Expansion of health insurance imperative: speakers
Health insurance coverage needs a massive expansion to grassroots level, to reach the goal of universal health coverage (UHC) by 2032, speakers at a seminar said yesterday.
They also said out-of-pocket (OOP) expenditures for Bangladeshis now stands at 67 percent, highest among all South Asian countries, from 64 percent in 2012.
The government plans to bring the number down to 32 percent by 2032.
OOP is the expense that a patient or their family pays directly to a healthcare provider, instead of a third-party (insurer or state).
Under the circumstances, a step-by-step approach should be taken in parallel to adopting new policy as well as supply side readiness (well-behaved doctors, medicine and good governance), they said at the programme held at Cirdap in the capital.
Health Economics UNIT (HEU) of the ministry of health and family welfare (MoHFW) organised the seminar titled “Future of Health Insurance in Bangladesh”, in association Institute of Health Economics (IHE) of Dhaka University.
“The mandate of the government is to provide healthcare facilities for all; there no scope to provide it to a special class. So we have to expand it step by step,” Shahadt Hossain Mahmud, director general (additional secretary) of HEU, said, explaining the economic reality of the country where “31 percent of the population is still below the poverty line”.
Speaking as chief guest, Md Ashadul Islam, secretary to the ministry of health, said, “We all know about the problems.
I would like to urge everybody to talk about the solutions as well.”
At the beginning of the seminar, three experts presented keynote papers while researchers, representatives from insurance companies and other stakeholders discussed on the issue.
Presenting his paper, Prof Syed Abdul Hamid of IHE highlighted the challenges and opportunities of health insurance in Bangladesh, in light of the government’s Health Care Financing Strategy 2012-2032.
By 2032, the government plans to increase its healthcare allocation to 30 percent, while other sources of health expenditure would be social health protection (32 percent), OOP (32 percent), and external fund (5 percent).
Prof Hamid said, “As per government strategy, social health protection will replace OOP.
However, there is a big gap in this sector. Expansion of health insurance could be an easy way out in this case.”
Currently, some 15 out of 33 life insurance companies (LICs) offer group health insurance with current market size of five to six lakh clients, which accounts for 90 percent of the market share.
Only 20,000 to 25,000 of them are individual clients, accounting only ten percent of total market share, worth Tk 25 crore.
“So it is necessary to make health insurance mandatory, and it could be done step by step,” Prof Hamid said.
Dr Md Nurul Amin, deputy director of HEU, presented another keynote explaining the government’s Shasthyo Surokhsha Karmasuchi pilot project in three upazillas in Tangail.
To reduce the burden of out-of-pocket expenses, HEU has developed health protection scheme for the below-poverty line population.
Dr Zaman, a representative from Netherlands-based development organisation SNV, presented another paper, where he showed according to a study by them, 57 percent of absentees at readymade garment factories stayed absent due to illness, which could be prevented if proper health service could be provided to them.
Currently, SNV is piloting a voluntary health insurance programme in four garment factories in Dhaka.
Discussants in the programme recommended to adopt new policy, find out area-based need for financing and good governance for the effectiveness of health insurance in the country.
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