Rezaei named Iran’s top security chief and Khamenei representative

Messages sent to Iran International on described medical bills consuming much or all of a typical monthly income, even for people covered by Iran’s Social Security Organization, the country’s main state-run social insurer.

One person undergoing tests for an abdominal and pelvic mass said CT and MRI scans, with and without contrast, cost 210 million rials ($113) despite having Social Security insurance.

“How are we supposed to pay these costs with such meager incomes?” the citizen said.

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  Rising care costs hit Iranians with spinal injuries

Many Iranian workers earn around 200 million to 250 million rials ($108-$134) a month, meaning the scans alone can cost roughly a month’s income. The rial trades at around 1.86 million to the dollar on the free market.

Another said an echocardiogram, electrocardiogram and clinic appointment cost 120 million rials ($65), with the medical provider requiring payment upfront rather than accepting Social Security insurance.

The patient was given documents to seek reimbursement from the insurer but said the process involved extensive bureaucracy and could result in only around half the money being returned.

A 33-year-old said the cost of dental treatment had left him without half his teeth.

“I feel like I’m 60,” he said. “The bitter part is that this humiliating way of life has become normal for me.”

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Another worker earning 10 million rials ($5.40) a day said an appointment with an ear, nose and throat doctor cost 5 million rials ($2.70), followed by 8.6 million rials ($4.60) for medicine.

“We really cannot afford to live anymore,” the worker said.

Lawmaker says shortages could worsen

The accounts echo comments from Salman Es’haghi, spokesman for parliament’s Health and Treatment Committee, who said shortages and rising prices were already causing some patients to stop treatment.

Around 43 medicines are in “critical shortage” and nearly 1,000 pharmaceutical products face some degree of shortage, Es’haghi told the Tabnak news website in an interview published Saturday.

Prices for chemotherapy drugs and medicines used by patients with cancer, hemophilia and thalassemia have risen enough to reduce consumption, with some patients stopping treatment because they cannot afford it, he said.

Es’haghi said patients now pay more than 70% of their healthcare expenses themselves, despite policies intended to leave individuals covering around 30% and the government and insurers paying the remainder.

Some hospitals and pharmacies are also refusing to provide certain services or medicines because insurers have delayed reimbursements or failed to pay them in full, he added.

The difficulties described by Iran International’s audience reflected those problems. One viewer said a packet of Sertraline tablets that previously cost 500,000 rials had risen to 8 million rials, a sixteen-fold increase.

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  Iran’s legal drug market is being hollowed out as shortages feed illicit channels

Another said the cost of healthcare had left the family worried about something as routine as a child catching a cold during the winter.

“We’re stressed about where we would get the money for treatment if, God forbid, we or our children even catch a cold,” the audience said.

Drug subsidy faces uncertain future

The pressure could intensify if the government removes preferential foreign currency for medicines and medical equipment from the budget for the Iranian year beginning in March 2027, Es’haghi warned.

Iran has used preferential exchange rates to lower the rial cost of importing medicines, pharmaceutical ingredients and medical supplies. Removing that support can expose producers and importers to much higher exchange rates and ultimately increase prices for patients.

Discussions about eliminating the preferential rate have been under way since late 2025, with the government viewing the change as a possible way to address corruption and preferential access to subsidized foreign currency, Es’haghi said.

“If the currency allocated to medicines and medical equipment is removed from next year’s budget, it could become a ‘year of patient slaughter,’” Es’haghi said.

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  Iranians borrow for medicine while state shields Arbaeen healthcare

Iran International reported in April that prices for some domestically produced insulin had risen by as much as 212% compared with before the Persian New Year in March, while some imported varieties had increased by as much as 271%.

Pharmaceutical industry figures have attributed rising production costs to a combination of exchange-rate changes, the rial’s depreciation, more expensive raw materials and packaging, higher wages and financing costs, and disruption to supply chains from war.

Es’haghi said more than 70% of medicines had increased in price and argued that authorities should tackle corruption through closer oversight of the pharmaceutical supply chain rather than eliminating subsidized currency.

For patients confronting medical bills comparable to their monthly earnings, however, the pressure is already being measured in delayed care, abandoned treatment and anxiety over whether they can afford the next illness.

Tindex, an Iran-focused economic data platform tracking housing listings and other market indicators, put average advertised monthly apartment rent in Tehran at about 723 million rials, or roughly $389 at an open-market exchange rate of 1.86 million rials to the dollar, in its late-July data.

The figure is based on advertised properties rather than completed rental agreements, but provides a snapshot of prices confronting tenants searching for homes in the capital.

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  Shared housing spreads in Iran’s deepening rent crisis

Monthly salaries for many Iranian workers are commonly put at around 200 million to 250 million rials, equivalent to roughly $108 to $134 at the same exchange rate. That means the average advertised rent can approach three times the upper end of that monthly salary range.

Rent increases reach 100%

The pressure becomes greater when tenants seek to renew their leases.

Rokna News reported on Sunday that rents have risen by 70% to 100% in parts of Tehran, far exceeding the 25% ceiling set for the capital by the Supreme Housing Council.

