Volume 8, Issue 4 (Winter 2026)
Iran J Health Insur 2026, 8(4): 297-300 |
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Arabi A, Seyed-Nezhad M, Moradi-Joo M. Implicit Rationing vs. Explicit and Transparent Rationing in the Health System with an Insurance Approach. Iran J Health Insur 2026; 8 (4) :297-300
URL: http://journal.ihio.gov.ir/article-1-406-en.html
URL: http://journal.ihio.gov.ir/article-1-406-en.html
1- National Center for Health Insurance Research, Tehran, Iran
2- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran ,moradi2011@yahoo.com
2- Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran ,
Abstract: (66 Views)
Healthcare systems worldwide face resource constraints against ever-increasing demand, necessitating some form of rationing. Implicit rationing, implemented through long waiting lists, high out-of-pocket payments, and geographical barriers, has significant negative consequences including severe inequities in access, heavy financial burdens on households, economic inefficiency, and erosion of public trust. In contrast, explicit rationing based on transparent, evidence-based, and accountable criteria can lead to greater equity and efficiency. Successful experiences from countries such as England with NICE, New Zealand with PHARMAC, and Thailand with its Universal Health Coverage package demonstrate the feasibility and effectiveness of this approach. This policy brief presents five key recommendations for transitioning Iran's health insurance system to explicit rationing: establishing an independent health technology assessment agency, developing an essential health insurance benefits package, ensuring transparency and stakeholder participation, strengthening information and research infrastructure, and implementing a comprehensive change management and public communication program. Implementation of these recommendations can lead to a more equitable, efficient, and sustainable health system.
Keywords: Explicit Rationing, Implicit Rationing, Health Insurance, Health Technology Assessment, Health Equity, Health Services Prioritization
Type of Study: Policy Brief |
Subject:
Special
Received: 2026/01/13 | Revised: 2026/05/17 | Accepted: 2026/02/21 | ePublished: 2026/03/1
Received: 2026/01/13 | Revised: 2026/05/17 | Accepted: 2026/02/21 | ePublished: 2026/03/1
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