Economists, health experts and lawmakers at a programme said that the out-of-pocket (OOP) expenditure could be lowered to 51% from the present 68% by raising the health budget allocation by three times and recruiting health workers in the vacant positions.
"By tripling the allocations for the medical and surgical supplies sub-sector of the health budget and by filling up all the vacancies at the upazila health complexes, union health sub-centres, and community clinics- the share of the out-of-pocket cost can be brought down from 68% to 51%," Unnayan Shamannay Chair and former Governor of Bangladesh Bank Professor Atiur Rahman said in the keynote paper presented at a pre-budget dialogue.
The event was organised jointly by Bangladesh Health Watch, Brac James P Grant School of Public Health, Brac University, and Unnayan Shamannay on Monday at the Daily Star Bhaban in Dhaka.
Atiur Rahman pointed out that the lack of capacity of the health ministry in spending budget is a major obstacle to increasing the health budget allocation as it has been observed that half of the allocation remains unspent every year.
"Inefficiency in spending budget allocation should not be the reason for reducing budget share; rather importance should be given to developing skills of the officials on how to implement the budget efficiently," said Atiur Rahman.
The noted economist suggested increasing the budget allocation to 7%-8% in the FY2022-23 budget, of which at least 45% should go to the primary healthcare sector.
Speakers noted that about 86 lakh people slip below the poverty line every year while bearing a gigantic 68% cost of the total health expenditure on their own.
They called upon the government to increase the health budget allocation in such a way so that people feel less pressure while spending on healthcare in a time of high inflation which has put people in difficulties to meet their daily expenditures.
In his remarks, Lawmaker Habib e Millat, laid emphasis on the health sector needs in the medium-to-long-term national planning documents such as the five-year plans.
Barrister Rumeen Farhana, a BNP lawmaker, said that neighbouring Bhutan has universal healthcare, and India is experimenting with different health insurance schemes for the lower-income groups.
But the government is more interested in building infrastructures instead of paying attention to the education, health and social protection sectors, as those give them more scope for corruption.
Lawmaker Shamim Haider Patwary pointed out that the government alone cannot ensure quality healthcare for all the people in the country, rather it should go for building partnerships with private sector healthcare providers.
Dr AM Zakir Hussain, a working group member of Bangladesh Health Watch, said, "We need more human resources in the medical sector. Compared to our population, we have a very limited number of nurses, paramedics, and medical technicians,".