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The findings point to a wide divide between restrictions imposed by authorities and the increases some landlords demand from tenants.

A member of parliament’s construction committee also acknowledged that government rent restrictions are widely disregarded.

“The 25% rent increase is clearly not being observed, and in practice landlords do not implement it,” Alireza Novin said.

Some landlords justify increases of more than 50% by pointing to inflation of around 60%, but rents should not simply rise at the same rate as broader prices, Novin said.

Weak government oversight has left the housing market largely unchecked, according to Novin, who called for stronger enforcement against those who disregard the restrictions.

“If we identify 10 violators and close their places of business, others will also understand that the law must be implemented,” Novin said.

Tenants can file complaints against landlords who breach the ceiling, but pursuing a case can lead to legal proceedings and uncertainty over whether the landlord and tenant can subsequently reach an agreement, according to Novin.

Housing costs reshape how Iranians live

Iran has been grappling with a prolonged housing affordability crisis as property prices and rents have risen faster than wages. Years of high inflation, currency depreciation and rising construction costs have pushed homeownership beyond the reach of many ordinary Iranians while increasing pressure on renters.

The pressure is particularly acute in Tehran, where roughly half of residents are renters.

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  Skyrocketing rents push Iranians back to parents’ homes, shared housing

Buying a home presents an even greater obstacle. Tindex put the average advertised value of a Tehran home at more than 240 billion rials, or about $129,000 at the open-market exchange rate, in late July, placing ownership far beyond the purchasing power of households dependent on ordinary salaries.

The widening gap between incomes and housing costs has also changed how some Iranians live. Tenants have moved from Tehran to cheaper cities or peripheral areas, returned to their parents’ homes or begun sharing smaller apartments with others to divide housing costs.

Housing experts have warned that continued movement toward cheaper areas on the outskirts of major cities could contribute to further expansion of informal settlements.

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The government has sought to ease the burden through rent ceilings, deposit loans and measures intended to protect tenants. But the increases documented in Tehran show how difficult those policies are to enforce when housing costs continue to outrun earnings.

For workers earning around 200 million to 250 million rials a month, an average advertised Tehran rent above 720 million rials amounts to roughly three months of individual pay – before food, transport and other basic household expenses are considered.

Judiciary spokesperson Asghar Jahangir said on Saturday that legal proceedings began immediately after Kharrazi's recent remarks and that he had now been summoned to the court, which handles cases involving members of the clergy.

“Immediately after his recent remarks, legal action was initiated to prosecute him,” Jahangir said, adding that Kharrazi's case was under criminal investigation and further details would be released after the proceedings.

‘Islamic Republic doesn't work anymore’

In a video released this week, Kharrazi said the Islamic Republic had “reached a stage where, in this form, it simply doesn't work anymore” and said his organization had already drawn up plans for replacing it with an “Islamic government.”

Kharrazi, who heads the Hezbollah of Iran organization, said his group had produced 60 volumes of plans covering state institutions and had maintained what he described as a “shadow government.”

He also outlined a recruitment drive intended to build a nationwide network of 250,000 supporters, saying it could “surround all the ministries” and converge on Tehran following a single announcement.

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  A Khamenei in-law is openly recruiting to replace the Islamic Republic

“Mr. Khamenei and the government must understand that a 250,000-strong organization stands ready to move,” he said.

Kharrazi also attacked President Masoud Pezeshkian, calling him a “buffoon” who “understands nothing,” and said his government “will not reach its end.”

Claims about Khamenei

Kharrazi is tied by marriage to Iran's ruling family: his sister is married to Masoud Khamenei, a brother of Supreme Leader Mojtaba Khamenei.

He has also presented himself as a longtime confidant of the new supreme leader, saying he has known him for four decades and held numerous private meetings with him. In his latest remarks, Kharrazi said Mojtaba Khamenei's thinking was “far more radical than his father's.” His accounts of private conversations and the supreme leader's views cannot be independently verified.

The leader's office had already publicly rejected earlier remarks Kharrazi attributed to Mojtaba Khamenei, including that Pezeshkian's next resignation would be accepted, describing them as unauthenticated and false.

From a strictly economic perspective, former US Treasury official and sanctions strategist Miad Maleki says the greater danger to the regime may emerge once the fighting stops and it must govern a country burdened by soaring inflation, reconstruction costs and years of economic decline.

"If the conflict ends today, then you're going to see the economic effect of the war doing its work," Maleki told Eye for Iran.

"That would be very scary if I was an Iranian regime official, having to face the reality of a post-war economy."

Maleki argues Iran is already inside what he describes as a "tipping zone," where years of inflation, currency depreciation and economic mismanagement have steadily eroded purchasing power.

The question, he says, is no longer simply whether the government can continue paying salaries, but whether those salaries still buy enough to sustain loyalty.

"The salary might keep coming," he said. "You just won't be able to afford very basic needs."

The scale of that pressure is reflected in official consumer-price data.

In June, food and non-alcoholic beverage prices were nearly 134% higher than a year earlier, while prices for oils and fats rose about 278% and meat about 172%, according to data from the Statistical Center of Iran.

