CHAPTER TWENTY FIVE:
Health and Medical
Care
ARTICLE 192-
A- The following measures shall be taken in order to
enhance the efficiency of the medical care, to develop health and medical care
services in the country, to facilitate accessibility of the public to these
services, and also to determine the scope and extent of the government and non-public
sectors’ responsibility in these areas:
1- All the hygienic services in urban and
rural areas will be rendered by government free of charge.
2- The outpatient medical care services
for the rural population will be provided by government in the existing units.
Development of the rural medical care centers in the regions where there is no
incentive for the private and cooperative sectors to invest will also be made
by government.
3- The urban outpatient medical care
services in the existing health and medical care centers is the responsibility
of the government, but further development of these services shall be made
possible through participation of the private and cooperative sectors. Development of the public sector
activities will be confined to the regions where the private sector finds no
incentive to make investment.
4- Government will continue its
undertakings in providing inpatient medical care in the undeveloped or
less-developed regions and towns (of less than one hundred thousand population)
and will provide educational beds proportionate with the number of students of
the medical science universities.
Development of the inpatient treatment centers in large cities (of over
one hundred thousand population) shall be the responsibility of the non-public sectors. Moreover, in the large cities
facilities will be provided to divest the existing inpatient treatment
facilities and to set up new inpatient treatment center by the non-governmental
sectors, with priority given to the medical cooperative groups.
5- The Welfare Organization is charged
with taking action in preparation, design and execution of a plan for reorganizing
and rehabilitating chronic mental patients and the aging people during the
first year of the Plan.
The executive by-law of the above Item shall be
prepared through cooperation of the Ministry of Health-Medicare and Medical
Education, and the Plan and Budget Organization. The by-law shall be approved by the Cabinet.
B- In order to enhance efficiency and participation of
the employees and the public in provision of the health, medical care,
pharmaceutical and rehabilitation services, Ministry of Health-Medicare and
Medical Education is authorized to take the following actions, taking into
consideration the provisions of Item (A) of this Article:
1- To compensate the specified services rendered
by its own employees according to the approved tariffs (service charge system
instead of daily payment). The
non-public sector may provide the same services likewise.
2- Payment of a portion of the proceeds of
the services rendered by the employees in the units under auspices of the
government to them in the form of merit rewards aiming at enhancing the work
efficiency of the employees.
To implement the provisions of Item (B) of
this Article, the required funds will be provided in the annual budget bills.
The proceeds of the same services in each province shall be appropriated within
the framework of the annual budget in order to develop the quality and quantity
of the health and medical care services in the same province.
The executive by-law of this Item including
identification of the status of the active employees, the criteria for defining
the services to be rendered, the
manner of assigning the services, the manner of pricing the services, the mode
of payment, and the manner of
spending the proceeds, etc. will be prepared within a maximum period of six
months from the date of enactment of this Law jointly by the Ministry of
Health, Medicare and Medical Education and the Plan and Budget Organization for
the Cabinet for approval.
ARTICLE 193- In order to secure and
properly distribute the inpatient treatment services in proportion to the needs
of different regions of the country, and in due consideration of two important
factors of accessibility of the services to individual people and to prevent
over-investment, classification and grading the inpatient treatment services
while taking into account the compensation for the cost of patient
transportation, and preserving the ratio of the dispatched patients from the
lower levels by government, shall be performed according to the different specializations
and their locations as broken down by county. The establishment, development, and equipping the country’s inpatient treatment
facilities, and also, allocating the manpower to provide the treatment services
shall be done according to the organization and grading of the country’s
treatment services. The criteria
and the grading program for the country’s inpatient treatment services shall be
prepared jointly within six months from the enactment of this law, by the
Ministry of Health-Medicare and Medical Education and the Plan and Budget
Organization, for approval by the Cabinet.
A- To achieve the goals of service grading, the
Ministry of Health, Medicare and Medical Education is required to take
necessary actions during the Third Plan period to eliminate inadequacies of the
services and to reduce the possibilities of over-treatment in excess of need,
including the excess manpower, equipment, replacing the outworn and dilapidated
and substandard units, in order to make necessary adjustment in the existing
inpatient treatment capacities and ordering the urgent medical services.
Note: In order to range the care-taking services
of the accident victims and to improve the emergency care system, government is
required to set up urgent care system (trauma centers) for these patients and
convert sections in the medical care centers to these units (trauma centers),
and establish new centers wherever needed in such a way that all the accident
victims could receive the urgent care free of charge.
B-
In order to adapt and harmonize the proper and needed capacities with
the existing capacities, the whole set of the country’s inpatient treatment facilities
including those of the Ministry of Health, Medicare and Medical Education, the
Social Security Organization, banks and the state-owned enterprises, Armed
Forces, the charity and private organizations, and the like will be viewed as
one integrated system and seen together as a whole regardless of their
proprietorship and management.
C- In order to enhance the quantity and quality level
of the rehabilitation services and facilitate people’s accessibility to these
services aiming at equalizing the opportunities and enabling the disabled to
actively participate in the society, proper preparation of the public facilities (private or
public) will take place during the Third Plan. Moreover, during the Plan period, a certain number of
sanitariums will be allocated to the war-injured female patients; the use of
ambulance service for the war-injured with the intensity of above seventy
percent (70%), spinal cord cut, neurological, psychological and chemical war victims shall be provided
free of charge.
The executive by-law of this Item to be prepared
through cooperation of the Ministry of Housing and Urban Planning, the State
Administrative and Employment Affairs Organization and the Plan and Budget
Organizations, and shall be approved by the Cabinet.
