Accountability
According to Clark-Weale, accountability has two aspects: first, people whom decision makers should be accountable in front of; second decisions which decision makers should be accountable because of them. Health system is accountable in front of patients, insurers, taxpayers, health professionals, courts and so on. According to managers, there is not any protocol or guideline for responding to public. As a result MOHME can’t justify decisions and public groups or some organizations protest them.
“I think if there were instructions about accountability, managers feel more responsibility”( a micro level manager) Based on participants, objection to decisions has generally two main causes: first, authorities don’t have enough information about main reasons of decisions and second, there is conflict of interests among various decision makers. While public don't have enough understanding and sufficient power for objection to healthcare organizations, some supervisor institutions such as the Supreme
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On the other hand, treatment and rehabilitation services are provided in hospitals and day clinics those affiliated to Treatment Deputy. People can choose their desirable physicians in the hospitals and day clinics. some respondents opposed to freedom or individual choice of patients because first, they think it is inconsistent with the principles of justice and result in enjoying the rich people from more and better services while poor people can' t have access to some necessary services. Second, people don’t have enough knowledge about health needs and they may demand for services that are not appropriate to their needs. Controversial, some interviewees stated that physicians mislead unaware patients and recommend them some unnecessary treatments and