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'The end of illness is not treatment. It is death': Iranian MP on the cost of care

Oct 3, 2026, 12:28 GMT+1
Patients receive treatment at Imam Khomeini Hospital in Tehran.
Patients receive treatment at Imam Khomeini Hospital in Tehran.

Iranians are selling livestock, cars and furniture to pay for treatment their insurance no longer covers, and a member of parliament's health committee says the system has reached the point where falling ill can end in death rather than care.

"We have reached a point where we hope people don't get sick, because if they do, the end of that illness is not treatment. It is death," Salman Es'haghi, spokesman for parliament's Health and Treatment Committee, told the labor-affiliated news agency ILNA.

The pressure cannot simply be blamed on war and sanctions, Es'haghi said, accusing the authorities of failing to tackle corruption and poor decision-making as households struggle to pay for medicines, equipment and diagnostic tests.

A separate ILNA report from clinics in Tehran found the same thing from the other side: insured patients waiting weeks or months for diagnostic services, or paying privately for tests they could not get through the Social Security Organization, the state insurer that covers most of Iran's workers and retirees.

A couple sells their sheep and their car

Es'haghi described a rural couple who had sold their livestock and their Pride, the cheap Iranian-built car that was for decades the country's most common, after being told the wife needed a heart valve.

"A man and a woman from one of the villages came to see me," he said. "They said they had several sheep and a Pride, and they had sold them because they were told they needed to buy a heart valve for his wife."

The couple paid 13 billion rials for the valve, about $5,000 at Saturday's open-market rate, or six and a half years of the minimum wage, Eshaghi said. They were then told it was unsuitable and that they would need another.

"A suitable, high-quality valve costs close to 42 billion rials," he said, about $16,000, or 21 years of the minimum wage. "Which patient can pay 42 billion rials?"

Many farming families were selling animals, vehicles and other assets to cover both the equipment and the surgery, he said.

"We have unfortunately closed our eyes to our people dying because of a lack of medicine and the high cost of treatment," Es'haghi said.

Insurance leaves patients exposed

Iran's health insurance funds have stopped protecting patients from the cost of care, Es'haghi said.

"Our insurance funds have effectively declared bankruptcy, but they don't say it out loud," he said. "Because they don't acknowledge their own bankruptcy, they have shifted that bankruptcy onto the people."

More than 80 percent of treatment costs are now paid directly by patients, he said, without giving a source for the figure.

ILNA's reporting on the Social Security Organization points the same way. Nearly 9.9 million people insured by the organization in Tehran province have access to just 36 medical facilities it owns, including 16 polyclinics, according to official figures the agency cited. That is roughly one polyclinic for every 620,000 insured people.

Seeing a doctor is only the beginning

For many patients, getting an appointment does not mean they can complete the treatment prescribed.

At the Abureihan Social Security clinic in Tehran, one woman told ILNA that the ultrasound service the clinic once offered had disappeared.

"This place used to have ultrasound, but it hasn't had it for some time, and now I have to pay a huge amount outside," she said.

Another patient said the clinic had no mammography.

A middle-aged woman in severe abdominal pain said she could not afford the imaging and examinations she had been prescribed.

"I am in severe pain, but further imaging, tests and doctors are beyond what I can afford," she said.

She was the household's breadwinner, she said, earning money from weaving carpets while her husband was out of work. When she was referred to another hospital, she learned the care there would not be free either.

"I have to wait until the carpet is sold and I get the money," she said.

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Spokesman for parliament's Health and Treatment Committee Salman Es'haghi

Weeks or months of waiting

Patients who stay inside the Social Security system face long queues instead.

Those referred to larger centers such as Milad Hospital, the organization's flagship hospital in Tehran, must often start over, ILNA reported, because diagnostic departments may accept orders only from the hospital's own doctors. That means another appointment, another consultation, and another wait for imaging or tests.

"These appointments are really useful for someone with a chronic illness who needs constant monitoring, not for someone who has an acute problem right now, today," one patient said.

The squeeze is hardest on retirees and lower-income households who cannot turn to private care.

