Adverse impact of rising cost of health service

Dhaka,  Sat,  19 August 2017
Published : 10 Aug 2017, 21:06:37
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Adverse impact of rising cost of health service

There is no doubt about the quality of physicians of Bangladesh. All they lack is the right attitude towards their profession, their patients and near and dear ones anxiously waiting for the latter's recovery. There are, of course, a few rare exceptions who have taken their profession seriously and are not too commercial to bring their profession to disrepute, writes Nilratan Halder
Rising healthcare cost renders 6.4 million people without any means for survival each year. Of the total population, according to the World Health Organisation (WHO), 3.4 per cent become poorer on account of medical treatment cost and the percentage of families courting financial disaster is as high as 15 per cent. A study carried out in 2012 and published in 2015 revealed these disconcerting facts. The Bangladesh National Health Accounts Survey published every two or three years, according to a report carried in a Bangla contemporary, is going to bring out its next such publication this month. From 2012 to 2016, the prices of medicines alone have shot up to new high. Physicians' consultation fees have also gone up. So the overall healthcare cost by this time is apprehended to have left their far greater adverse impacts on people's financial status.

If the results of the earlier study are upsetting enough, the newer one is likely to be even gloomier. According to the health economic unit under the ministry of health, per head healthcare cost in the country is US$30. The government bears 23.9 per cent whereas patients' families have to bear 63 per cent of the total cost. Intriguingly, 65 per cent of this personal cost is spent on medicine. This means more people will go broke as a result of the astronomical rise in drug price in 2016. 

According to the concept of Universal Health Security, medical service costs are supposed to be brought down to a tolerable level and within everyone's reach by the year 2030. But signs are not positive at all. In the country the health sector is increasingly growing anarchic. If it had not, health services would not be so dearer. The list of tyrannies and malpractices resorted to by a large majority of healthcare providers is long and detestable. 

Apart from arbitrary increase in prices of medicines by drug companies, prescription of those from a select company in exchange for financial gains by doctors is randomly resorted to. The same is the case with laboratory tests. No rule is followed to fix the rate of fees by physicians. Then patients are asked to go through a host of unnecessary laboratory tests. In the absence of referral system, a patient from a health complex or hospital from upazila or district has to depend on acquaintances in the capital or just fall in the trap of middlemen who are becoming increasingly influential.

In a situation like this, the patients and members of their families or other near and dear ones have to manage transports on their own to go to Dhaka. This is one of the reasons why the cost of treatment of diseases goes up many fold. Only rarely can patients avail of ambulance service from the hospitals for the purpose. Making healthcare available to all -irrespective of rich and poor - should, however, be the stated goal of a nation. Private hospitals fleece patients and government healthcare facilities run mostly in a nonchalant manner. Indifferent service and absence of many items of essential medical aid including medicine mark the healthcare system there. 

Not all the poor patients are fortunate enough to seek medical treatment at the government hospitals in the capital. The question of treatment at the costly private hospitals does not arise. It is because of this, the quacks and some mountebanks or fake healers still go about their business with impunity. Yet another dangerous development involves false physicians or medical technicians who claim to have several medical degrees. They run private chambers and diagnostic centres in the absence of regular monitoring and supervision. If qualified doctors maintained ethical practices and were true to their profession, such things could not happen so frequently. The fake doctors and technicians are at times caught red-handed in their illegal medical practices but most likely not all are identified. 

No wonder that the people have lost confidence in the country's health sector. Those who can afford go abroad, mostly to neighbouring India. The number of medical tourists from Bangladesh has also marked a substantial rise in some of the South-east Asian countries. Treatment there is highly costly. But only the moneyed people can afford treatment there. So far as medical treatment in India is concerned, it is cheaper compared to Bangladesh. In certain cases, treatment plus the journey costs is less than what it costs here. Also, patients feel confident in leaving themselves at the hands of doctors there. The system is quite developed. 

There is no doubt about the quality of physicians of Bangladesh. All they lack is the right attitude towards their profession, their patients and near and dear ones anxiously waiting for the latter's recovery. There are, of course, a few rare exceptions who have taken their profession seriously and are not too commercial to bring their profession to disrepute. But exception does not make a rule. 

There is an overriding need for bringing the health sector in order. The drug companies found guilty of producing substandard drugs have been barred from manufacturing those items. That is a first step. A series of actions should be initiated to set things in proper order. All these should be geared up to have a health insurance policy ready for the nation in the near future.    

nilratanhalder2000@yahoo.com

 
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