Successful implementation of the ‘Health Reform Plan’ hinges on the support of the insurance sector, a lawmaker said.
Lamenting the gap between the healthcare sector and insurance companies, Ali Kaeidi, member of the Majlis committee on healthcare said, “Unless there is full cooperation between the two sides, the health reforms cannot achieve the objectives,” Mehr news agency reported.
The current dichotomy between insurance firms and healthcare sector has rendered the former to act autonomously, he said, adding that the ministry has thus been forced to allocate funds directly to health services. However, the MP said, once the role of insurance companies’ is transformed and enhanced in healthcare, the problem will be largely addressed.
Hassan Tamini-Litaei, deputy head of the committee, said the success of health reforms depend on the support of insurance companies. “Unless the insurance infrastructure is improved, there will be challenges to the plan.”
Reform Plan
President Hassan Rouhani in a live interview on national television more than a year ago announced a comprehensive health plan in fulfillment of his electoral campaign promise. Rouhani promised healthcare for all Iranians by 2018, and thus the Health Reform Plan was launched in May 2014.
The president said “he wanted all Iranians to be protected under a nationwide health insurance program.” At least five million of the most vulnerable citizens (not already insured) were to benefit from the initiative and achieve universal coverage. This was the first step taken by the government to extend medical insurance to all Iranians.
The government also sought to ensure that hospitals could provide all the services. The president said his healthcare plan would be partly funded by cuts to government subsidies.
Implementation of the plan, as independent evaluations show, has resulted in 75% greater public satisfaction with healthcare services and reduced “out of pocket payment to 10%,” say media reports.
The constitution guarantees basic health care, and most public clinics, vaccination programs and prescription drugs are already heavily subsidized by the state.
The health ministry had stated that by the end of the Fifth Five-Year Economic Development Plan (2011- 2016) the contribution of patients to healthcare costs will decline to below 30%.
Experts argue that the ministry’s decision “has undoubtedly taken into account the per capita healthcare costs, as well as the annual increase in the allocated budget to the insurance sector. The insurers were thus assessed by the regulator to be able to provide for 70% of healthcare costs,” said Dariush Taherkhani, member of the Islamic Republic of Iran Medical Council (IRIMC).
Drawbacks
Less than a year remains before the fifth plan concludes and households still pay a large part of healthcare costs. “Insurance companies violate the law through different excuses and deprive people of their rights stipulated by law,” said Taherkhani.
In spite of considerable achievements, the health sector has not made strides in terms of the ‘healthcare economy’. People do not expect too much from the patrons of the health sector but they expect quality services at reasonable costs.
The laws in the field of healthcare are advanced and capable of improving the health status and social welfare of the population. However, these laws are often not implemented because they contradict the interest of “certain groups,” whom he didn’t mention.
Although the Healthcare Reform Plan has satisfied 70% of the population, some still criticize that it is the “Achilles heel of the present incumbent.”
Nevertheless, the main concern of Health Minister Hassan Hashemi is whether or not the primary insurers will support the plan. The issue can be a major challenge before the ministry and the government in the coming year (starts March 21), officials say.
Hashemi has several times expressed concern over the refusal of insurers to support the plan and that “their failure to integrate into a single fund can seriously damage the plan.”
