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Table1 Main features of health financing agents in Iran

From: Measuring inequalities in the selected indicators of National Health Accounts from 2008 to 2016: evidence from Iran

Financial agencies (Financing schemes)

Proportion of THE (approximate estimation %) from NHA report 2014 [19]

Population size (estimated) [26]

Payment contribution and user charges [26]

Brief description of resources [26]

Public

~ 50

Total population of country

 

Includes government and non-government resources

Government

~ 25

Total population of country

 

Includes natural resources (e.g. oil), taxes and other government resources

 MSUs

~ 20

Total population of country

Public health and medical services/programs

Public budget allocated by government at provincial and district levels

 Others

~ 5

Employees and their dependents mentioned in (~ 5,000,000)

Medical services/programs

Including Municipalities, Armed Forces Medical Insurance, Medical Organization of Petroleum Industry, National Broadcasting Organization, etc

Non-government

~ 25

 

Mainly health insurance schemes

Includes basic and supplementary health services insurances and other non-government resources

 HIO

~ 10

Rural Residents

Payment contribution: 6% of the minimum wage (paid by the government)

User charges: 5 and 30% of in-patient and out-patients health services, respectively, based on medical tariffs in public sector. Also the gap between private and public tariffs in private centers

Basic social health insurance which is financed by premiums paid by employee and employer and public subsidies

 

Government Employees

Iranians Fund

Payment contribution: 6% up to twofold of the minimum wage (paid by employee, employer, and government and payment contribution for Iranians Fund and Other Sectors are fixed premiums (50% by the government)

 
 

Other Sectors (34,123,681)

Fixed premiums (paid by the government)

User charges: 10 and 30% of in-patient and out-patients health services, respectively, based on medical tariffs in public sector. Also the gap between private and public tariffs in private centers

 

 SSIO

~ 13

Employees of the formal private sectors, self-employed and voluntary contributors (37,547,508)

Payment contribution: 30% (20% employers, 7% workers, 3% government) of which 9% is for health benefit package

User charges: 10% and 30% of in-patient and out-patients health services, respectively, based on medical tariffs in public sector. Also the gap between private and public tariffs in private centers. No copayment in SSIO’s hospitals and health centers

Basic social health insurance which is financed by premiums of paid by employee and employer

 Others

 ~ 2

2,146,571 and uninsured people

Payment contribution: 6% of the minimum wage (paid by the government) 13% of wage without ceiling for Iran Insurance Company and Central Insurance Company (4% employee and 9% employer)

User charges for Imam Khomeini Relief Foundation: Free of charge for inpatient health services in public sector, and 30% of out-patients services. A part of the gap between private and public tariffs in private centers is covered by the this scheme

Other medical insurance funds are free of charge in both private and public health centers

Imam Khomeini Relief Foundation, Red Crescent Society, etc

Private

~ 50

 

Mainly user fees paid by people and households at the point of service delivery

Includes OOPs paid by Households and other private and charity organizations

OOP

 ~ 40

 

Mainly user fees paid by people and households at the point of service delivery

 

Others

 ~ 10

 

Providers’ investment in private sector for health service delivery

Non-profit institutions serving households, Private Supplementary Insurance Companies, Banks, etc

THE

100 (823,000 billion rials)

  

Includes total current health expenditures (TCHE) and governance, and health system and financing administration except for some resources such as education and research