The government should introduce national health insurance in the country to provide proper health care for all people and to ensure universal health coverage for all, experts said.
They said health insurance is a part of health financing while the national health insurance is a system of insurance benefits established by a government to cover all or almost all the citizens of the country.
According to the health economists, the state health insurance is also a social safety programme. Under the health insurance coverage, people get treatment facilities, including consultancy, diagnosis and medicine, from hospitals and clinics and they deserve it.
They said though some group-based health insurances have been introduced in some private institutions, no national health insurance system currently exists in the country.
Speaking at a recent dialogue in the capital, Abul Kalam Azad, director general (DG) of Directorate General of Health Services (DGHS), said there is no alternative to introducing national health insurance system by the government to ensure health services for all people of the country.
Mentioning that the out-of-pocket health expenditure paid by individuals in Bangladesh is 67 percent of the country's total health costs, he said if the government itself takes total responsibility for providing health services to all people, then it can ensure complete health services.
The experts said lower budgetary allocations for the health sector accelerate the out-of-pocket expenditure as the out-of-pocket (OOP) health expenditure in Bangladesh is 63 percent of the total health spending, which is much higher than that of the world average of 32 percent.
According to the National Health Account reports, every year the OOP health expenditure pushes four to five million people into poverty, while many of the poor fail to afford minimum healthcare.
The health economists said if the national health insurance is introduced in the country, then people will get proper treatment. Physicians also can leave their private practice as they will get financial benefit from the insurance system, they said.
Talking to the daily sun, Dr Syed Abdul Hamid, director of the Institute of Health Economics at Dhaka University, said it is necessary to introduce national health insurance in Bangladesh but there is no atmosphere here to implement it for all diseases and all people of the country.
The health insurance may be introduced initially for expensive treatment only like various non- communicable diseases, cancer and kidney diseases, he added
Dr Hamid said the government can run the national health insurance system through forming an authority such as ‘the National Health Protection Authority’.
He said the national health insurance can be introduced primarily for government employees, then it can be extended gradually for private sector employees and others.
He said health insurance should start first in the formal sector, especially for the government employees and their family members.
“If the government employees and employees of autonomous institutions come under the health insurance coverage, then around one crore people initially will get benefit of the health insurance,” Dr Hamid said.
He further said at the same time, the government’s project called Shasthyo Suroksha Karmasuchi (SSK) which is going on in three upazilas as pilot programme can be continued for the ‘below poverty level population (BPLP) to ensure the universal health coverage for the country’s people.
“The government may keep enough allocation in its national health budget to ensure proper health care of those who will remain outside the coverage of the national health insurance initially,” the expert said.
Lamenting that there is no full-fledged private hospital in the country now, he said if the government and private hospitals are not established with full fledged facilities, then it is not possible to introduce the national health insurance system.
Abdul Hamid said the government has to give the public hospitals fiscal autonomy to implement the national health insurance system.
According to a study submitted by Dr Hamid, garment workers, who are covered by health insurance, increased their productivity and reduced the absenteeism, increasing the revenue of garments factories.
The health insurance also increases the behaviour of access to health care by the apparel workers.
The yearly premium of Tk 575 is being provided by the SNV and the apparel factory owners while the yearly benefits include outpatient and inpatient services at selected hospitals of up to Tk 15,000.
Presenting the findings, Dr Hamid said the study was aimed at looking at the existing health insurance scheme at apparel factories to see if the insurance was viable.