlar\u0131n\u0131 serbest\u00e7e belirleyebilmektedir. \u00d6zel sa\u011fl\u0131k kurulu\u015flar\u0131n\u0131n anla\u015fmal\u0131 b\u00f6l\u00fcmlerinde uygulanacaklar\u0131 ilave \u00fccret oranlar\u0131n\u0131n bina giri\u015flerinde herkesin g\u00f6rece\u011fi \u015fekilde ilan edilmesi ve ayr\u0131ca SGK\u2019 ya da bildirilmesi gerekmektedir.<\/p>\n<p><strong>12-<\/strong>Yukar\u0131da a\u00e7\u0131kland\u0131\u011f\u0131 \u00fczere <strong>\u00f6zel sa\u011fl\u0131k kurum\/kurulu\u015flar\u0131; sigortal\u0131lara verdikleri sa\u011fl\u0131k hizmetleri kar\u015f\u0131l\u0131\u011f\u0131, SGK\u2019dan alacaklar\u0131 bedelin yan\u0131 s\u0131ra bu tutar\u0131n\u00a0 iki kat\u0131 kadar da sigortal\u0131lardan ilave \u00fccret alabilmektedir.\u00a0 Bu y\u00fczden \u00f6zel sa\u011fl\u0131k kurumlar\u0131, resmi sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131na oranla daha avantajl\u0131 bir konumda bulunmad\u0131r.<\/strong><\/p>\n<p><strong>\u00dcstelik SGK\u2019n\u0131n sa\u011fl\u0131k hizmet bedellerini (istisnalar d\u0131\u015f\u0131nda) 2013 y\u0131l\u0131ndan beri g\u00fcncellemesi, dolays\u0131yla SUT belirlenmi\u015f sa\u011fl\u0131k hizmet bedellerinin yer yer sembolik say\u0131labilecek rakamlarda kalmas\u0131, SGK\u2019n\u0131n giderlerini art\u0131racak g\u00fcncelleme yerine \u00f6zel sa\u011fl\u0131k kurumlar\u0131n\u0131n yasa d\u0131\u015f\u0131 uygulamalar\u0131n\u0131 ola\u011fan kar\u015f\u0131lamas\u0131, \u015fikayetlerin s\u00fcr\u00fcncemede kalmas\u0131, s\u00f6zle\u015fmenin iptali yerine para cezas\u0131 uygulamas\u0131 ile yetinmesi\u00a0 vb. nedenlerle,\u00a0 \u00f6zel sa\u011fl\u0131k kurumlar\u0131n\u0131n; SGK\u2019n\u0131n belirledi\u011fi hizmet bedellerinin iki kat\u0131ndan da fazla ilave \u00fccret almaya ba\u015flad\u0131klar\u0131, sigortal\u0131n\u0131n sa\u011fl\u0131k hizmetleri i\u00e7in daha fazla \u00f6deme yapmak zorunda b\u0131rak\u0131ld\u0131\u011f\u0131,yasada ayk\u0131r\u0131 bu uygulaman\u0131n ola\u011fan hale geldi\u011fi g\u00f6r\u00fclmektedir.<\/strong><\/p>\n<p><strong>\u00d6rne\u011fin<\/strong> Ankara\u2019da SGK Ba\u015fkanl\u0131\u011f\u0131na y\u00fcr\u00fcy\u00fc\u015f mesafesinde bulunan \u00f6zel sa\u011fl\u0131k kurumunda, sigortal\u0131dan SGK\u2019ya fatura edilenin iki kat\u0131ndan fazla ek \u00fccret ald\u0131klar\u0131n\u0131n tespit edilmesi \u00fczerine (TBMM Kamu Denet\u00e7ili\u011fi Kurumu dahil) taraf\u0131mdan\u00a0 yetkili makamlara yap\u0131lm\u0131\u015f \u015fikayetler ve \u0131srarl\u0131 takipler sayesinde ancak yakla\u015f\u0131k dokuz ay sonra yan\u0131t al\u0131nabilmi\u015f,\u00a0 bu ba\u011flamda \u00f6zel sa\u011fl\u0131k kurumuna 4.892,70 idari para cezas\u0131 uyguland\u0131\u011f\u0131, fazla tahsil edilmi\u015f \u00fccretin (hukuka ve hastanelerle yap\u0131lm\u0131\u015f s\u00f6zle\u015fme