title: A qualitative study of the difficulties in reaching sustainable universal health insurance coverage in Iran.
abstract: OBJECTIVE To understand the Iranian health financing system and provide lessons for policy makers about achieving universal coverage.  METHODS Twenty-five interviewees from seven major health insurance companies were selected for a qualitative study in 2007. Using a semi-structured interview, three main tasks of the health financing system (revenue collection, risk pooling and purchasing) were investigated. A framework method was applied for the data analysis.  RESULTS The results of the study show the following seven major obstacles to universal coverage: unknown insured rate; regressive financing and non-transparent financial flow; fragmented and non-compulsory system; non-scientifically designed benefit package; non-health-oriented and expensive payment system; uncontrolled demands; and administrative deficiency. A long-term systematic plan is required to address the above problems.
authors.affiliation: Health Services Management Department, Management and Medical Information School, Kerman, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ibrahimipour
authors.forename: Mohammad-Reza
authors.initials: MR
authors.lastname: Maleki
authors.forename: Richard
authors.initials: R
authors.lastname: Brown
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Gohari
authors.forename: Iraj
authors.initials: I
authors.lastname: Karimi
authors.forename: Reza
authors.initials: R
authors.lastname: Dehnavieh
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007348:Insurance, Health; D007407:Interviews as Topic; D007492:Iran; D008297:Male; D011050:Policy Making; D019472:Universal Health Insurance