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The Dual Architecture of Crisis in Iran's Health System: Unpacking the Interactions of Macro Financial Fragility and Micro Legal Voids

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  • Qalavand, Mostafa

Abstract

Objective: This article analyzes the crisis-generating interaction between macro financial-governance fragility and micro legal-procedural voids within Iran's health and social security system, examining its role in systemic erosion. Method: Using qualitative analysis and critical conceptual synthesis, pathologies at both macro and micro levels and the negative feedback dynamics between them (financial instability, governance weakness, legal deficits, trust erosion) were investigated. Findings: The crisis exhibits a dual architecture: The macro level grapples with severe financial and governance pressures limiting long-term capacity; the micro level suffers from legal gaps (in the therapeutic relationship, informed consent, documentation, accountability) undermining patient rights and trust. These levels interact in a vicious cycle, reinforcing each other; macro constraints weaken micro standards, while negative micro experiences jeopardize macro sustainability. Results: Piecemeal reforms are ineffective. Overcoming the crisis requires an integrated systemic paradigm that links fundamental macro financial and governance reforms with the effective guaranteeing of rights and responsibilities at the micro level of service delivery to achieve sustainable resilience.

Suggested Citation

  • Qalavand, Mostafa, 2025. "The Dual Architecture of Crisis in Iran's Health System: Unpacking the Interactions of Macro Financial Fragility and Micro Legal Voids," SocArXiv 8ha7c_v1, Center for Open Science.
    • Handle: RePEc:osf:socarx:8ha7c_v1
    DOI: 10.31219/osf.io/8ha7c_v1
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