h\u00fck\u00fcmlerine ayk\u0131r\u0131 olarak) taraf\u0131ma iade edilemeyece\u011fi belirtilmi\u015ftir. (<em>Odatv, 2017)<\/em><\/p>\n<p>Ayn\u0131 hastaneye daha sonra (tedavinin devam\u0131 ba\u011flam\u0131nda) hizmet almak \u00fczere tekrar gidildi\u011finde, iki kat\u0131ndan fazla ek \u00fccret al\u0131nmas\u0131 uygulamas\u0131n\u0131n aynen s\u00fcrd\u00fcr\u00fcld\u00fc\u011f\u00fc\u00a0 tespit edilmi\u015ftir. Yetkililerle g\u00f6r\u00fc\u015f\u00fclmesine, yap\u0131lan i\u015flemin hatal\u0131 oldu\u011funu s\u00f6ylenmesine, internet sitesinde konuya ili\u015fkin olarak yazd\u0131\u011f\u0131m ve iki g\u00fcn \u00f6nce yay\u0131nlanm\u0131\u015f\u00a0 haber \u00e7\u0131kt\u0131s\u0131 da kendilerine verilmesine, yine \u015fikayet\u00e7i olaca\u011f\u0131m\u0131n belirtilmesine kar\u015f\u0131n\u00a0 <em>\u201d hastanenin belirledi\u011fi \u00f6zel fiyatlar\u0131n\u0131n korundu\u011fu<\/em>\u201d ifade edilmi\u015ftir.<\/p>\n<p><strong>II-GSS DI\u015eINA \u00c7IKARILMI\u015e M\u0130LLETVEK\u0130LLER\u0130\/Y\u00dcKSEK YARGI ORGANLARI BA\u015eKAN VE \u00dcYELER\u0130N\u0130N DURUM<\/strong><\/p>\n<p><strong>13<\/strong>-Milletvekillerinin, yasama organ\u0131 \u00fcyeli\u011fi\u00a0 g\u00f6revi sona erenlerin ve bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc olduklar\u0131 aile bireylerinin, \u00f6lenlerin dul ve yetimlerinin tedavi giderleri TBMM taraf\u0131ndan sa\u011flanmaktad\u0131r. <em>(26.10.1990 g\u00fcn ve 3671 s.k. de\u011f. 4\u2019\u00fcnc\u00fc md.)<\/em><\/p>\n<p>31.05.2006 g\u00fcn 5510 say\u0131l\u0131 Kanunla; \u00fclkemizde, \u201c<em>ki\u015filerin \u00f6ncelikle sa\u011fl\u0131klar\u0131n\u0131n korunmas\u0131n\u0131, sa\u011fl\u0131k riskleri ile kar\u015f\u0131la\u015fmalar\u0131 halinde ise olu\u015fan harcamalar\u0131n finansman\u0131n\u0131 sa\u011flayacak olan<\/em>\u201dgenel sa\u011fl\u0131k sigortas\u0131 sigortas\u0131 uygulamas\u0131na ge\u00e7ilmi\u015ftir.<\/p>\n<p>Daha \u00f6nce\u00a0 \u00e7al\u0131\u015fanlar\u0131n kurumlar\u0131nca \u00f6denen\u00a0 sa\u011fl\u0131k hizmetleri giderleri tek elden\u00a0 SGK Ba\u015fkanl\u0131\u011f\u0131nca kar\u015f\u0131lanmaya ba\u015flanm\u0131\u015ft\u0131r. <strong>Bu ba\u011flamda\u00a0 yasalarda mevcut\u00a0 genel sa\u011fl\u0131k sigortas\u0131na ayk\u0131r\u0131l\u0131k olu\u015fturan t\u00fcm h\u00fck\u00fcmler (3671 s.k.\/4. maddesi hari\u00e7 olmak \u00fczere) y\u00fcr\u00fcrl\u00fckten kald\u0131r\u0131lm\u0131\u015ft\u0131r. TBMM \u00fcyelerinin tedavi giderlerine ili\u015fkin genel sa\u011fl\u0131k sigortas\u0131 uygulamas\u0131na ayk\u0131r\u0131\u00a0 yasa kural\u0131\u00a0 g\u00fcn\u00fcm\u00fcze kadar \u00f6zenle korunmu\u015ftur.