Those increases squeeze not only ordinary households, counterterrorism and security specialist Roger Macmillan argues, but also lower-ranking members of the Basij, IRGC conscripts and their families—people drawn from the same society on which the state relies to maintain internal security and suppress dissent.

"The real question isn't how much damage a bomb can do," he said. "It's what happens when the money stops moving."

Iran's financial center of gravity

Military pressure has dominated discussion of Iran for months, with much of the debate centered on missile stockpiles, drone production and how long it might take Tehran to rebuild its military capabilities.

Macmillan argues that focus overlooks something more fundamental.

"They are built to absorb military pressure," he said. "But are they able to absorb payroll pressure?"

His argument is not that economic pressure alone will weaken the regime. Rather, he says policymakers should focus on disrupting the broader financial ecosystem that allows the Islamic Republic to function, from government payrolls to military-linked economic networks.

"We need to be looking at the financial center of gravity, which is not just the payroll but also the military bonyads," he said.

Bonyads are powerful quasi-official foundations that expanded after the 1979 Islamic Revolution, with some of the largest developing extensive holdings in sectors including banking, construction, manufacturing, agriculture and energy.

Major foundations enjoy significant economic privileges and limited public oversight, and several are overseen by or closely connected to institutions under the Supreme Leader.

Some have also served as important patronage networks and maintained extensive economic links with Iran's political and security establishment.

For Macmillan, the question is not simply how much revenue those networks generate. It is whether they can continue supporting rank-and-file security forces if inflation keeps eroding wages while the government takes on the additional burden of rebuilding a post-war economy.

"What we need to look at is how we can remove the will, shatter the cohesion and the will of the foot soldiers from the Basij and from the IRGC, and separate them from the state," he said.

The argument represents a different way of thinking about pressure on Iran.

Rather than asking only how much military capability can be destroyed, Macmillan and Maleki argue policymakers should also consider how much financial strain the Islamic Republic can absorb before maintaining the institutions that enforce its rule becomes increasingly difficult.

Peace itself could reduce some war-related economic pressures, particularly if it improves trade conditions or is accompanied by sanctions relief. But Maleki argues it would also force Tehran to confront accumulated economic problems while meeting the costs of reconstruction.

For him, that may be precisely where the regime is most vulnerable.

"The most punishing thing they can do to this regime is send it back to govern Iran in a state of peace and face the reality they had to kill their way out of," Maleki said.

The United States appeared to believe that military force would quickly weaken the Iranian government and compel Tehran to accept an agreement closer to US terms, Paul Saunders, president and CEO of the Center for the National Interest, said in an interview in Washington DC.

“I think the administration probably … overestimated how easy it would be to use force to bring about a successful agreement,” Saunders said.

Washington and Tehran remain divided over efforts to end the conflict, with the Strait of Hormuz at the center of competing military and diplomatic calculations. Recent reports have offered conflicting accounts of whether an agreement to reopen the waterway is imminent.

Strikes complicated diplomacy

“Targeting Iran’s leadership did more than escalate the military campaign,” Saunders said. “It also posed a direct threat to the survival of the Islamic Republic, making it harder for Washington to persuade Tehran to compromise.”

“I think that, from my point of view, it would have been better not to execute the strike on the Iranian leadership,” Saunders said, adding that the decision increased mistrust and left Washington in a weaker position to negotiate after the initial military action.

The US-Iran Memorandum of Understanding, signed in June, was a 14-point interim framework to end hostilities, restore commercial passage through the Strait of Hormuz, remove the US naval blockade and negotiate a final agreement within 60 days.

In July, Iran suspended implementation of its commitments under the MoU, accusing Washington of effectively abandoning its own obligations.

“In order to get a deal, we needed to have a government to negotiate with,” Saunders said. “When that government is really damaged and destabilized … will that new regime be sufficiently powerful that it will be able to make concessions to the United States?”

Trump has described Iran as being under a “third regime,” arguing that successive layers of the country’s leadership were killed in US and Israeli strikes and that the officials now in charge were different and more reasonable than their predecessors.

Iran’s internal response

Saunders said the political effects of the war extended beyond negotiations to Iran’s domestic response. He said it was predictable that Iranian society would rally behind the state when facing an external attack, even if many people remained unhappy with their government.

“Regardless of how angry or frustrated people might be with their own government, the only thing that they actually want less than their own government interfering in their lives … is someone else’s government doing it,” Saunders said.

“The Iranian government is responding to a threat to its survival, while Iranian society is reacting to an external attack. At the same time, the US president and the American public are weighing how much risk and cost the conflict justifies,” he added.

The conflict is important to Washington but not existential for the United States, Saunders said. He added that the administration had shown sensitivity to growing public concern over the costs of continuing the campaign.

Hormuz remains central

The Strait of Hormuz remains central to Iran’s leverage and to efforts to end the conflict. Commercial traffic through the waterway has fallen sharply, while Iran is also bearing substantial economic costs from the disruption.

Saunders said traders had so far expected the strait to reopen, limiting the immediate impact on global oil prices. But he warned that the economic consequences could become far more serious if the disruption persisted and refiners were forced to adapt to reduced supplies.