Bangladesh's poor, the vast majority, rely on fate for their good health and remain unaware of medical safeguards as routine blood tests or a BP check. Furthermore, the majority are uninformed about the importance of proper diet or exercise. They are also ignorant about simple First Aid methods that can save lives in accidents or sudden illnesses. Statistics reveal that average longevity in Bangladesh is around 60 years, but if satisfactory healthcare were available and people better informed, that figure would surely soar as in the developed world.

Annual government allocations are in few thousand crores in the health sector, a priority, but national output is below standard the past 35 years. There have sprung up countless but wholly unreliable private providers in urban areas. The rural areas, where the bulk of our population live, are worst in matters of healthcare as they are in all other aspects of life.

Reasons for poor medical care are many but mainly boil down to stiff government protection from competition that foreign providers may offer in Bangladesh. The protectionist policy pledges to employ doctors and nurses that our few medical institutions produce. It would also save foreign currency by reducing reliance on anything foreign. Protectionist policy and restrictions on foreign currency apply to all segments of the economy and are responsible for poor performances of local industries and services from tourism to healthcare.

Few individual units may be doing well as the pharmaceuticals but how far these have succeeded in bringing benefits to the people, with reliable drugs, is quite unknown other than corporate claims in the media. Until early 1980s, people had complete trust in the quality of drugs produced in Bangladesh by foreign pharmaceuticals as Pfizer or Squibb, but the market view today, on medicines produced by wholly Bangladeshi-owned companies ousting those multi-nationals, is not the same.

Individuals and households, however, do not wait for the government to provide services, neither do they depend on the disorganised private medical facilities when in dire distress, but find alternate means for medical attention abroad with great difficulty and cost. All through the year, Bangladesh sees an exodus in thousands to foreign destinations seeking medical attention. The vast majority leave it to their destiny to whatever care is possible within the country and millions go without any.

The Bangladesh healthcare arrangement is highly protective and vested stakes of medical professionals aligning politically force governments to prohibit foreign entry. Neither does the government make it easy for people going abroad for care. Stamping visas that are increasingly complex, getting additional foreign exchange by hundi means, and finding accommodations in a foreign land are no happy experience for most unless a VIP or rich.

Undoubtedly, Bangladesh has a mammoth requirement of reliable medical services that the locals cannot supply and will never until their vested opposition to foreign input fades away. Our domestic doctors find foreign involvement a threat to their jobs but foreigners could well be keen to utilise local experience and enhance knowledge and skill for both if working together. It has become impossible for foreign medical organisations to set up services in Bangladesh unless a powerful member of the society is directly associated with it. However, this cannot be the national norm or the manner to develop health sector or any.

Not long ago, only the rich would fly overseas for treatment but today people on low incomes flee Bangladesh for care abroad. Kolkata, Chennai, Singapore, Bangkok, are competing foreign destinations for our people in need of healthcare. Numerous Kolkata centres thrive on Bangladeshi patients and business abroad is so good that hospitals in Singapore and Bangkok have Bangla speaking receptionists, translators, and other logistics for visiting Bangladeshi patients.

For speedy improvement of medical care in Bangladesh, and to increase its capacity, the government should permit free entry of foreign medical service providers and reverse the unhappy trend of Bangladeshis forced abroad for treatments. A simple and straightforward policy would encourage foreigners to set up medical systems in Bangladesh.

For any service or industry to grow and deliver, competition is compulsory, which foreign services would provide. The only protection a government can extend, and is obligated to give, is protection to life and property. Government's protective cover to doctors or industrialists from competition is counter-productive. People suffer most by this policy that is unjust in protecting few and enriching that few at the expense of the majority.

Policies that control foreign currency are an integral part of protectionism and this restriction increases the cost of foreign money that people must carry for treatment abroad. It always poses a hazard and a guilt feeling when doing something that rules do not permit. No government restriction stops a black market to provide foreign currencies for treatments in Kolkata or Singapore, or to prevent illegal Taka markets to operate in foreign countries frequented by Bangladeshis. Taka, if officially convertible, can become an acceptable mode of payment with foreign doctors and institutions, but the likelihood is jeopardised by government controls producing a national and international network of illegal and criminal activities.

Nevertheless, informal economic activities, celebrated by the Austrian Free Market School and classical liberals, are constantly at work to meet human wants, and this unrestricted human action is the fundamental nature of a prosperous economy not bureaucratic or expertly devised lawful plans.

Government proscriptions complicate methods, increase cost, and produce nothing but poverty and corruption. Human wants remain unfulfilled, as entrepreneurs stay unfree to act and unleash creative enterprise. Unfortunately, the protectionist wisdom continues by bureaucratic governments powerfully backed by groups of intelligentsia believing in the merits of a mighty government to generate jobs and distribute wealth without creating it.

The notion of saving foreign currency and valuing it more than the welfare of the people has taken a ridiculous proportion in Bangladesh. Our policy makers like an ostrich shoving its head in the sand and believing no one can see it. The macro economists, the government, and agencies as the World Bank and IMF have forced upon us a view that preserving Dollars are more important than spending it on life.

Ideally, and as in the informal market, Bangladesh can permit an open multi-currency regime to meet individual requirements without bureaucratic limitation. Furthermore, governments, to meet their obligatory role of protecting life, and property, should engage in punishing criminals counterfeiting currencies not coercively restricting genuine use and ownership.

The US is the biggest exporter of its own currency but as the economic system is freer than most in the world, Dollars held by foreigners, and by foreign governments, return to the US to redress national deficits. Policies that support competition inform that an economy is free. The country then becomes a secure FDI destination to meet foreign currency requirement of the people and of the government.

No country sustains in isolation. People are dependent beyond their nation in many matters as we experience in education, health, or commerce. Individuals must enjoy open access to foreign money to satisfy individual needs according to individual capacity. No one is saying that the government cannot hold on to its foreign currency that it earns or receives, but there can be nothing to disallow people to do the same from open currency markets.

Restrictive policies rob economic freedom and without it, there can be no development; and instead only pervasive ill health, corruption, and privileges for the few. It is for the Free Society of Bangladesh to remind the government that freedom is not for the government to give but a natural condition of man that government is responsible to protect. For a nation to develop, in all sectors, this is the only way forward.

Nizam Ahmad is Director of Liberal Bangla, UK.