Three weeks after the approval by Iran’s top three branches of power to pay 700 trillion rials (approximately 608.7 million dollars) of the government’s debt to the Social Security Organization, the securities have still not been delivered to Refah Bank, creating the risk of further disruption in healthcare services for workers and retirees.
The state-run ILNA news agency reported on Tuesday, October 28, that according to the decision made on October 6 by Iran’s three branches of power, the government was supposed to settle part of its debt to the healthcare sector of the Social Security Organization by issuing 700 trillion rials in securities, and transfer the remaining 1.2 quadrillion rials (approximately 1.043 billion dollars) to the organization by the end of the year through state-owned shares and assets.
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However, three weeks after the October 6 approval, the relevant bonds have still not been signed by the Planning and Budget Organization or delivered to Refah Bank.
Although the head of the Planning and Budget Organization promised on October 11 that “part of the government’s debt will be paid soon,” bureaucratic delays in the organization have once again halted the payment of healthcare dues—a problem that has also plagued other issues such as retirees’ back pay, salary adjustments, and teacher ranking plans.
Earlier, on August 27, Reza Jabbari, a member of the presidium of Iran’s parliament (Majlis), warned about an “imbalance crisis” in the country’s healthcare system, emphasizing that given the current conditions, the government will no longer be able to cover healthcare costs in the future.
In a meeting with Mohammadreza Zafarghandi, the Iranian regime’s minister of health, treatment, and medical education, he warned: “If no plan is made for the country’s healthcare system, given the aging population and dietary patterns, the same imbalance crisis we are currently facing in the energy sector will emerge in healthcare.”
Experts’ Warnings
Nima Amirshokari, an economist and faculty member at the Monetary and Banking Research Institute, told the state-run ILNA news agency that converting debt securities into cash in banks usually takes less than two weeks, but: “When this process takes too long, the problem lies within the decision-making body—the Planning and Budget Organization—which has a more complex bureaucratic mechanism.”
He emphasized that banks assume only limited risks in such processes, bearing the financial costs and delays in liquidity, but not responsibility for the delay in bond issuance.
Alireza Heydari, a social security expert, also told ILNA that these are actually “one-year Islamic treasury bonds” through which the government defers its payment obligations to the future.
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According to him, this method is a form of debt shifting and does not increase the government’s budget deficit, but its liquidity depends on the prompt action of the Planning and Budget Organization and the cooperation of the designated bank.
He also stressed that the approval of this resolution at the highest level of the three branches reflects an understanding of the “emergency situation” in social security, and it is expected that the government will exert more pressure on executive bodies for its swift implementation.
Shahram Kalantari, head of the Iranian Pharmacists Association, stated on August 26 that “the government is a massive debtor in the pharmaceutical supply chain,” adding: “Since March 21, 2025, except for the Health Insurance Organization—which only paid its April debt—we have received nothing from insurers.”
He further said: “The Health Insurance Organization owes us 100 trillion rials (approximately 87 million dollars), the Social Security Organization owes 150 trillion rials (approximately 130.4 million dollars), and the Daroyar drug subsidy plan owes 90 trillion rials (approximately 78.2 million dollars) since July.”
Risk of Contract Cancellations and Healthcare Disruptions
Delays in implementing the resolution have pushed the insured healthcare network into crisis.
According to Heydari, the Social Security Organization currently faces a six-month delay in paying its debts to Atieh Sazan supplementary insurance, private hospitals, pharmacies, and university medical centers.
He warned that if this situation continues, insurance companies and medical centers may unilaterally terminate their contracts, as the private sector has no obligation to continue providing services without payment.
This concern has become more serious as the renewal period for new contracts between supplementary insurers and medical centers approaches, with experts warning that continuation of this trend could disrupt the healthcare cycle for workers and retirees.
