DUE to the high rise of medical expenses, particularly for non-communicable diseases (NCDs), the country’s poor people get poorer, albeit the authorities showcased outstanding success in healthcare improvement and public health indicators as well as poverty reduction. The Health Ministry study found that out-of-pocket (OOP) health expenditure is as high as 67 percent of the total healthcare cost in Bangladesh, which is the highest in South and Southeast Asia while the global average is 32 percent. In contrast to the poverty reduction success, the OOP expenditures push four to five million people into poverty every year in the country. The authorities concerned must chalk strategy to lower the OOP otherwise all the success in social indicators would be in the bay.
As public health facilities are not fully equipped with the logistics and human resource and are often riddled with irregularities, healthcare service is largely provided by the country’s mostly unregulated private sector. Over 63 percent of households seek healthcare services from the private sector. Drugs cost comprises of a large part of the total healthcare cost but drugs price is almost beyond government control. There is a nexus between a section of pharmaceutical companies and the healthcare providers. Unnecessary tests are often advised due to collaboration between diagnostic centres and physicians.
Transparency International Bangladesh stated that Commission-based marketing system has developed in the private healthcare sector. The beneficiaries of the system include government and private doctors, other health workers, medicine sellers and brokers. The amount of Commission varies from 25 to 50 percent of the cost of the service. Commission is even given to the brokers for sending cases to the hospitals. According to icddr,b, NCDs: heart, lung or kidney conditions, diabetes and cancer, account for an estimated 59 percent of the total deaths each year in the country. As NCDs are the major threats, the government should establish specialised hospitals in all the divisional cities.
If the public hospitals in the union and upazila levels were functional with adequate health personnel and logistics, much of the problems faced today would have been solved. We do urge the authorities concerned to increase the capacity of the public healthcare system.