<\/strong><\/p>\n<p>3671 say\u0131l\u0131 (\u00f6zel) yasaya g\u00f6re TBMM \u00fcyelerine sa\u011flanacak sa\u011fl\u0131k\u00a0 hizmetlerinden yararlanma usul ve esaslar\u0131, TBMM Ba\u015fkanl\u0131k Divan\u0131nca \u00e7\u0131kar\u0131lm\u0131\u015f \u00a0bir y\u00f6netmelikte ayr\u0131nt\u0131l\u0131 olarak belirlenmi\u015ftir. Y\u00f6netmelik 02.05.2012 g\u00fcnl\u00fc R.G. yay\u0131mlanm\u0131\u015ft\u0131r.<\/p>\n<p><strong>Y\u00f6netmelik ile hak sahibi olanlara, SGK arac\u0131l\u0131\u011f\u0131yla genel sa\u011fl\u0131k sigortal\u0131lar\u0131na verilenlerle k\u0131yaslanamayacak oranda (onlar\u0131n hayal bile edemeyece\u011fi), \u00f6zel sa\u011fl\u0131k sigortas\u0131 poli\u00e7elerinde dahi \u00f6ng\u00f6r\u00fclmeyen h\u00fck\u00fcmler i\u00e7eren tedavi yard\u0131mlar\u0131n\u0131n sa\u011flanm\u0131\u015f oldu\u011fu anla\u015f\u0131lmaktad\u0131r.<\/strong><\/p>\n<p>Sa\u011fl\u0131k yard\u0131mlar\u0131na y\u00f6nelik d\u00fczenleme s\u0131ras\u0131nda 5510 say\u0131l\u0131 Kanuna ve SGK Sa\u011fl\u0131k Uygulama Talimat\u0131na ba\u011fl\u0131 kal\u0131nmad\u0131\u011f\u0131 g\u00f6r\u00fclmektedir.<\/p>\n<p><strong>14-Milletvekillerine tan\u0131nm\u0131\u015f bu t\u00fcr ayr\u0131cal\u0131klardan baz\u0131lar\u0131 a\u015fa\u011f\u0131ya \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r.<\/strong><\/p>\n<ul>\n<li>\u00a0<em>Serbest hekim ve di\u015f hekimlerin muayenehanesi \u00f6zel sa\u011fl\u0131k kurumu olarak kabul edilmi\u015ftir.\u00a0 Dolays\u0131yla \u00f6zel muayehanede\/evde yap\u0131lan muayene ve tedavi \u00fccretleri de TBMM taraf\u0131ndan kar\u015f\u0131lanabilmektedir. <\/em><\/li>\n<li>\u00a0\u00a0<em>GSS sigortal\u0131lardan farkl\u0131 olarak; hak sahibince muayene katk\u0131 pay\u0131,\u00a0 ila\u00e7 re\u00e7eteleri i\u00e7in re\u00e7ete bedeli,\u00a0 \u00f6nerilmi\u015f (ucuz) ilac\u0131n kabul edilmesi halinde e\u015fde\u011fer ila\u00e7\u00a0 fark\u0131 vb. i\u00e7in \u00f6deme yap\u0131lmamaktad\u0131r.<\/em><\/li>\n<li><em>Di\u015f hastal\u0131klar\u0131 tedavisi giderleri T\u00fcrk Di\u015f Hekimleri Birli\u011fi tarifesi \u00fczerinden; g\u00f6zl\u00fck\/i\u015fitme cihaz\u0131 giderleri Ba\u015fkanl\u0131k Divan\u0131nca belirlenmi\u015f tutarlar \u00fczerinden \u00f6denmektedir.<\/em><\/li>\n<li><em>Resmi sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131nda tedavi giderleri,\u00a0 \u00f6denmesi gereken \u00fccretleri g\u00f6sterir\u00a0 kurum taraf\u0131ndan\u00a0 d\u00fczenlenmi\u015f ( \u00d6\u011fretim \u00fcyesi muayene \u00fccret fark\u0131 dahil) fatura esaa al\u0131narak \u00f6denmektedir.<\/em><\/li>\n<li><em>\u00d6zel sa\u011fl\u0131k kurumlar\u0131ndaki tedavi giderleri; T\u00fcrk Tabipleri Birli\u011fi birim fiyatlar\u0131n\u0131 ge\u00e7meyecek miktarlar \u00fczerinden (s\u00f6zle\u015fme\/paket fiyat anla\u015fmas\u0131 h\u00fck\u00fcmlerine g\u00f6re) \u00f6denir. (Hak sahipleri taraf\u0131ndan ek \u00fccret \u00f6denmemektedir.)<\/em><\/li>\n<li>\u00a0<em>Tedavilerde hak sahibi ( \u00f6zel\/birinci s\u0131n\u0131f odada) yat\u0131r\u0131lmaktad\u0131r.