The Turkish government’s announcement of health fees for Syrians holding temporary protection cards has stirred wide debate locally and internationally. Set to take effect in early 2026, the decision marks a sharp change after more than 13 years of free medical services for refugees under government support and international funding.
While the government presents it as a measure to reorganize health resources and ensure equality among all residents, critics see it as a financial strain that could deepen refugees’ vulnerability. The main challenge lies in balancing state requirements with human rights in healthcare access. As the implementation date approaches, Syrians and international agencies await details on fees and mechanisms, highlighting the urgent question: Can Turkey and the international community protect refugees’ dignity while ensuring sustainable public services?
Economic Pressures and Declining EU Support
According to Turkey’s Ministry of Health, over 14 billion lira has been spent in the past five years covering treatment and preventive care for Syrians under temporary protection.
A finance ministry official says the decision is not austerity but an organizational step to ensure fair resource distribution and include all residents in the general insurance system. “The health sector faces serious financial pressure, and millions of refugees in the free system require a review to sustain service delivery,” the official noted.
Approximately 2.375 million Syrians will now pay contributions under the General Health Insurance (GSS) program, after receiving free medical care for over a decade. The Ministry of Health justified the fees due to rising treatment costs, while some experts see it as part of a broader effort to reduce direct subsidies for non-Turkish residents.
International organizations, including UNHCR and WHO, have expressed concern, emphasizing the need for transitional support systems for low-income Syrians to maintain essential healthcare access.
What Changes for Syrians in 2026?
Official documents state that Syrians will pay symbolic fees for hospital visits. Emergency services remain free, maternal care and childbirth services have reduced fees, and children under five receive free vaccinations. Chronic disease management will follow a support mechanism, though details remain unclear, particularly for the poorest families.
Experts warn that the fees could create significant financial strain. Most Syrians work in informal sectors with low and unstable incomes. Monthly wages often fall below Turkey’s 2025 minimum net wage of 22,104 lira (~$610), making new healthcare costs a serious burden. Expected fees may range from 200 to 500 lira per month, while basic medical visits could cost 100–150 lira and chronic disease care up to 400 lira monthly.
Human rights lawyer Khaled Mulla noted: “Many Syrian families live under the poverty line. Even symbolic fees could prevent them from accessing care, potentially increasing preventable diseases and maternal-child mortality.”
Social and Economic Implications for Refugees
Economist Dr. Arol Demir from Istanbul Technical University explains that the decision reflects Turkey’s goal to reduce direct public subsidies. “Free healthcare for refugees has added more than 7% to the Ministry of Health budget in recent years,” he said. While fees may not exclude Syrians from care, they introduce an ongoing economic burden.
Humanitarian researcher Delara Ozcan adds that advance-payment systems could limit access for vulnerable populations if no targeted support exists. A survey by the Turkish newspaper Cumhuriyet in November 2025 found that 63% of Syrians surveyed could not afford the new fees, while only 21% were willing to participate in the new system.
Refugees emphasize the need for a system aligned with real income levels. Abu Said, a construction worker in Adana, said: “Our monthly income doesn’t exceed 10,000 lira. Additional fees would force us to forgo care.” Similarly, Ahmed Al-Saadi, living in Gaziantep, added: “Medical care is a basic right, not a luxury.”
Three Possible Options for Syrian Refugees
Human rights activist Abbas Sabouni outlines three potential outcomes once fees are implemented in early 2026. Some refugees may integrate into the insurance system, paying fees but remaining financially strained, especially larger families and those with chronic illnesses. Others might reduce hospital visits, opting for self-treatment or pharmacies, raising the risk of untreated conditions and complications. The government and international organizations may activate exemption and support mechanisms, reducing the financial burden for low-income families and ensuring essential services like vaccinations and maternal-child health programs remain free.
Sabouni stresses the importance of local aid coordination, awareness campaigns in Arabic, and clear administrative guidance to prevent confusion from creating further barriers to healthcare access.
