Out-of-pocket payment at point of service exceeds 64pc of health expenditure
The Financial Express: Despite having significant results in some of the health fronts, the out-of-pocket (OOP) expenditure accounts for 64 per cent of the total health expenditure in the country, said a health watch report Monday.
"Despite continuing improvements in the health sector in recent times in Bangladesh, the income erosion effect of ill health for the poor households is also well documented. This is because in Bangladesh, the main source of financing healthcare is out-of-pocket (OOP) payment at the point of service which currently exceeds 60 per cent of the total health expenditure," the report said.
The 4th annual report titled 'Bangladesh Health Watch Report for 2011, moving towards Universal Health Coverage' was launched by Bangladesh Health Watch held at BRAC Centre Inn in the city.
The health sector watchdog suggested for introducing some insurance through prepayments and risk-pooling mechanism to reduce the income-erosion effect of illness and concomitant OOP health expenditures for achieving the universal health coverage (UHC).
Finance minister AMA Muhith was present as the chief guest, while health minister AFM Ruhal Haque attended as the special guest and Nobel Laureate Amartya Sen was present as the guest of honour at the programme.
The report said that an analysis of National Health Accounts data revealed various level of inequity (with respect to age, sex, division) in resource allocation and expenditure incurred with little gain on the parts of the poor. The richest 10 per cent of the population enjoyed 15 per cent of the national health expenditure compared to health budget that has to grow by 35+ per cent.
It also said UHC requires all people to have access to needed health services--- prevention, promotion, treatment and rehabilitation-without the risk of financial hardship associated with accessing services. Among the neighbouring countries Thailand has achieved universal coverage for all citizens and India has made impressive progress towards UHC coverage.
Ruhal Haque said the main constraint for Bangladesh in achieving UHC is finance.
He said with the little money the country has for health sector one cannot say the sector is badly managed.
AMA Muhith said the health insurance sector is terribly disorganized and unregulated. But it can be a great opportunity in future.
Amartya Sen suggested not to follow other countries' example of introducing UHC blindly lent carefully analyse the overall experience of the programme worldwide.
Citing many countries' example of failure in health insurance system he warned the policymakers that the health insurance programme may not be helpful for the poor as it can be manipulated by doctors and the insurance companies.
"The main issue is the entitlement to basic healthcare services which should be ensured by the state," he said.