Healthcare system needs a better deal

Rising healthcare costs have virtually sapped solvency of many families in the country. Common people today, according to a recent survey, spend 64 per cent of total health-related cost from their own pocket compared to that of the global average at 32 per cent. The high private health expenditure pushes 4.0 to 5.0 million people into poverty every year, while many fail to seek healthcare. This is indicated by the National Health Account 2011.
Against this backup, availability of medicare at the doorstep of common people at affordable costs must be a priority of the government while formulating national plans and programmes. The country has otherwise witnessed a faster growth in numbers of hospitals, clinics and diagnostic centres almost everywhere in urban areas, taking advantage of pitiful inadequacies in government medical facilities. But the vast multitude of people in villages are compelled, in the absence of qualified medical attendants in Union Parishad Family and Welfare Centres and Community Health Centres, to visit urban private hospitals and clinics for medical treatment. However, the costs that they have to bear for this are simply beyond their reach. Some of the union-level government-run health centres are even manned by poorly-trained nurses who prescribe medicines merely on their intuition, not after any proper diagnosis. Under such circumstances, the poor patients have hardly any other alternative but to visit private hospitals and clinics as the government ones are overcrowded.
This newspaper reported on Saturday that hospitals and clinics, in the absence of any government guidelines, realise charges and fees according to their wish without considering the patients' financial status. While qualified doctors are still reluctant to serve the rural medical centres, the government is yet to come up with any other workable alternative to fill the vacuum. It is not difficult to identify the reasons for poor management of rural health centres. The allocations for health in the national budget for the current fiscal 2014-15 leave much to be desired. According to the WHO, the health sector should be allocated at least 15 per cent of the national budget. But sadly, this allocation now in Bangladesh is only 4.60 per cent of its aggregate national budget. This in effect runs counter to the government's health financing strategy that seeks to raise the allocation for health to 15 per cent by 2032 to ensure quality and affordable healthcare for all.
Yet there is another disconcerting development concerning the medicare facilities in the country. This relates to the drug stores across the country that are allegedly flooded with date-expired, low quality but pricey medicines. There are allegations that some pharmaceutical companies arbitrarily fix the prices. Unfortunately, the Adverse Drug Reaction Advisory Committee (ADRAC), formed by the government to monitor public health and drug safety and identify drugs that may cause death of any patient, is yet to be made fully operational. It is high time that the government raised allocations for the health sector to beef up rural health centres and ensure proper utilisation of the allocated fund in order to ease mounting pressure on private hospitals and clinics. Along with some built-in arrangements for providing better facilities to doctors serving in rural areas, steps should also be taken to help streamline arrangements for supply of cheap and quality medicines in pharmacies. Furthermore, stringent monitoring of the activities of private hospitals and clinics merits due attention.