flagship course on: health financing & provider payment
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Flagship Course on: Health Financing & Provider Payment. Iran Health Financing May 12-15, 2005 Khoramabad - Lorestan Dr hamidreza Jamshidi. Iran Health Financing. Iran is a lower middle income country with a 2002 GDP US$ 108.2 billion (US$ 438.5 billion PPP). Iran Health Financing. - PowerPoint PPT PresentationTRANSCRIPT
Flagship Course on:Health Financing & Provider
Payment
Iran Health Financing
May 12-15, 2005
Khoramabad - Lorestan
Dr hamidreza Jamshidi
Iran Health Financing
Iran is a lower middle income country with a 2002 GDP US$ 108.2 billion (US$ 438.5 billion PPP)
Iran Health Financing
2002 GDP Per Capita equal to US$ 6690 PPP.
Government revenues are 25 Percent of GDP
54% from oil and gas
24% from taxes
The remainder from other Sources
Iran Health Financing
Iran Health Financing
Public health expenditure as % of GDP = 2.8% (2001)
Private health expenditure as % of GDP = 3.6%(2001)
Out of Pocket Payment = 56%
Iran Health Financing
Iran Spent an estimated 6.4% of its GDP on health US$ 422 Per Ca Pita in PPP.
Health Spending accounts for some 10% of Government spending and 5.5 percent of house hold spending.
Iran Health Financing
Iran Health Financing
Population with Sustainable
access to improved Sanitation
(%)
1990
)-(
2000 (%83)
Population with Sustainable
access to an improved water
Source: (%)
1990
)-(
2000 (%92)
Under nourished People: (% Total
Population) 1990/92
(%5)1991/2001
(5)
Children under weight for age: (% under s year)1990-2002
%11
Iran Health Financing
Children under height for age1990-2002 :%15
Infants with low birth weight)%( 1998-2002 : %17
Life expectancy at birth (years)1970-75 “55.3 years”
2000-05 “70.3 years”
Infant mortality rate (Per, 1000
live births)
1970
“ 122”
2002
“35”
Under-five mortality rate (Per,
1000 live Births)
1970
“ 191”
2002
“ 24”
Iran Health Financing
Poverty Safety Netin IR. IRAN
Social Security Structure
Expansion of the Equal Opportunities
& Empowerment
Development the
Infrastructures
High Education
Public Education
HousingJob
CreationHealth-Health Insurance
-Social Insurance-Rehabilitation-Social protection system:
Through establishing:1- Imam Khomeini Emdad Committee
Establish the Ministry of
Welfare Since 2004
PHC system
Providing human resources for
deprived areas
Health insurance
system
Infrastructure
Capacity Building
Iran Health Financing In formal sector 30% of income paid
for social security benefits (24 million population). Nearly one third of this (9%) amount allocate to health insurance fund.
Government employees pay a monthly fix amount Per Capita and armed forced personnel pays the same amount. Nearly two third of premium paid by Government, just as an employer.
Iran Health Financing
Iran Health Financing
Rural Population premium Paid by Government as a fixed amount equal to 40% of civil Servant Premium.
New incoming rural insurance is established by the parliament. Almost totally financed by GOV (5% by people)
Workers Contribution Pooled by Social Security organization fund.
Iran Health Financing
Iran Health Financing
Medical Services insurance organization manage Contributions related to civil Servants, Rural Population , Self employed, and other groups.
Armed forced organization provide insurance Services for military Personnel.
Iran Health Financing
Iran Health Financing
Poor people is financed partly through charity which Pooled by “Imam khomeini foundation” fund.
Government pay & compensate for poor people premium.
Iran Health Financing
Iran Health Financing
Other Social groups (Students, clergies, etc): 80% of their Premium Paid by Government.
Banks, Oil Company and municipality have Own insurance fund.
Self-employed Pay the full amount of their premium.
Iran Health Financing
Primary Health Care (PHC) services is delivered by the GOV through widespread health network.
PHC (fully financed through government budget) account for 20% of Government health expenditure.
Iran Health FinancingIran Health Financing
Health insurance sharing in health expenditure = 23%
Health insurance expenditure (Resource Allocation):
Hospitals : 40-45%
Drug : 25-28%
Physicians : 25-22%
Para clinics : 15-18%
Iran Health FinancingIran Health Financing
Medical Insurance System Covered groups ) 2003 (
GroupPopulation
(Millions)
Percent)%(
Basis of CoverageFinancing
Method
Total AmountsInsurance
Provider BillionRail
Billion $
(ppp)
Outpatient
Inpatient
Labors2436.6√ √ %7 of salary by employee 21% by employer3% by the Gov.
70003.5Social Security Organization
(SSO)
GovernmentEmployees
6.810.4√√Per capita 200,000 Rls.Per year 80% by Gov.
30% by employee
13600.68Medical Services Insurance
Organization
( MSIO)
Villagers1929√Coverage Via PHC-(
_
Per capita, 50,000Provided by Gov.
9000.45MSIO
Poor people under social protection coverage
4.26.4√√ Via
referralsystem
Per capita, 120,0004820.24Imam Khomeini Emdad Committee
Self- employed,&
Special patients
.55.84√√Per capita, 250,000110.055MSIO
Poor self employees first
level of services
61√─Per capita, 66,000Provided by Gov.
4000.2MSIO
Others (students, war injured, etc)
.851.3√√Per capita, 200,000Rails per year
170.085MSIO
Iran Health Financing
1 .Revenue sources are complex
2 .Risk pooling limitation
3 .No cost-effectiveness analysis of benefit package
4 .Regressive method of financing
5 .Multiple insurance funds
6 .Mixed financing and provision
Iran Health Financing
Iran Health Financing
Iran Health Financing
Iran Health Financing