“The coronavirus does not differentiate between the weak and the rich and affects everyone”, this is what government officials have said from the very beginning of the coronavirus outbreak in Iran.
But it did not take long for the reality to be revealed to everyone, that the backbreaking cost of the health system and the increase of hospital beds have pulled more than 3 million people below the poverty line.
While the only support for people infected with the virus is health insurance, it seems that the officials have forgotten that article 29 of the regime’s constitution emphasizes that for all citizens the insurance and health service are free, and they should be able to profit from it without any restrictions.
According to the government’s decree, the average cost for any coronavirus case is 4.5 million tomans in the ICU and 2.5 million tomans in the normal care units. But now when the government-run hospitals do not have any empty beds, they are demanding several times more to accept a person in the ICU.
Also, the cost of ICU beds in private hospitals has multiplied and reached 50 million Tomans, while many do not recognize any insurance.
According to the Ministry of Welfare, in 2020, the total basic health insurance coverage of the country was 86%. The most advantageous province in the country is Chaharmahal and Bakhtiari with 94.2% and the least advantaged province is Tehran with 78.9%.
In other words, in Tehran province, about 21 percent of people are without health insurance, which imposes heavy costs on these households under coronavirus conditions.
According to these statistics, during 2020 after Tehran, 17% in Alborz, 15% in Qom, and 13% in Khuzestan and in Kermanshah and Bushehr, more than 12% of people had no health insurance.
As the statistics speak, in these critical situations, people who lack insurance suffer more, and according to an unofficial report, about 40 percent of patients who died of coronavirus have had no insurance.
To investigate this issue, we can also point to statistics published by the Ministry of Welfare last year that 16 percent of nearly 13.5 million Iranians and 21 percent of people in Tehran province lacked health insurance.
Statistics from the Ministry of Welfare also show that before the coronavirus, Iranians have paid 35% of all medical expenses personally.
Other statistics from the ministry show that 2.4 million Iranians fell below the poverty line in the past year due to high medical costs, which increased dramatically in 2021.
But statistics from the Ministry of Welfare in 2019, when the catastrophic costs of coronavirus were not imposed on the people, showed a tragedy according to its numbers. The Ministry of Health announced in October 2019 that 3.76 percent of the population suffers from impoverishing annual health costs.
The deputy of insurance and health services of the Health Insurance Organization also said that following the statistics of the high costs, the number of clients of the health care system has decreased by nearly 30 percent and the rate of services has become such that the cost of treatment is significant compared to households’ income.
Statistics from the Ministry of Welfare also confirm this. In 2017, the amount of out-of-pocket treatment costs paid by people reached 32.6%. Also, in the last year, 2.41 million people suffered from catastrophic medical expenses.
According to the World Bank, the out-of-pocket payment of Iranian households for medical expenses in 2018 is about 35 percent, which is much higher than the global average of the index, i.e., 18 percent. Iran ranked 116th out of 187 countries in the same year.
Today, vulnerable people in the community who are forced to contract coronavirus in a workshop or at work and receive a salary of two to three million tomans, if they do not have insurance, must pay 20 to 40 million tomans out of pocket for the hospital, which means increasing poverty in the community.
On average, about five percent of Iranians spend 25 percent of their income on health care costs. Amid the coronavirus, medicine and oxygen have become insufficient and many patients die in their homes due to their inability to afford medicines and treatment.
What is surprising is that medicine and medical equipment enter the country at the 4,200 tomans currency exchange rate but are handed over at a very high price to the consumer.
It has been reported that imported medicines and items needed by patients are smuggled to neighboring countries or are stashed in customs for days, and government agents prevent them from reaching the people.