Iranian Health Officials Call for Structural Reforms to Strengthen Universal Healthcare System
Tehran – Senior Iranian health officials have emphasized the critical need for structural reforms and financial consolidation within the nation’s healthcare system to ensure the sustainability of its extensive coverage, which currently provides free services to tens of millions of citizens.
The calls for reform were made during a specialized policy meeting, where leaders from major health insurance and research organizations outlined both the achievements and the pressing challenges facing the system.
A System Under Financial Strain
Mr. Nasehi, the Managing Director of Iran’s Health Insurance Organization, highlighted the scale of the system, noting that approximately 80% of the country’s insured—comprising villagers and the five lowest income deciles—receive healthcare services free of charge, with the government obligated to fund their coverage.
However, he reported a significant financial challenge, stating that only one-third of the approved financial resources for these groups has been allocated. “This has placed a heavy burden on the Health Insurance Fund,” Nasehi said, adding that the fund for patients with special and hard-to-treat diseases is also facing a serious resource shortage.
He identified the lack of a unified payment system within the healthcare sector as a key issue, pointing to the simultaneous use of various methods such as capitation, fee-for-service, and performance-based payments. “We have not yet reached a specific consensus on this matter,” he noted.
The Push for a Unified System and Transparency
To address these challenges, officials proposed consolidating financial resources. “The formation of a unified health insurance fund and the consolidation of financial resources can lead to coherence in services and cost control,” Nasehi stated, adding that negotiations with the Parliament Research Center and the Academy of Medical Sciences are underway.
Echoing the need for systemic reform, Dr. Fatemeh Hashemi, Head of the Special Diseases Foundation, stressed the importance of transparency and collaboration. She highlighted the essential role of charitable contributions and non-governmental organizations in providing the country’s medical infrastructure.
“The trust of benefactors is earned when there is transparency in the performance of organizations and in how donations are spent,” Dr. Hashemi said. She also pointed to the lack of a clear protocol for cost reimbursement as a serious challenge, leading to overlaps in services and confusion for patients navigating multiple organizations.
A Model of Efficient Service
In contrast, Brigadier General Masoud Fayaz Arbababi, Head of the Armed Forces Medical Services Insurance, presented his organization as a model of efficient operation. He detailed its unique, integrated structure that combines basic and complementary insurance into a single policy, facilitating seamless service for its approximately five million beneficiaries.
Despite financial pressures, General Arbababi reported that his organization has advanced payments to medical centers and maintains high service levels. “Providing peace of mind and an attractive service package for our target community, especially the armed forces who defended the country in wars, is a red line,” he affirmed. He also reported a satisfaction rate of over 76% among their insured members.
Broader Challenges and the Path Forward
The broader challenges were summarized by experts, including Dr. Kamran Bagher Lankarani, Head of the Health Policy Research Center. He warned of the persistent structural problems in the pharmaceutical industry, emphasizing the urgent need to reform reimbursement policies, create a smarter pricing system, and strengthen coordination between responsible institutions.
General Arbababi further cautioned that the aging population and the imbalance between resources and expenditures represent the most significant future challenge for all insurance organizations. He called on health policymakers to find solutions to prevent harm to the people and safeguard their health.
The consensus from the meeting was clear: while Iran’s healthcare system provides extensive coverage, achieving long-term stability requires immediate, coordinated structural reforms, financial consolidation, and enhanced transparency across all stakeholders.