\u00a0 \u0130lave \u00fccretler TBMM taraf\u0131ndan kar\u015f\u0131lanmaktad\u0131r.<\/em><\/li>\n<li><em>Yurtd\u0131\u015f\u0131na tedaviye <u>g\u00f6nderilenlerin<\/u> tedavi, organ\/doku nakli, tetkik ve tahlil giderlerinin tamam\u0131 ile hak sahibi ve refakat\u00e7isinin yol gideri\u00a0 ve yevmiyeleri\u00a0 TBMM taraf\u0131ndan kar\u015f\u0131lanabilmektedir. (Yurtd\u0131\u015f\u0131nda acil hallerdeki tedavi giderinin ise\u00a0 %70\u2019i \u00f6denmektedir. \u00d6demeler o \u00fclkedeki misyon \u015feflikleri arac\u0131l\u0131\u011f\u0131yla yap\u0131labilmektedir.)<\/em><\/li>\n<li><em>Tedavi s\u0131ras\u0131nda kullan\u0131lan protez\/ortez ile t\u0131bbi sarf malzemeleri <u>gerekti\u011finde<\/u> Ankara Ticaret Odas\u0131n\u0131n belirledi\u011fi veya onaylad\u0131\u011f\u0131 fiyat \u00fczerinden \u00f6denmektedir.<\/em><\/li>\n<li><em>\u00d6zel sa\u011fl\u0131k kurumlar\u0131ndaki t\u0131bbi tahlil; tetkik, fizik tedavi ve rehabilitasyon uygulama giderleri T\u00fcrk Tabipler Birli\u011fi birim fiyatlar\u0131n\u0131 ge\u00e7meyecek \u015fekilde (serbest piyasa fiyatlar\u0131 \u00fczerinden) \u00f6denmektedir<\/em>.<\/li>\n<li><em>Resmi\/\u00f6zel sa\u011fl\u0131k kurumlar d\u0131\u015f\u0131nda yapt\u0131r\u0131lan enjeksiyon, hasta taraf\u0131ndan temin edilmi\u015f kan bedelleri TBMM taraf\u0131ndan \u00f6denmektedir<\/em>.<\/li>\n<\/ul>\n<p><strong>15-<\/strong>GSS mevzuat\u0131na ayk\u0131r\u0131 olarak muhafaza edilen\u00a0 bu \u00f6zel d\u00fczenlemenin kald\u0131r\u0131lmas\u0131; milletvekillerinin de (\u00fclke n\u00fcfusunun asgari\u00a0 %97,7 si gibi) genel sa\u011fl\u0131k sigortas\u0131 kapsam\u0131na girmeleri gerekmekte iken, y\u00fcksek yarg\u0131 organlar\u0131 mensuplar\u0131 da \u00f6zel yasa kapsam\u0131na al\u0131nmaya, \u00f6zel yasan\u0131n uygulama alan\u0131n\u0131n geni\u015fletilmeye\/sa\u011flamla\u015ft\u0131rmaya ba\u015fland\u0131\u011f\u0131 g\u00f6r\u00fclmektedir.<\/p>\n<p>Nitekim ilk olarak;\u00a0 30.03.2011 g\u00fcn ve 6216 say\u0131l\u0131 Anayasa Mahkemesinin Kurulu\u015fu ve Yarg\u0131lama Usulleri Hakk\u0131nda Kanun\u2019un 71. maddesi ile,\u00a0 <u>AYM ba\u015fkan ve \u00fcyeleri ile bunlar\u0131n emeklileri ve bakmakla y\u00fck\u00fcml\u00fc olduklar\u0131 aile fertlerinin sa\u011fl\u0131k giderlerinin TBMM \u00fcyelerinin tabi oldu\u011fu h\u00fck\u00fcmler ve esaslar \u00e7er\u00e7evesinde Mahkeme b\u00fct\u00e7esinden \u00f6denmesine ili\u015fkin d\u00fczenleme getirilmi\u015ftir. <\/u><\/p>\n<p><u>Daha sonra da 24.12.2017 g\u00fcnli R.G. yay\u0131mlanm\u0131\u015f 696 say\u0131l\u0131 KHK 32 ve 42 maddeleri ile getirilmi\u015f h\u00fck\u00fcmlerle Dan\u0131\u015ftay ve Yarg\u0131tay te\u015fkilat kanunlar\u0131na da AYM benzer h\u00fck\u00fcmler getirilmi\u015f, bu suretle Dan\u0131\u015ftay\/Yarg\u0131tay ba\u015fkan ve \u00fcyeleri ile emeklileri de an\u0131lmakta olan \u201c\u00f6zel kanun\u201d kapsam\u0131na al\u0131nm\u0131\u015ft\u0131r.