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Learning from Iran
According to Ralph Nader, USA
The media has painted Iran as a backward third world country of 72 million people, who have little to teach us.
Baptist Town in the Mississippi Delta is an impoverished community neglected by the rapacious
US pay-or-die business of health care. The Delta area suffers a host of health
woes, with some of the highest rates of diabetes,
obesity, hypertension and infant mortality in the
nation. It just so happened that a 77 year old
pediatrician, Aaron
Shirley  , who 40 years ago helped start public health care in the Delta, and was despairing of any changes
occurring, bumped into a native of Iran, Dr. Mohammad
Shahbazi. Iran has an innovative primary health care system, praised by the World Health Organization (WHO), that Dr. Shahbazi believed was worth
visiting. Its simplicity is its genius. Its focus on
prevention, diagnosis and proper referral for various illnesses goes through three
tiers.
At the ground level, first stop “health houses” were established and staffed by trained villagers called “bhevarzes” who provide basic health services for up to 1500 people. So far there are 17,000 health houses with twice the number of behvarzes—half male and half female—who reach 90 percent of the rural
population. These health outposts are now setting up in urban
neighborhoods.
Regional health center staff supervise the bhevarzes, and health
houses. A regional health center also receives the patients that cannot be helped by the “health
houses.” Between them, about 80 percent of the cases are
treated.
For the more serious illnesses or traumas, there are the larger
hospitals. Iranians can go to any level they choose. The Iranian government got this “health house” system underway as part of a
policy, according to the Bulletin, that provides inexpensive health insurance for
everyone.
Over the past thirty years, this top-down-bottom-up program has reduced infant mortality in rural areas by 90 percent and sharply reduced other illnesses and infections by the preventive attention of these “health
houses,” operated by people in their communities.
Iran, a country, with a GDP the size of Connecticut, can do what the richest country in the world cannot do to organize itself to take on corporate greed and get it
done. Presently, over 46 million Americans have no health insurance and 45,000 of them die every year as a
result.
Swinging into action, Dr. Shirley and his colleagues, who already have a large community clinic in Jackson, are applying for a $20 million grant from the U.S. Department of Health and Human Services to fund 10 health house pilot programs in Louisiana, Arkansas and Mississippi. Without
waiting, he is renovating a Baptist Town shack into a primary care clinic for free screenings and immunizations by trained people living in their
town. Preventive care keeps people from getting sick in the first place and postoperative care will save billions in
readmissions. This really could be an answer for what ails the U.S. health care system.
The concept behind “health houses” and a three-tier system has been known by many health care practitioners and policymakers in the U.S. for many
years. The problem is that such a system is seen as a threat to intransigent corporatized medicine lusting for ever greater
profits, no matter the cost to penniless innocents from an economic class recruited to fight the criminal wars of Bush and
Obama. Those who serve in the armed forces get full health
coverage.
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