ARTICLE 194- All the centers of
production and distribution of the food items, cosmetic and hygienic products
and also all the centers rendering services related to the these areas must, in
addition to complying with the hygienic criteria that will be set forth by the
Ministry of Health-Medicare and Medical Education and other related agencies,
obtain periodical certificate of inspection and compliance from the legal and
real persons (public and private) whose qualification in the matter has been
confirmed for a certain period of time by the aforesaid agencies. Ministry of Health, Medicare and
Medical Education and other concerned agencies are required to monitor
continually the services of the real and legal persons whose qualification has
been confirmed. In case of any
violation the qualification license must be revoked and the matter be reported
to the competent authorities.
The by-law of this Article including the method of
identification of the production, distribution and service units content of
this Article, determining the period of validity of the hygienic certificate
for any of the concerned centers, tariff rating, handling the violators either
to charge them or to refer them to the court of law, the criteria for
determining qualification of the real and legal supervisors, and other related
matters will be prepared within a maximum period of six months from the date of
enactment of this Law by the Ministry of Health, Medicare and Medical Education
in cooperation with the relevant agencies and shall be approved by the Cabinet.
ARTICLE 195-Setting up and building
any type of medical treatment unit by the entities content of Article (11) of
this law and the non-public entities and institutions except Ministry of
Health, Medicare and Medical Education and Ministry of Housing and Urban
Planning (as the executor) and except for the cases authorized in Article (192)
of the Law, is prohibited. Setting
up and building medical care units by the aforesaid entities in urgent cases
shall be permissible upon confirmation by the Ministry of Health, Medicare and
Medical Education and ratification of the Cabinet. Special centers for treatment of the war-injured are
excluded from this provision.
ARTICLE 196- The following measures
will be taken in order to regulate the pharmaceutical market, to provide the required foreign exchange and import
of the pharmaceutical raw material and medicine, to prevent irregular increase
of price of the urgent hygienic drugs for long term use, to support the
insurance system and also to prevent the side effects and risks related to the
use of drugs:
A- The list of authorized drugs will be published
annually. Import, production,
distribution and administration of the medicine, other than those listed
officially, are prohibited.
B- Import of raw material for production of medicine
and import of the subsidized drugs will take place at the official rate of
exchange. In the event of change
in the rate of foreign exchange, the differentials will be computed and
provided for within the budget law in form of subsidy in local currency (Rial)
.
C- The hygienic and necessary drugs for long term use
and the drugs needed for refractory and the war-injured patients are entitled
to receive subsidy in local currency (Rial) in addition to the facilities
indicated in item (B) of this Article.
D- The Rial subsidy and the differentials indicated in
items (B) and (C) of this Article shall be paid proportionate with the coverage
of population by the insurance and through strengthening and expansion of the
insurance system.
F- Supply of drug to the end-users out of the pharmacy
system (with the exception of
non-prescription pharmacies whose list will be made available by the Ministry
of Health, Medicare and Medical Education) is prohibited.
G- In order to guarantee the quality of the drugs
produced domestically, all factories producing medicine are required to control
the quality of their products by setting up the quality control units and
utilizing the service of the specialists in the field. To achieve this objective, the said
factories are authorized , in coordination with the Ministry of Health,
Medicare and Medical Education, to utilize up to fifty percent (50%) of the
revenue content of the Law of Amending Item (2) and Note (2) of Article (5) of
the Law of the Need for Re-training and Training of the Medical Society enacted
on 5/09/1992, within the framework of the annual budget.
H- One hundred percent (100%) of the per capita share
subject of the Law of the Universal Insurance of the Country’s Medical Services
enacted on 24/10/1994 for the war-injured patients, and also the doubled
insurance of the war-injured patients with the intensity of fifty percent (50%)
and over, provisions for import of drugs and medical and rehabilitation
equipment for the war-injured patients will be paid through the foreign
exchange at the official rate, and they will be exempted from charges, tax,
customs fees and the trade tariffs.
The executive by-law of this Article shall be prepared
by he Ministry of Health, Medicare and Medical Education, and shall be approved
by the Cabinet.
ARTICLE 197- In order to
institutionalize food security (accessibility of all the society to sufficient
and healthy food), to improve people’s diet, to reduce sickness emanating from
malnutrition, and to promote the society’s health, Ministry of Health, Medicare
and Medical Education is required to determine, within a maximum period of one
year, the desirable diet and nutritional basket. The following actions shall be taken in order to
materialize the said basket:
A- The cultural and educational ministries and the
Islamic Republic of Iran Broadcasting Organization are required to take
measures to enhance awareness, to promote nutritional culture and to provide people
with necessary training in order to secure the desirable nutritional basket.
B- In allocating the financial resources in form of
subsidy on food items and upon soliciting the opinion of the Ministry of
Health, Medicare and Medical Education, the Economic Council shall prepare the
ground for implementation of the policies of desirable nutritional basket.
C- In order to eliminate malnutrition amongst the low
income families, the subsidies granted to the needy and rural inhabitants and
residents of the less-developed area will be increased in proportion to the
rest of the population.
D- In order to raise the level of public health, Iran
Standard and Industrial Research Institute is required to prepare the whole set
of the food safety standards no later than the end of the Third Plan, and
advise the Ministry of Health, Medicare and Medical Education and other
relevant agencies in order to enable them to impose quality control over the
production and supply of the food items.
E- The proper structure and organization of food and
nutritional safety at the national and provincial levels will be designed by
the Ministry of Health, Medicare and Medical Education within six months from
the date of enactment of this Law, and to be approved by the Cabinet upon
confirmation of the State Administrative and Employment Affairs Organization.