<\/u><\/p>\n<p><strong>16-<\/strong>Ancak \u00fclke n\u00fcfusunun t\u00fcm\u00fcn\u00fcn zorunlu GSS kapsam\u0131na al\u0131nmaya ba\u015fland\u0131\u011f\u0131, bir d\u00f6nemde kabul edilmi\u015f bu t\u00fcr d\u00fczenlemelerin;\u00a0 Anayasa\u2019n\u0131n 12. maddesinde yer alan <em>\u201c Hi\u00e7bir ki\u015fiye, aileye, z\u00fcmreye veya s\u0131n\u0131fa imtiyaz tan\u0131namaz.\u201d<\/em> kural\u0131na ayk\u0131r\u0131 olaca\u011f\u0131 hususunun g\u00f6z ard\u0131 edilmemesi gerekmektedir. GSS sistemin yerle\u015fmesi\/bozulmamas\u0131\/aksayan yanlar\u0131n\u0131n d\u00fczeltilmesi\u00a0 i\u00e7in \u00f6rnek tav\u0131r sergilemeleri gereken TBMM ve y\u00fcksek yarg\u0131 organ\u0131 mensuplar\u0131n\u0131n, Cumhurba\u015fkan\u0131 T. Erdo\u011fan\u2019\u0131n d\u00fcnyada \u00f6rnek olarak g\u00f6sterdi\u011fi, \u00f6vg\u00fcyle bahsetti\u011fi sistemin d\u0131\u015f\u0131nda kalmak istemeleri, a\u00e7\u0131k\u00e7as\u0131 imtiyaz pe\u015finde ko\u015fuyor olmalar\u0131, d\u00fc\u015f\u00fcnd\u00fcr\u00fcc\u00fc\/ \u201c\u015f\u0131k\u201d olmayan yakla\u015f\u0131m olarak de\u011ferlendirilmektedir.<\/p>\n<p>Milletvekillerine g\u00f6revlerini daha iyi yapabilmeleri, halk\u0131 temsilde zorluk \u00e7ekmemeleri ba\u011flam\u0131nda baz\u0131 ayr\u0131cal\u0131klar \/kolayl\u0131klar sa\u011flanmas\u0131 ola\u011fan kar\u015f\u0131lanabilir. Ancak s\u00f6z konusu\u00a0 d\u00fczenlemelerin, \u00fcstlenilen g\u00f6revin\u00a0 s\u00fcresi ile s\u0131n\u0131rl\u0131 kalmad\u0131\u011f\u0131,\u00a0 tan\u0131nan olanaklardan bakmakla y\u00fck\u00fcml\u00fc oldu\u011fu ki\u015filerle birlikte\u00a0 \u00f6m\u00fcr boyu yararlanacaklar\u0131 \u015feklinde kurallar i\u00e7erdi\u011fi g\u00f6r\u00fclmektedir. Bu haliyle d\u00fczenleme, TBMM \u00fcyeleri\u00a0 y\u00f6n\u00fcnden\u00a0 kamuoyunda olu\u015fan de\u011ferlendirmelere g\u00f6re\u00a0\u00a0 \u201cmezara kadar vekillik\u201d\u00a0 tezini kuvvetlendirmektedir. Oysa Anayasa Mahkemesinin baz\u0131 iptal kararlar\u0131nda \u201c<em>Parlamento \u00fcyeli\u011fi ve s\u0131fat\u0131 son bulmu\u015f ki\u015filerin art\u0131k yurtta\u015flardan farkl\u0131 bir stat\u00fc i\u00e7inde bulunmalar\u0131 i\u00e7in sebep kalmad\u0131\u011f\u0131\u201d <\/em>husus a\u00e7\u0131k\/se\u00e7ik belirtilmi\u015ftir.( <em>A\u015f\u0131k, 2015)<\/em><\/p>\n<p><strong>17-<\/strong>Di\u011fer yandan; TBMM \u00fcyelerine ili\u015fkin \u00f6zel yasada\u00a0\u00a0 (3671 s.k.