An elderly woman said she kept making the long trip to a Social Security clinic because private doctors were too expensive, even though she still had to get some medicines and tests elsewhere.

"It's crowded, it's far away and getting here is difficult for me, but because the doctors here are good and my treatment costs less, I still come," she said.

'Why don't we import medicine?'

Es'haghi rejected the argument that Iran's medicine shortages can be explained by sanctions and the war.

"Whenever something happens, we say there is a war, there is no medicine, there are sanctions," he said.

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Patients wait for care at the Abureihan Social Security clinic in Tehran.

Iran should be able to use its relationships with Russia and China to obtain medicines and pharmaceutical ingredients, he said.

"We can import medicine and pharmaceutical raw materials from Russia and China. Why don't we?" he said. "If we are vigilant, if there is the will and if we fight corruption, I can tell you seriously that supplying medicine and pharmaceutical raw materials has nothing to do with the war."

Figures presented at official meetings showed some pharmaceutical and medical equipment companies had sharply increased their profits during the war, he said.

"Why don't they tell these companies that during wartime they should at least accept a minimum profit margin so that people don't face such hardship?"

Inflation deepens the squeeze

The health crisis is unfolding as household purchasing power collapses.

Consumer prices in September were 89.8 percent higher than a year earlier, according to the Statistical Center of Iran, and average inflation over the preceding twelve months reached 73.6 percent. Food and drink prices had already risen 127.5 percent year on year in August.

The rial's fall to record lows has raised the local cost of imported medicines, equipment and pharmaceutical ingredients.

The strain is visible in the volume of demand on a system that cannot meet it. Social Security facilities in Tehran recorded more than 18.1 million outpatient visits in the Iranian year that ended in March, including about 8.5 million doctor consultations and 9.6 million visits for diagnostic and other services.

For poorer patients, each extra appointment means transport costs, lost wages and another delay. The result, ILNA said, is that some workers and retirees are forced to choose between paying privately, waiting, or abandoning part of their treatment.

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Smartwatches on Iran's security chiefs spark row within the inner circle

Oct 3, 2026, 09:58 GMT+1
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IRGC General Gholamreza Jalali has been heading Iran’s National Organization for Passive Defense since 2005.

Senior Iranian military and security officials have been photographed wearing smartwatches, drawing fresh criticism of their basic security discipline after years of reports that Israel has used electronic devices around Iranian commanders to track and kill them.

The images drew widespread reactions after they were posted on X on Friday by Ali Gholhaki, a conservative commentator with ties to Iran's security establishment. Some Iranian outlets describe him as close to parliament speaker Mohammad-Bagher Ghalibaf.

The pictures show smartwatches on the wrists of three men: Gholamreza Jalali, who heads the Passive Defense Organization, the body that protects Iran's critical infrastructure; Reza Farahi, a Defense Ministry official; and Ali Shamkhani, the former secretary of the Supreme National Security Council.

Shamkhani was killed in US-Israeli airstrikes on February 28, on the first day of the current war. He had survived an Israeli strike in June 2025.

Asked about his watch by a Fars News reporter, Jalali asked whether people had smart televisions at home and said his device was effectively the same thing.

Gholhaki rejected the comparison. The man in charge of protecting the country's critical infrastructure, he argued, faces a different order of risk from an ordinary citizen, and such devices are hard to justify for senior security officials when Israel has repeatedly exploited electronic lapses to track Iranian personnel.

Smartwatches can transmit location and activity data through GPS, Bluetooth, Wi-Fi or a paired phone, and some carry microphones and other sensors.

The US military has long restricted location-tracking devices, smartwatches included, in operational areas because they can expose movements and routines; in 2018, a fitness app's public heat map revealed the outlines of American bases from soldiers' running routes.

'Careless use'

The row touches a much larger argument inside the Islamic Republic about repeated intelligence failures.

During the 12-day war in June 2025, Iran's Cyber Security Command banned officials and their security teams from using any device connected to public communication or telecommunications networks, Fars reported, as concern grew that mobile tracking was being used for targeted assassinations.

The directive named smartphones, laptops and smartwatches, and warned that switching a device off might not prevent it from being located.

