A recent government study has revealed that out-of-pocket healthcare expenses pushed approximately 10.8 million people, or 6.4 percent of the population, below the poverty line in 2022, underscoring significant challenges within the country’s public healthcare system. The report also indicates that 41.7 percent of the population experienced financial hardship due to medical costs that year, a notable increase from 28.2 percent in 2005.

This rise in medical-related financial strain comes despite a marked decrease in the overall national poverty rate, which fell from 40 percent in 2005 to 18.7 percent in 2022. The burden of healthcare costs is disproportionately borne by poorer households, with 90.8 percent of individuals in the lowest income bracket facing financial difficulties linked to medical expenses, compared to 13.6 percent among the wealthiest. Rural residents also face a heavier impact, with 47.9 percent experiencing financial stress related to healthcare costs, versus 28.2 percent among urban populations.

The study cites recent outbreaks of measles and dengue as exacerbating factors, noting that thousands of low-income families were driven into debt to afford treatment. Nearly nine out of ten households affected by the measles outbreak had to borrow money, highlighting the vulnerability of these communities in managing healthcare expenses.

Between 2016 and 2022, household incomes grew by 38 percent, yet healthcare expenses increased by 43 percent in the same period, indicating that medical costs are rising faster than earnings. Major contributors to these expenses include medicines, diagnostic tests, hospitalizations, and consultation fees. These costs can be particularly burdensome for patients requiring ongoing treatment.

The report also points to a rising trend in people seeking healthcare from pharmacies, with the proportion increasing from 32.5 percent in 2016 to 55.4 percent in 2022. This shift suggests many individuals face barriers in accessing formal medical care or that public healthcare facilities may be inadequate. Additionally, there has been a decline in inpatient treatment at government hospitals, while reliance on private healthcare providers has grown, further amplifying out-of-pocket costs.

Experts attribute these issues to longstanding weaknesses in the public healthcare infrastructure, including understaffed hospitals, insufficiently equipped upazila health complexes, and limited community-level services. These gaps have led many to seek care outside the public system, often at significantly higher costs. The study raises concerns that poor households are not sufficiently benefiting from public healthcare spending, calling for reforms to ensure that government resources are effectively targeted.

To address these challenges, officials emphasize the need for increased monitoring, transparency, and accountability in healthcare funding to prevent misallocation and corruption. Strengthening primary healthcare facilities by improving staffing, equipment, and reliable access to medicines and diagnostics is also critical to reducing the financial burden on patients and improving overall access to affordable care.