Universal healthcare: Govt allocation must increase

There are provisions on five basic necessities of life in the constitution and medical care comes at the fifth. Socialism, which is the one of the constitution’s major fundamental policies, states about the fulfilment of basic necessities of all citizens. So, medical care by any means cannot be neglected.

It is essential to ensure better healthcare to build a healthy nation. Since the state is responsible to fulfil the basic necessities, a drop in the state’s expense for its citizens is not only a matter of frustration but also a matter of concern.

According to a Prothom Alo report, the health economics unit under the health ministry said the government’s portion of expenditure on health sector is 28, 26 and 23 per cent in 2018, 2019 and 2020 respectively, and that means a gradual drop in government’s expenditure.

This gradual drop in the government expenditure in the health sector does not mean that people are voluntarily spending for healthcare service or people’s capacity to receive healthcare service has increased. Rather expenditure on medicines and diagnosis continues to rise.

As a result, individual expenditure increased to 64, 66 and 69 per cent in 2018, 2019 and 2020 respectively. Previously, the health economics unit and the health ministry published such five reports on the health sector’s financing and expenditure.

World Health Orgnisation’s Bangladesh representative Bardan Jung Rana said if 69 per cent of total health expense is made at the individual level, then this is a hindrance to achieving universal health safety. The government bears the lion's share of individual’s healthcare in many welfare states including neighbouring Sri Lanka, but the scenario is opposite in Bangladesh. A health complex was established in every upazila after independence to deliver healthcare service at the door step of the people. Later, Awami League government set up communality clinics and many people have been receiving health service at an affordable price at union level. This is obviously a good initiative. Yet, it cannot be said that the healthcare service has been ensured for all across the country. Many people have become victims of mistreatment and ill-treatment in remote area.

New infrastructures are built and new machines are purchased in the health sector of Bangladesh every year, but we hear reports on infrastructures lying abandoned in many places and expensive machineries being damaged in the boxes. Many hospitals do not have physicians and health workers in the rural area. Many hospitals have machines, but they do not have required workforce to operate those.

As a result, people are compelled to go to private hospitals and, in some cases, people are deceived while receiving healthcare service. To change this situation, allocation of the government must be increased to bring healthcare service to the people’s door, and there is no alternative to strengthening monitoring on whether this allocation is being utilised properly.

Policymakers of the present government have been working to ensure healthcare service for all within 2030, and if the persisting inertia does not change, that goal will remain unfulfilled.