It came too late. The New York Times later reported, citing Iranian and Israeli officials, that Israel tracked and targeted senior Iranian leaders and nuclear scientists in that war by hacking the phones of their bodyguards and drivers.

On June 16, 2025, the Supreme National Security Council met in a bunker deep beneath a mountain in western Tehran; none of the officials carried phones, but the Israelis found the meeting through the phones of the bodyguards who had driven them there. The bodyguards had long been exempt from the strict phone bans imposed on the commanders themselves, even after earlier assassinations.

Gholhaki tied the smartwatches directly to those failures, arguing that complacency had helped Israel and the United States kill senior military, security and political figures in successive wars. He called for fundamental changes in security practice and renewed his demand for a broad postwar inquiry into how the failures happened.

Gholhaki himself was among a group of Telegram channel operators arrested by the Revolutionary Guards' counterintelligence arm in 2022, accused of disturbing public opinion and publishing classified documents.

A blogger on death row

The judiciary has shown no such tolerance for ordinary Iranians accused of far smaller breaches.

Marziyeh "Sevda" Ebrahimi Shamsabadi, a 33-year-old blogger from Bandar Abbas who has been held since March, was sentenced to death in August by a Revolutionary Court on charges including insulting the supreme leader, intelligence activity on behalf of hostile governments, and taking and sending photographs to Persian-language media abroad.

One allegation concerned a photograph she was said to have taken, from a distance, of a site hit by a missile. She was held in solitary confinement for 20 days and faced severe pressure during interrogation.

Islamic Republic's 'slow meltdown' leaves it fewer ways out, analysts say

Oct 3, 2026, 08:49 GMT+1
•
Negar Mojtahedi
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The Islamic Republic is in a "slow meltdown" that may not bring it down soon but is narrowing its options as the economy sinks, repression deepens and divisions open up among its own hardliners, analysts told Iran International's Eye for Iran podcast.

"I just don't see a pathway to rehabilitation," said Kamran Bokhari, a strategic forecaster and senior resident fellow at the Middle East Policy Council.

“This regime cannot go back to what it was.”

The pressure is coming from every direction. The rial fell past 2.5 million to the dollar this week, a record low; at that rate the minimum monthly wage of 166 million rials is worth about $66.

On Wednesday, Washington extended sanctions to Iran's auto and rail industries, on top of a naval blockade of Iranian ports and a campaign against sanctions evasion that have already cut deep into oil revenue and access to foreign currency.

At home, two people detained after January's nationwide protests were executed this week, and four others arrested during the unrest have recently been sentenced to death.

An appeals court upheld sentences of 74 lashes against the singer Parastoo Ahmadi and seven musicians and organizers over a concert she performed without a headscarf, filmed and posted online.

Human Rights Watch and the Abdorrahman Boroumand Center documented 29 executions between March and the end of August of people arrested in connection with the protests. Five were carried out in public.

'They want to show they're in charge'

Alberto Fernandez, a former US diplomat and vice president of the Middle East Media Research Institute, said the repression should be read alongside the economic pressure.

"They want to show they're in charge," he said. Extreme violence, he said, is one way of demonstrating to Iranians and to the world that the state can still impose its will. The more it relies on that, the more it shows both the power it has left and the pressure it is trying to hold down.

"The challenge of the regime is not the war," Bokhari said. "The challenge is governance and economic statecraft."

Three senior Iranian sources told Reuters last month that the US campaign against oil exports and sanctions evasion was becoming increasingly hard to withstand. The average monthly wage now covers less than a third of a household's basic costs, Reuters reported.

Even if Tehran wins some sanctions relief, Bokhari said, he sees little prospect of it recovering what it had.

"Regimes take a long time to undergo a meltdown," he said. "That meltdown was happening even before this war."

The price of eggs

David Patrikarakos, a special correspondent for the Daily Mail and an author, said he watches one basic indicator.

"I have become a keen watcher of the price of Iranian eggs," he said.

When he spoke with people inside Iran during the war, he said, the conversation kept returning to the cost of necessities.

