In addition to their health issues, Iranian patients in recent years have had to deal with other issues: shortage of certain medicine, exorbitant treatment costs, a shortage of facilities, the black market for medicine, fake medicine, etc. Many specialists believe that the major cause for these was Mahmoud Ahmadinejad administration’s mismanagement. Today, patients have pinned hopes in Hassan Rouhani administration’s ministry of health to find solutions and improve the situation.
While the current national budget has increased in size compared to last year (the last year of Ahmadinejad’s administration), this is not sufficient to deal with these many issues. Majlis member in the health committee Abdol Rahman Rostamian spoke with Rooz about these issues. He believes more funds should have been allocated to this sector. “The ministry of health is in debt. Seven billion Toman from the budget are needed to pay existing debts,” he said.
Rostamian believes that this year’s health budget is better than last year’s. “Towns with less than 20,000 people will be better off in health, retention of resources, and medical facilities. Allocated funds can also be used to acquire new ambulance vehicles, since more than 50 percent of existing ambulances are over seven years old and thus aging,” he said.
Statistics indicate that over seven percent of the country’s population falls below the poverty line because of rising medical expenses. It is now many years since patients have been paying close to 70 percent of their medical expenses themselves, leaving only 30 that is paid by insurance companies. The question that is asked is whether the new budget will result in a drop in the costs of medical expenses. Rostamian says, “There is a drop of one percent patient out-of-pocket expense for approximately every 300 billion Toman that is added to this sector in public funds. With the current budget, we may be able to drop this out-of-pocket expense between five to ten percent. But we cannot most certainly achieve the goals set in the five-year plan, where by patients pay only 30 percent of their medical expenses themselves.”
But the situation is distressing because medical costs are rising. According to a report by Iran’s Statistical Center, medical and treatment costs were 37 percent higher during this year’s month of Day (December 22 to January 20) in comparison to the same month last year.
Bankrupt Hospitals; Dissatisfied People
“Insurers owe us about one billion Toman which is expected to be paid in six months. This has created a liquidity problem for hospitals:” these are the words of Mohammad Aghajani, the deputy minister of health. He continued, “In depth discussions have been held about amounts owed to the ministry and the debts of the insurance companies in the targeting subsidies workgroup and it was agreed that paying off the debts to the ministry would be one of the goals of the targeted subsidies.”
Rostamian also told Rooz, “Insurance companies will be strengthened in the coming year, the credit available to them will be increased which will be done in a manner that will support government hospitals.” He said government hospitals bought most of their services from insurance companies. “Today, the debts that insurance companies have to hospitals is large and because of this the actual purchasing power of hospitals to buy equipment and medicine has fallen. Payments to personnel face delays,” he said.
He also said that because of the problems that government hospitals face, they cannot provide medical services to patients in a manner that they are responsible to do. But people’s complaints go beyond this. Most people who have been to these hospitals talk about carelessness, delayed cremations, long waiting times, and other issues. The situation is so bad that the minister of health spoke in very clear terms last month when he said, “We are not lying to people; Government hospitals are bankrupt. The ministry of health is in disarray and lost.” And he also said that through the implementation of phase two of the subsidies law, people’s out-of-pocket payments for health must be reduced.
The head of Iran’s food and drug organization recently announced that since the Geneva nuclear agreement, banking transactions between Iranian and Western banks in the sphere of medicine have resumed. But while at first glance it may appear that the problems of medicine and treatment relate to the sanctions and foreign exchange issues, specialists have repeatedly said that what threatens the life of patients are the bad policies and mismanagement issues that existed in the previous administration and in the ministry of health.
Shargh newspaper published a report on February 12 in which it said that while the volume of imports of medicine into the country have risen by 900 percent since 1996, and domestic production of medicine has seen a rise of 500 percent resulting in a drop in imports from 1.3 billion Rials in 1997 to 33 billion Rials in 2011. The report concludes that had the ninth and tenth administrations (Ahmadinejad’s two presidential terms) focused on increasing domestic production of medicine rather than increasing imports, Iran would not have been facing the series effects of the sanctions in its medical sector.
Rostamian agreed with this. “The production cost of medicine in Iran is a third to a fifth cheaper than comparable medicine purchased from abroad. We must get to a position where we not only meet our domestic needs by producing our own medicine, but we should also be exporting medicine to neighboring countries.”
Rooz online