The picture we usually get of the Iranian poor in the media is one of two extremes: the wretched of the earth, or the equivalent of Ronald Reagan’s “welfare queens.” (If you remember, Reagan attacked the meager US welfare system by inventing a group of people who did not even exist: pink-Cadillac-driving, children-producing, unwilling-to-work black women.)
One hears similar things about Iran, in an exaggerated caricature of the truth. Rural villagers are handed money and told to vote for conservatives. The religious poor are recruited into the basij and indoctrinated. War veterans get the plum jobs and their kids get into the universities. The middle classes get nothing and, due to the favorable treatment of the poor, end up resentful and rebellious against the lower class. This is usually called “populism,” a pejorative word that has almost no analytic value in its current usage.
At the same time, one also hears that the Iranian poor are the extreme lumpenproletariat with nothing to lose except their chains. They are taken advantage of by a state where connections mean everything, exploited by a capitalist sector that laughs at the de jure wage laws, and get shamed by the middle classes because they cannot compete in the conspicuous consumption race (without a finish line). In some versions of this story, they are also the most revolutionary, about to rise up.
When you hear either one of these extremes, you should first realize you are encountering a highly politicized debate. This involves domestic Iranian political factions from right to left, diaspora Iranians of various political lineages, Western-trained Iranian academics who import the latest fads in social science, and, finally, the “common sense” of journalists who do not know much about Iran.
In this debate, you would not hear that the largest welfare program in Iran is the Social Security Organization (sazman-e ta’min-e ejtema’i), which covers 27 million Iranians to some degree. This organization provides various forms of health coverage, old age pensions, and unemployment insurance to mostly formal workers in the labor market. It also is attempting to extend coverage to Iran’s self-employed (the large informal sector or the petty bourgeoisie), agricultural workers, carpet weavers, seminary students, and even nomads. It has not been very successful at getting the more vulnerable social groups covered since these new policies were only recently implemented in the Khatami era, but could be expanded if it were more of a priority. A smaller, more “revolutionary” welfare organization, the Imam Khomeini Relief Committee, gives regular aid to no more than 5-6 million Iranians, who are usually the poorest.
Health care in Iran can be disastrous if you have a catastrophic disease, and the various public health insurances that exist often cover no more than 30% of out-of-pocket costs. However, almost all health services in Iran are subsidized by the state and the costs are kept well below market prices. Many Arabs, Russians, Turks, Pakistanis, and Iranians from Los Angeles travel to Iran each year to obtain cheap, professional medical care. I spoke to a dentist in Tabriz two weeks ago who informed me that, although there is almost no dental insurance in the country, I could get a root canal for around $75-100. He actually looked at my own teeth and said that my gold fillings, which I had gotten in a Chicago dentist’s office on the cheap because I had no insurance and could not afford the more expensive composite fillings, were of shoddy quality. He could replace them all for around $250-300. Pharmaceuticals in Iran are incredibly cheap, and 97% of them are made domestically.
More good news is that, in the upcoming subsidy reforms that may be finally enacted this year, health services and pharmaceuticals will not be touched. They were removed from the subsidy reform bill in its early stages in the Majles. The only health services that are not subsidized in Iran are cosmetic surgeries — the ubiquitous nose jobs being the well-known example. My dentist friend said that services like teeth whitening, orthodontics, and “smile therapy” are the equivalent in his profession.
Furthermore, if you are part of the 30% of the population who live in villages, or you can at least claim residence in a village, you have access to Iran’s village insurance system and get free basic healthcare along with free medicine, check-ups, vaccinations, and birth control and family planning. On a recent trip to a village clinic — a “health house” or khaneh-ye behdasht — the health workers told me that the biggest diseases in the village were diabetes, hypertension, and depression. These are diseases which many middle-income countries would love to have, because they usually only manifest themselves if your population survives to old age.
I could go on, but the overall point is that Iran’s welfare system, while it is confusing, is primarily targeted towards the middle strata of the population. Universal programs such as subsidies, or welfare programs stemming from the “German model” such as formal-sector pensions, are both the norm and the most expensive part of the system. As we also know from the US welfare system, universal programs usually end up benefiting the middle classes rather than the poor, and they are politically quite popular. The Iranian elites are all in favor of removing subsidies for gasoline, but look how scared they are of actually implementing it — it now seems that subsidy reform will not happen in March as was planned and will be pushed back to September if not further.
Why does none of the coverage — sadly, I am not exaggerating here — discuss social welfare in Iran in these terms? One reason is that certain state policies — subsidies, pensions, control of health costs — are seen as entitlements or social rights, while other policies — preferential hiring of veterans, dividend-paying “justice” shares — are seen as charity or means-tested benefits. This dual character exists in any welfare system, and activists have long known that, if you want a policy to last beyond its implementation, it is best to give it a universal flavor. Otherwise it leaves the policy more open to political jockeying.
Another reason, however, is that normal conversations about normal politics are cordoned off by the electrified fence of Iran media coverage, where anyone can be accused of being a regime apologist if they say that the tap water in Tehran is potable. This is not likely to go away, but one hopes that basic media literacy — that is, don’t trust everything you read — will expand enough so that the “common sense” on Iran becomes less common.
I have listened to middle-class Iranian students, not rich by any means, fulminate about the preferential treatment of the poor. On such occasions I would ask the students if they had themselves received free health care at the state university they were attending. Their reply: “Of course.” I then usually enjoyed the look on their face when I told them that, in the US, public university students are bankrupted by health care and loans before they even enter the job market.
Kevan Harris is a graduate student in the Department of Sociology at Johns Hopkins University. His research interests are the political economy of international finance, labor and social movements, and West Asia. Read his blog The Thirsty Fish: <www.kevanharris.com>.