"When the basics become too expensive, no government can deal with that," he said. "You can only terrorize people back into their homes for so many things. If they're starving, they can't afford food, there's nothing you can do."

The authorities appear to know it. More than 6,000 people have been arrested since the war began, Reuters reported this week, as officials worry about renewed protests.

But repression has limits. Bokhari called it a "precision instrument" that can backfire when used too broadly.

"You can oppress people, but if you start to do it at scale, then it can backfire," he said. "At some point, your own security forces will say, 'Where is this going?'"

'The butter part is going out'

If the Islamic Republic survives, Fernandez said, one model is what he called the "North Koreanization" or "Houthization" of Iran: a poorer, more predatory state that can still repress at home and project force abroad while its economy and institutions are hollowed out.

That was never the plan. The Islamic Republic wanted revolutionary and military power abroad and a functioning society and middle class at home, Fernandez said, the old combination of guns and butter.

"Well, the butter part is going out," he said.

Without a reversal, he said, Iran could become "a more ramshackle predatory state." "It still can bite, but it becomes much more fragile, much more fractious."

That trajectory would run against Iran's own sense of itself and the aspirations of its educated population, Patrikarakos said. "The Iranian self-image is wanting to take part in the world."

Even the Islamic Republic, for all its decades of confrontation with the West, never sought North Korea's isolation, he said.

"They don't want to go down the North Korea path," Bokhari said. "The question is, can they avoid it?"

As the options narrow, he said, survival is overriding everything else. "Regime survival is now more than ever before the primary imperative."

What to watch

Bokhari said he is watching for infighting that can no longer be contained. "I'm also watching for signs of infighting, where different elements of the regime start to disagree to a point where the disagreement isn't behind closed doors," he said.

Fernandez said the visible divisions are no longer mainly between moderates and conservatives, the old frame for Iranian politics, but among hardline factions themselves.

He is also watching the currency, and how long Tehran can hold out without real relief. Iran's leaders may be looking to the US midterm elections and the next Congress in the hope that politics in Washington will ease the pressure, he said. If that hope fails, they face a long period of no war and no peace while the squeeze continues.

The Islamic Republic has survived periods when it looked weaker, more isolated and less popular than before. Survival and recovery are not the same thing. The price of food, the value of the rial, unrest in the streets, fractures at the top and the loyalty of the security forces will show how far the meltdown has gone.

"This situation is untenable," Bokhari said.

You can watch Eye for Iran on YouTube or listen on any podcast platform.

Officials trade blame as Iran’s economy sinks deeper

Oct 3, 2026, 04:14 GMT+1
•
Maryam Sinaiee
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A worker at the Iranol oil refinery in Tehran, Iran, September 29, 2026

Iran’s worsening economic crisis has opened an increasingly bitter argument over who is responsible, as the government points to outside pressure and market psychology while hardliners accuse Tehran’s own economic officials of making the situation worse.

On Thursday, the end of Iran’s market week, the rial fell to another record low. Year-on-year inflation has reached almost 90 percent, with food prices rising even faster.

The deterioration comes as US sanctions and a naval blockade squeeze Iran’s sources of revenue. The blockade has severely constrained oil exports, while Washington on Thursday expanded sanctions into the automotive and rail sectors, targeting some of the country’s largest industrial companies.

US Treasury Secretary Scott Bessent has seized on the rial’s collapse as evidence that Washington’s pressure campaign is working, saying this week that it had driven the currency to its lowest level in history.

Iranian Economy Minister Ali Madanizadeh rejected Bessent’s assessment, telling the official IRNA news agency Thursday that predictions of an imminent economic collapse had repeatedly proved wrong.

“They want to create unrest and stress among the people so they rush to the currency market and the exchange rate increases; otherwise, these statements serve no purpose, and we will not allow this to happen,” he said.

The Central Bank has offered a similar diagnosis. It said Friday that the exchange rate was not “fully consistent with the economy’s fundamental variables,” attributing much of the gap to heightened uncertainty, psychological pressure and market expectations.

The bank announced Wednesday that it planned to inject $2 billion in banknotes into the market. So far, however, the intervention has failed to halt the rial’s slide.

