Fayez Uddin (55) works at a private organization in the capital, earning a monthly salary of 18,000 taka. His son, Shihab Uddin (31), is currently undergoing treatment for a brain tumor at the National Institute of Neurosciences & Hospital in Dhaka. Fayez Uddin says that his son not only has a brain tumor but also several other complications. Altogether, surgery, medication, and diet will cost nearly 500,000 taka. Already, they’ve spent 200,000 taka of their savings on doctor consultations and diagnostic tests.
"It’s hard enough to run a household on my salary," he says. "To save my son, I’ve had to borrow 300,000 taka. I don’t know how I’ll ever repay this debt."
Every year, around 6.1 million people in Bangladesh fall below the poverty line due to healthcare expenses. The majority of this spending goes toward purchasing medicines.
This data comes from a study conducted by the Bangladesh Institute of Development Studies (BIDS).
The study reveals that patients suffering from cancer, heart disease, liver and kidney issues are becoming financially devastated. Public confidence in the country’s healthcare system remains low. Government hospitals suffer from mismanagement, resource shortages, and outdated technology. On the other hand, private hospitals are plagued by trust issues and exploitative practices. In urgent situations such as heart attacks or strokes, patients from district areas are often forced to travel to Dhaka due to the absence of fully developed healthcare facilities outside the capital.
Despite the allocation of government funds and financial support from donor agencies for large healthcare projects, corruption and mismanagement have stalled any real improvements in the healthcare system.
In private hospitals, since there is no fixed pricing for diagnostic tests, patients are charged exorbitant amounts. Due to the absence of hospital category regulations and standardized price lists, fees for surgeries and bed rentals are arbitrarily set.
According to the Directorate General of Health Services, there are currently about 750 government healthcare facilities in Bangladesh, including medical college hospitals, specialized institutes, district and general hospitals, and upazila health complexes. In addition, various other government health service institutions exist. There are about 5,000 registered private hospitals and clinics, over 10,000 diagnostic centers, and 180 blood banks in the private sector. In total, there are more than 167,000 hospital beds, of which nearly 95,000 are in private facilities.
Researchers emphasize that without a national health insurance system, it is impossible to reduce healthcare costs in the country. As time progresses, the prevalence of diseases is increasing, and so are treatment expenses. To assess the latest situation regarding medical expenses, Bangladesh Institute of Development Studies–BIDS analyzed data from more than 14,000 patients and their families.
Last July, BIDS presented the report titled "The Impact of Catastrophic Health Expenditure and Poverty in Bangladesh: Findings from the 2022 Household Income and Expenditure Survey."
The study revealed that 3.7% of the country's population has fallen below the poverty line due to medical expenses. This means that 20% of the people living in poverty became poor because of health-related costs. The main factor behind this is the rise in out-of-pocket spending on healthcare.
Dr. Abdur Razzaque Sarker, a health economist at BIDS, stated that patients receiving regular treatment spend approximately 3,500 taka per month, on average. Cancer patients face the highest average monthly cost at around 19,000 taka, followed by heart patients at over 8,000 taka. The majority of spending goes toward buying medicine, accounting for more than half of total medical expenses, followed by diagnostic tests and doctor’s fees.
Dr. Abdur Razzaque Sarker, a health economist at BIDS, noted that patients receiving routine healthcare spend roughly 3,500 taka per month on average. Cancer patients face the highest costs, with monthly expenses averaging around 19,000 taka, while those with heart conditions typically spend over 8,000 taka. A significant portion of these expenses is spent on purchasing medicines, which make up more than half of the total treatment costs. Diagnostic tests and consultation fees follow as the next major expenses.
A separate study by the Health Economics Unit found that patients have to pay 68.5% of their total medical costs out-of-pocket. Of this, 64% is spent on medicine alone. Because of this heavy burden, 16.4% of patients cannot seek medical care even when they need it.
Professor Dr. Syed Abdul Hamid from the Institute of Health Economics at Dhaka University stated to Bangladesh Pratidin that the country's healthcare system is suffering from a serious trust deficit. Treatment costs are high, and patients often encounter significant difficulties in getting proper care. With most health services centered in Dhaka, it's crucial to improve service delivery in public hospitals.
He stressed the importance of setting clear pricing and quality standards for private hospitals and making those publicly available. Hospitals should be categorized so that patients can access care based on what they can afford.
He also recommended setting fixed rates for diagnostic services with proper quality checks and introducing prescription audits. Strengthening diagnostic services in public hospitals is equally important, he added.
Bd-pratidin English/ Afia