\/4. maddesi)\u00a0 milletvekillerinin sa\u011fl\u0131k giderlerinin TBMM b\u00fct\u00e7esinden \u00f6denece\u011finin belirtilmesi ile yetinilmi\u015ftir. Sa\u011fl\u0131k hizmetlerinden yararlanma usul ve esaslar\u0131n\u0131n \u00e7\u0131kar\u0131lacak y\u00f6netmelik ile TBMM Ba\u015fkanl\u0131k Divan\u0131 kararlar\u0131na b\u0131rak\u0131lm\u0131\u015f oldu\u011fu, bu konularda da Ba\u015fkanl\u0131k Divan\u0131n\u0131 ba\u011flayacak\/s\u0131n\u0131rland\u0131racak yasal bir d\u00fczenlemenin olmad\u0131\u011f\u0131 anla\u015f\u0131lmaktad\u0131r.<\/p>\n<p>Durum b\u00f6yle oldu\u011fu halde y\u00fcksek yarg\u0131 organlar\u0131n\u0131n ba\u015fkan ve \u00fcyelerine sa\u011fl\u0131k giderlerinin yarg\u0131 organlar\u0131n\u0131n b\u00fct\u00e7elerinden \u00f6denmesine ili\u015fkin\u00a0 kabul edilmi\u015f \u00f6zel yasa\/KHK\u2019lerde de, <strong>\u201csa\u011fl\u0131k giderlerinin TBMM \u00fcyelerinin tabi olduklar\u0131 h\u00fck\u00fcmler ve esaslar \u00e7er\u00e7evesinde\u201d \u00f6denece\u011finin belirtilmesi ile yetinilmi\u015ftir.<\/strong> Bu itibarla y\u00fcksek yarg\u0131 organ\u0131 mensuplar\u0131, sa\u011fl\u0131k giderlerinin \u00f6denmesi gibi ya\u015famsal \u00f6nem ta\u015f\u0131yan bir konuda TBMM Ba\u015fkanl\u0131k Divan\u0131na ba\u011flanm\u0131\u015ft\u0131r. Zira\u00a0 bilindi\u011fi \u00fczere y\u00f6netmelik \u00e7\u0131karmak veya Ba\u015fkanl\u0131k divan\u0131n\u0131n TBMM y\u00f6netimine ait karar alma faaliyetleri, TBMM\u2019nin yasal olmayan idari nitelikli kararlar\u0131ndand\u0131r.<strong> Dolays\u0131yla y\u00fcksek yarg\u0131 organlar\u0131na sa\u011flanacak sa\u011fl\u0131k yard\u0131mlar\u0131, yasama organ\u0131n\u0131n ( Ba\u015fkanl\u0131k Divan\u0131n\u0131n) idari kararlar\u0131na g\u00f6re yap\u0131lacakt\u0131r. ( \u00d6rne\u011fin <u>y\u00fcksek yarg\u0131 organ\u0131 mensubunun<\/u> <u>kullanaca\u011f\u0131 g\u00f6zl\u00fck bedeline dahi TBMM Ba\u015fkanl\u0131k Divan\u0131 karar verecektir<\/u>.)<\/strong><\/p>\n<p><strong>\u00a0Bu y\u00fczden konu salt sa\u011fl\u0131k giderlerinin \u00f6denmesi sorunu olmaktan \u00e7\u0131kmakta, yarg\u0131 organlar\u0131n\u0131n ba\u011f\u0131ms\u0131zl\u0131\u011f\u0131 ve tarafs\u0131zl\u0131\u011f\u0131n\u0131 da do\u011frudan ilgilendirmektedir.<\/strong> Getirilen \u00f6zel d\u00fczenlemelere bu y\u00f6nden de bak\u0131lmas\u0131nda\/incelenmesinde\u00a0 yarar vard\u0131r. Bu konunun, \u00f6zellikle yarg\u0131n\u0131n tarafs\u0131zl\u0131\u011f\u0131\/ba\u011f\u0131ms\u0131zl\u0131\u011f\u0131 konusunda herkesten daha fazla duyarl\u0131l\u0131k g\u00f6stermesi gereken y\u00fcksek yarg\u0131 mensuplar\u0131n\u0131n dikkatlerinden ka\u00e7mamas\u0131 gerekti\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n<p>Di\u011fer yandan kapsam d\u0131\u015f\u0131na \u00e7\u0131kar\u0131lmalar\u0131n\u0131n do\u011fal sonucu olarak; GSS sigortal\u0131lar\u0131n\u0131n sorunlar\u0131ndan uzakla\u015facak olan y\u00fcksek yarg\u0131 mensuplar\u0131n\u0131n, SGK\u2019n\u0131n hatal\u0131 eylem ve i\u015flemlerinin yarg\u0131 yoluyla d\u00fczeltilmesi, i\u00e7tihat olu\u015fturmas\u0131n\u0131 y\u00f6nelik \u00e7al\u0131\u015fmalar\u0131n\u0131n zay\u0131flat\u0131c\u0131 bir etki do\u011furaca\u011f\u0131 hususu da g\u00f6zard\u0131 edilmemelidir.