Title: Negotiations Stall on Critical Supplemental Health Insurance for Iranian Retirees
Tehran – Intensive negotiations to finalize a supplemental health insurance plan for Social Security retirees have reached an impasse, leaving a critical coverage gap for a vulnerable segment of the population. After multiple marathon sessions, stakeholders have failed to reach a consensus, citing fundamental disagreements over financial calculations.
A Negotiation Deadlock
According to Ali Dehghan Kia, Head of the Tehran Retirees Association of the Social Security Organization, lengthy meetings involving the organization’s CEO, deputies, and insurance representatives concluded without a final agreement. “Some sessions lasted over ten hours, but in the end, we did not reach a final accord,” Dehghan Kia stated.
The core of the disagreement lies in differing assessments between the Social Security Organization and the insurance provider regarding tariff increases and the estimation of medical treatment costs. “This disagreement directly impacts the calculations and is why the negotiations did not yield a result,” he explained, emphasizing that while the exact figures are highly technical, the rapid rise in costs for medicine and medical services far outpaces official estimates.
Legal Mandates and Implementation Gaps
Dehghan Kia highlighted existing laws that mandate the provision of both basic and supplemental insurance services for retirees. He pointed to a specific legal note that required a foundational framework to be drafted within six months, a regulation that remains unfulfilled after more than twenty years. “While supplemental insurance is being implemented in practice, the basic levels and ceilings are still undefined. This has caused confusion for the people,” he noted.
The urgency is underscored by a massive registration drive, with over 20,000 retirees signing up for supplemental insurance within a 24 to 48-hour period, demonstrating the severe need for these services.
Systemic Challenges and a Call for Solutions
The official also addressed challenges within the Social Security Organization’s own medical centers, noting that many facilities require equipment upgrades. He mentioned that low tariffs and payments have reduced doctors’ motivation to work in these centers, sometimes leading them to refer procedures to private clinics. “This ultimately harms the insured,” Dehghan Kia said.
He firmly asserted that a retiree, after 30-35 years of premium payments, has the right to receive medical services without worry. “Saying that there are no resources is not acceptable to the insured,” he stated, adding that the government is also legally obligated to cover portions of healthcare costs through various channels, but these funds are not being fully allocated to the Social Security Organization, increasing the financial pressure on retirees.
An Urgent Advisory for Retirees
In light of the unresolved status, Dehghan Kia issued a crucial advisory to all retirees. “Because no definitive agreement has been reached, we officially announce that the Association bears no responsibility for supplemental insurance costs.” He strongly urged retirees to avoid seeking treatment at private hospitals or centers with high costs under the assumption of future reimbursement, as they risk being unable to reclaim these expenses.
For now, retirees are advised to use only the Social Security Organization’s owned medical centers or its contracted partners to avoid personal financial liability.
The Path Forward
Dehghan Kia concluded by reaffirming that providing healthcare is an inherent duty of the Social Security Organization, and solutions must be found. “We are making every effort to follow up on the treatment problems of the insured, but a fundamental solution is only possible when the Social Security Organization and the insurers reach an agreement,” he said, underscoring the need for a swift and responsible resolution to this pressing issue.