‘The Central Bank shoots it into its own goal’

Hardliners have challenged the government’s explanation, arguing that sanctions and the war cannot by themselves account for the surge in the exchange rate and prices.

Nadergholi Ebrahimi, a hardline lawmaker, claimed in an online interview Thursday that the war had contributed no more than 25% to the recent rise in prices and accused government economic officials of deliberately fueling inflation.

Threatening to seek the impeachment of economic ministers, he accused them of waging an “economic sedition” that was reducing the public’s ability to withstand economic pressure and increasing dissatisfaction.

Hossein Samsami, an economist and hardline lawmaker, has also attacked the Central Bank’s handling of the exchange rate.

“Today, the currency is the enemy’s tool in an all-out economic war, and the measure of its success is the devaluation of our national currency,” Samsami wrote on X.

But he accused the Central Bank itself of helping drive that process by following an exchange rate he said was artificially determined by Iran’s enemies.

“The enemy passes the ball, and the Central Bank shoots it into its own goal!” he wrote.

Inflation approaches 90 percent

Whatever the relative weight of sanctions, war, expectations and domestic policy, their combined effect is increasingly visible in household finances.

According to the Statistical Center of Iran, annual inflation has reached 73.6%, while year-on-year inflation rose to a record 89.8%.

Food and beverage prices have risen substantially faster than overall inflation, hitting lower-income households particularly hard because they devote a larger share of their income to food and other essentials.

Accelerating prices have also eroded the value of government food vouchers introduced after subsidized foreign-exchange rates for a range of goods were removed amid a sharp depreciation of the rial and economic protests in December and January.

Although the government pledged to increase the value of the vouchers in line with rising prices, it has yet to do so.

Wages fall behind as prices surge

The pressure is also increasingly visible among salaried workers.

Videos circulating on social media in recent weeks have shown teachers and nurses saying low wages have left them with no choice but to resign after years in their professions.

Ali Farhadi, spokesman for Iran’s Education Ministry, dismissed reports of widespread teacher resignations as a “rumor” on Friday.

The dispute has become another front in the broader argument over the economic crisis, with government supporters alleging that expressions of discontent are being amplified to encourage unrest and critics accusing authorities of dismissing genuine economic grievances.

Samsami, however, has placed greater responsibility for the hardship on domestic economic policy than on Washington.

“The pressure imposed on people’s livelihoods by misguided economic policies is far greater than that caused by sanctions and the naval blockade,” he wrote, adding: “We are not at an impasse. By reforming our policies, we can control inflation even under these sanctions.”

Iran denies teachers are quitting despite viral resignation videos

Oct 2, 2026, 19:38 GMT+1
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A teacher embraces a young student in a girls’ classroom in Iran's southern port city of Bushehr, September 2026

Iran’s Education Ministry dismissed reports of teacher resignations over working conditions and security pressure as a “rumor,” despite numerous videos of teachers announcing departures and a teachers’ council warning of a growing exodus.

Education Ministry spokesman Ali Farhadi said Friday that reports of teacher resignations were “not true” and accused unspecified actors of trying to undermine in-person education.

“The resignation of teachers is a rumor,” Farhadi told the Tasnim news agency, saying teachers and students had welcomed the return to classrooms across the country, including in southern provinces such as Hormozgan.

But the Coordinating Council of Iranian Teachers’ Trade Associations has offered a sharply different account, saying numerous videos and reports of resignations have emerged from different parts of the country in recent weeks.

The council said teachers were leaving because of a combination of wages below the poverty line, worsening living conditions, administrative pressures and what it described as the securitization of the profession, including dismissals, suspensions, arrests and legal cases against teachers and union activists.

It warned that experienced teachers were being driven out of classrooms by policies that had pushed the education system toward decline.

Videos circulating on social media in recent days have shown teachers announcing their resignations and citing financial hardship, workload and a lack of recognition for their work.

The dispute comes as Iran’s education system is already grappling with teacher shortages and longstanding discontent over pay and working conditions.

Teachers have repeatedly protested over salaries and benefits, including at a demonstration outside the Planning and Budget Organization in Tehran in September.

