Halting soaring health costs

Health expenses in Bangladesh have been soaring with proper health care services being just elusive for long, for all. The services rendered by both public and private entities are equally inefficient and expensive. Once there was a saying that the poor have no health facilities in the country. The saying has changed in recent times and the saying is now-- the rich also don’t get proper health service and required treatment here. Free treatment facilities for the poor are largely non-existent, the number of public hospitals is inadequate and ill-equipped, their treatments and services are in shambles, and the out-of-pocket (OOP) cost of medicines keeps going up, exacerbating the plight of the lower middle class and the poor further.

A partial shabby picture of health service, particularly the OOP cost in Bangladesh, was shared on Sunday at a study unveiling programme of the Ministry of Health and Family Planning. The report says that out-of-pocket healthcare expenditure stood at 68.5 per cent in 2020, rising by 1.5 per cent from 2015 when the medical expense was 67 per cent. The OPP is the expense for treatment borne directly by a patient where neither public nor private insurance covers the full cost of the health service. Health Minister Zahid Malek also admitted the ground reality of the soaring medicine and health care cost in the country, expressing his desire for a turnaround from the dire situation. But, when and how the health expenses would be lowered, tightened, regulated, or made cheaper for all walks of life, particularly for those in poverty, new poor, and sandwiched middle class are questions to be answered by the government. Though the country is committed to achieving universal health coverage (UHC) by 2032, any significant scheme is yet to be launched or even planned to reach the goal included in the SDGs (Sustainable Development Goals).

The UHC implies that all people will have access to quality health services they need without facing financial hardships. It is upsetting that our health infrastructure and facilities have failed to keep pace with the economic advancement the nation has so far achieved as the health sector and health expenses are dogged by planning lacuna, corruption, and mercenary attitudes by our medics and clinic owners.

According to a recent research, catastrophic health expenditure forces 5.7 million Bangladeshis into poverty. Inequity is present in most of the health indicators across social, economic, and demographic parameters. We believe achieving a poverty-free nation is simply impossible without effective medical care and robust health coverage facilities at lower and affordable costs.

Coordination between community clinics and Upazila Health Complexes by introducing e-health services, ensuring efficiency of the public healthcare facilities, and introducing a social health insurance system are some of the tools the government may adopt. Medicine price regulation on a broader base is now a necessity given the fact that drug makers focus more on their profitability and expansion, ignoring the inevitable price pressures weighing on common people.

The study further says of the expense, patients spend 64 per cent on drugs, 23 per cent on hospital bills and 8 per cent on the diagnosis. The Health Economic Unit under the Ministry of Health conducted the research. It finds that due to the huge healthcare expenditure, 16.4 per cent of patients refrain from seeking treatment even after having diseases.

The study suggested that the government increase the health budget to address the issue, adding that the trend is going opposite to the government target set to reduce out-of-pocket expenditure by 32 per cent in 2032.

On top of the government’s initiatives to fix the plagued and inefficient health care sector, it is indeed imperative that our private sector, philanthropists, and non-government organisations come forward to cater to the health needs of common people. Providing health services at affordable costs is the prime responsibility of the government, while ultra-rich and big corporations have also social responsibility towards the end.

However, applying regulations, or enacting new laws, if needed, to control drug prices solely rest on the government. Corona-affected people who have been struggling to cope up with the soaring price pressures are no longer in a position to endure higher health expenses.