Table1 Main features of health financing agents in 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 |