<\/p>\n<p><strong>III-SONU\u00c7<\/strong><\/p>\n<p><strong>Sonu\u00e7 itibar\u0131yla; <\/strong><\/p>\n<ul>\n<li>\u00a0Cumhurba\u015fkan\u0131 Recep Tayyip Erdo\u011fan\u2019\u0131n da: <em>\u201cD\u00fcnyada belki de tek \u00f6rnek oldu\u011funu, ABD\u2019nin bu modelin dar bir \u00f6rne\u011fini uygulamaya kalkt\u0131\u011f\u0131 halde ba\u015faramad\u0131\u011f\u0131n\u0131, be\u015f y\u0131ld\u0131r t\u0131k\u0131r\/t\u0131k\u0131r i\u015fledi\u011fini, incelemek i\u00e7in d\u00fcnyan\u0131n her yerinden heyetler geldi\u011fini\u201d\u00a0 belirterek<\/em> \u00f6vg\u00fcyle bahsetmi\u015f oldu\u011fu zorunlu GSS sistemine ili\u015fkin mevzuat h\u00fck\u00fcmlerinin, eksiksiz uygulanmas\u0131 ve t\u00fcm vatanda\u015flar\u0131m\u0131z\u0131n ayn\u0131 sosyal g\u00fcvenlik \u015femsiyesinin alt\u0131nda toplanmas\u0131na y\u00f6nelik \u00e7al\u0131\u015fmalar\u0131n sonu\u00e7land\u0131r\u0131lmas\u0131;<\/li>\n<li>\u00a0\u00a0Milletvekilleri ve y\u00fcksek yarg\u0131 organlar\u0131 mensuplar\u0131n\u0131 GSS d\u0131\u015f\u0131nda b\u0131rakan, Anayasa\u2019n\u0131n e\u015fitlik ilkesine, yarg\u0131 ba\u011f\u0131ms\u0131zl\u0131\u011f\u0131\/tarafs\u0131zl\u0131\u011f\u0131\/kuvvetler ayr\u0131l\u0131\u011f\u0131 ilkelerine \u00a0ayk\u0131r\u0131l\u0131k olu\u015fturmakta olan imtiyaz niteli\u011findeki istisnai \u00a0yasal h\u00fck\u00fcmlerinin kald\u0131r\u0131lmas\u0131;<\/li>\n<\/ul>\n<p>Bu suretle; d\u00fcnyaya \u00f6rnek model olarak a\u00e7\u0131kland\u0131\u011f\u0131, askerlik g\u00f6revini yapmakta olan 350 bin er\/erba\u015f ile yedek subay \u00f6\u011frencinin sisteme dahil edildi\u011fi bir s\u0131rada, (ayn\u0131 y\u0131l i\u00e7inde) \u00a0baz\u0131 y\u00fcksek yarg\u0131 organ\u0131 mensuplar\u0131n\u0131n sistemden \u00e7\u0131kar\u0131lmas\u0131ndan kaynaklanan \u00e7eli\u015fkinin giderilmesi;<\/p>\n<p>TBMM\/y\u00fcksek yarg\u0131 organlar\u0131 ba\u015fkan ve \u00fcyelerinin toplumun t\u00fcm\u00fcn\u00fc kapsayan sistem i\u00e7inde olmalar\u0131 halinde,\u00a0 sa\u011fl\u0131k giderlerinin \u00f6denmesine y\u00f6nelik sorunlar\u0131 bilen\/ya\u015fayan ki\u015filer olarak; GSS aksayan yanlar\u0131n\u0131n yasal de\u011fi\u015fiklikler veya yarg\u0131 kararlar\u0131 ile daha kolayl\u0131kla \u00e7\u00f6z\u00fcmlenebilece\u011fi;<\/p>\n<ul>\n<li>Resmi sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131n\u0131n faaliyetlerini zorlanmadan y\u00fcr\u00fctmeleri, \u00f6zel sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131ndan hizmet alan\u00a0 sigortal\u0131lar\u0131n daha az ilave \u00fccret \u00f6demeleri a\u00e7\u0131s\u0131ndan \u00f6nem arz eden, 2013 y\u0131l\u0131ndan beri