Labor activists have also warned that financial pressures are forcing some teachers to work multiple jobs, while shortages of teaching staff are affecting the quality of education.

The resignations have emerged against a wider backdrop of pressure on teachers and union activists, who in recent years have faced arrests, prison sentences, dismissal and suspension from work.

The Coordinating Council rejected the government’s portrayal of the unrest in schools as the product of outside agitation, arguing that the discontent stems instead from conditions within the education system itself.

Whether the resignations amount to the “wave” described by the teachers’ council is difficult to establish. The pressures it says are driving teachers out are considerably easier to document.

As the rial sinks, Iranians seek shelter in almost anything else

Oct 2, 2026, 17:59 GMT+1
•
Behrouz Turani
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Visitors look at vehicles on display at the seventh Tehran Auto Show in the Iranian capital, September 2026

Iran’s stock market is breaking records even as the dollar and gold hit new highs, an apparent contradiction that may point to the same dynamic: households and investors scrambling to protect their wealth as the rial weakens and the economic toll of the Iran-US war grows.

Before trading closed on Wednesday, the final working day of the week in Iran, the Tehran Stock Exchange reached a record 7,766,000 points.

The market has risen 109 percent since the start of the Iranian year, while small investors poured roughly 4.7 trillion tomans, or about $19 million, into shares in a single day.

Iran’s prominent economic daily Donya-ye Eghtesad argues that the surge is not necessarily a sign of confidence. People are buying shares as political and economic risks rise, it says, while savers are also moving into gold, coins and dollars, all of which hit record highs on the same day.

The open-market dollar has passed 250,000 tomans, while measured in dollars, the stock market remains well below previous peaks.

At least part of the rally therefore appears to reflect a search for protection against the falling rial rather than confidence in the underlying economy.

Similar pressures are visible in consumer markets, where prices for cheaper mobile phones rose 33 to 42 percent in a month, outpacing the currency’s decline as import quotas, registration rules and fees hit lower-priced devices particularly hard.

Earlier this week, the government announced that the central bank would sell up to $2 billion in cash. The first $1 billion tranche is being sold through banks, with adults holding a national ID card allowed to buy up to $10,000.

The government’s own newspaper, Iran, warned that selling cash may slow the dollar’s rise but cannot reverse the underlying trend while inflation, budget pressures and political uncertainty remain unresolved.

Tehran’s prosecutor also ordered action against “market disruptors,” including online channels publishing exchange rates. Eyewitnesses on Ferdowsi Avenue, the capital’s main currency-trading hub, reported shorter queues and more sellers than buyers on September 30.

The respite was brief. On October 1, the open-market dollar rose 1.49 percent to 2,593,000 rials, its highest level in a year.

The central bank has been steadily raising the official exchange rate, from about 137,000 to more than 174,000 tomans this year, to encourage exporters to repatriate their foreign-currency earnings. Even so, the open-market rate remains much higher.

Because official imports are priced at the exchange-center rate, increases can feed through into the cost of imported goods. They also reduce the real value of the government’s electronic food-voucher scheme unless the state spends more rials to maintain it.

Hardline outlets including Kayhan and the IRGC-linked Javan portray the rial’s fall as part of Washington’s economic war. But their criticism is also directed at Iranian policymakers.

Kayhan calls currency sales a repeatedly failed policy and a waste of resources in wartime. It wants the government to reverse its economic liberalization and use judicial and security pressure to force exporters to repatriate their foreign-currency earnings.

The criticism exposes an argument within the establishment over how Tehran should respond: spend scarce foreign currency trying to contain demand, or preserve it while tightening controls over exporters and the domestic market.

That argument is becoming more urgent as the US blockade curtails Iranian oil exports, depriving Tehran of a major source of foreign currency.

Diplomacy could provide some relief, with Iran seeking access to frozen assets and an easing of sanctions and the blockade as part of negotiations with Washington.

For now, however, the clearest signal comes from the markets themselves. Stocks, gold and the dollar are all setting records. The simultaneous rush into them suggests that for many Iranians, almost anything that might preserve its value increasingly looks preferable to holding rials.