A HIGH out-of-pocket expenditure, poor access to quality health care, rampant corruption, poorly regulated growth of private healthcare system and low government investment in the health sector have eroded people鈥檚 access to health care. The out-of-pocket expenditure has also pushed a large number of households below the poverty line. At least 6.13 million people slid below the national poverty line, as the Bangladesh Institute of Development Studies report says, having to meet their healthcare expenditure only in 2022 while 35 per cent of people went below the poverty line having to manage their healthcare expenditure. The expenditure put 61.13 per cent of hospitalised patients in a financial distress while 17.72 per cent of households faced catastrophic healthcare expenditure in the period. Of the distressed patients, 15.53 per cent had to sell their assets, 26.83 per cent had to borrow money and 18.77 per cent had to take help from friends and relatives. Of the 38.87 per cent households that could afford the expenditure, only 6.29 per cent could bear their expenses from their regular income and 32.58 per cent used their savings.
The report says that a family had to spend Tk 55,134 in out-of-pocket expenditure for at least one case of hospital admission while the highest average of Tk 223,938 was spent on cancer treatment. The situation is so bad that even middle-income households appear to be just one medical bill away from poverty. Out-of-pocket healthcare expenditure in Bangladesh is the second highest in South Asia, with patients needing to spend almost 70 per cent of the bill. The sorry state of public healthcare facilities is one of the major reasons for the high out-of-pocket expenditure. An unregulated growth of private healthcare facilities, which charge patients exorbitantly, and high drug prices have also contributed to such a situation. The budgetary allocation for health has remained worryingly low, too. Bangladesh stands at the bottom among South Asian countries in budgetary allocation for health. Moreover, the allocated budget is hardly used timely and effectively. The unavailability of quality health care for critical diseases compels the affluent to go to private or overseas hospitals whilst it pushes tens of thousands of poor patients towards premature death.
The government must, therefore, attend to the growing out-of-pocket healthcare expenditure. The authorities must also put a special focus on the public healthcare facilities to ensure health care for low- and fixed-income people. The authorities must put the private health care under strict monitoring. The authorities should also work on universal healthcare coverage, where all people would benefit from quality health services without suffering financial hardship.