de\u011fi\u015ftirilmemi\u015f olan SGK\u00a0 sa\u011fl\u0131k hizmeti bedellerinin (SUT tarifelerinin) g\u00fcncelle\u015ftirilmesi;<\/li>\n<li>\u00a0\u00a0\u00d6zel sa\u011fl\u0131k kurum ve kurulu\u015flar\u0131n\u0131n SGK sa\u011fl\u0131k hizmet bedellerinin iki kat\u0131ndan fazla ek \u00fccret almalar\u0131na y\u00f6nelik uygulaman\u0131n \u00f6nlenilmesi, SGK sa\u011fl\u0131k giderlerinin artmamas\u0131 ba\u011flam\u0131nda\u00a0 g\u00f6z yumulmamas\u0131;<\/li>\n<\/ul>\n<p>Gerekti\u011fi d\u00fc\u015f\u00fcn\u00fclmektedir.<\/p>\n<p><strong>KAYNAK\u00c7A<\/strong><\/p>\n<p>Say\u0131\u015ftay, 2013 Y\u0131l\u0131 D\u0131\u015f Denetim Genel De\u011ferlendirme Raporu, (http:\/\/www.sayistay.gov.tr\/rapor\/genel\/2013_D\u0131s_Denetim.pdf<\/p>\n<p>SGK, 2016 Y\u0131l\u0131 \u0130statistikleri, ( http:\/\/www.sgk.gov.tr\/wps\/portal\/sgk\/tr\/kurumsal\/istatistik\/sgk_istatistik_yilliklari)<\/p>\n<p>http:\/\/www.bumko.gov.tr\/Eklenti\/10849,2018yilibutce-gerekcesipdf.pdf<\/p>\n<p>https:\/\/www.haberler.com\/cumhurbaskani-ulkemizde-uygulanan-gss-dunyada-9170708-haberi\/<\/p>\n<p>http:\/\/t24.com.tr\/haber\/prof-dr-erbug-keskin-capa-cokerse-devasa-sehir-hastaneleriniz-onun-yerini-tutar-mi-saniyorsunuz,427400<\/p>\n<p>http:\/\/www.cumhuriyet.com.tr\/haber\/yazi_dizileri\/895392\/Hastaneler_hasta.html<\/p>\n<p>http:\/\/www.cumhuriyet.com.tr\/haber\/turkiye\/900202\/<\/p>\n<p>Universite_hastanesi_250_milyon_liralik_borc_nedeniyle_faaliyetlerini_durdurmak_uzere.html<\/p>\n<p>https:\/\/odatv.com\/yasa-tanimayan-bazi-hastaneler-valileri-bile-dolandiriyor-1712171200.html<\/p>\n<p>Melih A\u015f\u0131k, Milliyet Gazetesi, 27.02.2015, \u00a0http:\/\/www.milliyet.com.tr\/Milliyet.aspx?aType=gundemYazarTumYazilar.<\/p>\n<div class=\"mom-e3lanat-wrap  \">\n<div class=\"mom-e3lanat \" style=\"\">\n<div class=\"mom-e3lanat-inner\">\n<div class=\"mom-e3lan\" data-id=\"38247\" style=\" \"> \t\t\t\t\t \t\t \t<\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131na Toplu Bak\u0131\u015f Mahmut ESEN Emekli M\u00fclkiye Ba\u015fm\u00fcfetti\u015fi mahmutesen@gmail.com \u00d6z\u00fc: \u00dclke n\u00fcfusunun t\u00fcm\u00fcn\u00fc kapsamas\u0131 gereken, 2012 y\u0131l\u0131ndan itibaren zorunlu hale gelen ve sa\u011fl\u0131k giderlerinin tek elden yap\u0131lmas\u0131n\u0131 \u00f6ng\u00f6ren genel sa\u011fl\u0131k sigortas\u0131 \u00a0(GSS) sisteminde ula\u015f\u0131lm\u0131\u015f son a\u015fama; milletvekilleri ile y\u00fcksek yarg\u0131 organlar\u0131 ba\u015fkan ve \u00fcyeleri i\u00e7in getirilmi\u015f istisnalar, GSS uygulamalar\u0131nda resmi\u00a0 ve \u00f6zel&hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[39],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v16.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131na Toplu Bak\u0131\u015f &#8211; Mahmut ESEN, E. 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