Introduce Nat'l Social Security Fund Membership for Citizens

Dr. Mohd Mizanur Rahman

Dr. Mohd. Mizanur Rahman 

Bangladesh, a nation of over 160 million people, has made remarkable strides in economic growth and poverty reduction over the past few decades. However, despite these achievements, a significant portion of the population still struggles to access basic healthcare services. The high cost of medical care, especially in private hospitals, remains a daunting challenge for low-income families, many of whom earn less than 20,000 Taka per month.

This article argues that the Bangladesh government should introduce a National Social Security Fund (NSSF) membership card for citizens with a monthly income of less than 20,000 Taka. This card would grant them access to healthcare services in every public and private hospital across the country, offering a safety net similar to those implemented in other developing countries like Cambodia, Thailand, Malaysia, and Brazil.

The Healthcare Dilemma in Bangladesh Healthcare in Bangladesh is a mix of public and private services. While the government provides free or low-cost healthcare through public hospitals and clinics, the quality and accessibility of these services often fall short. The public healthcare system is overburdened, with limited resources, outdated infrastructure, and a shortage of skilled professionals.

Consequently, many citizens turn to private healthcare providers, where the costs can be prohibitively high.

For the estimated 34 million Bangladeshis living below the poverty line, even routine medical expenses can push them deeper into poverty. The absence of a comprehensive social security system exacerbates this issue, leaving low-income families vulnerable to financial ruin in the event of illness or injury.

The Potential Impact in Bangladesh The introduction of an NSSF membership card in Bangladesh would not only align with global trends in social security and healthcare but also address specific challenges faced by the country. Firstly, it would help reduce the high out-of-pocket healthcare expenditures that currently plague low-income families. According to a 2020 World Bank report, out-of-pocket health spending in Bangladesh accounted for nearly 74% of total health expenditure. This heavy financial burden often leads to a cycle of debt and poverty, particularly for those already struggling to make ends meet.

Secondly, the NSSF card could foster greater trust in the healthcare system among the general population. In Bangladesh, public hospitals are often perceived as underfunded and overcrowded, while private hospitals are seen as unaffordable. By providing a mechanism for low-income citizens to access private healthcare services, the NSSF card would create a more balanced and equitable healthcare system. This, in turn, could lead to better health outcomes and increased public confidence in the country's healthcare infrastructure.

Moreover, the NSSF card would promote social cohesion by reducing inequalities in healthcare access. In a society where income disparities are widening, ensuring that all citizens have access to essential services like healthcare is crucial for maintaining social stability. The card could also serve as a tool for monitoring and improving public health by enabling the government to track healthcare usage patterns and identify areas where additional resources are needed.

The Need for an NSSF Membership Card Bangladesh is a nation where approximately 20.5% of the population lives below the poverty line, according to the Bangladesh Bureau of Statistics. For these individuals, the cost of healthcare can be an insurmountable burden. Even those who are slightly above the poverty line, earning less than 20,000 Taka per month, find it challenging to afford necessary medical treatment. The introduction of an NSSF membership card would be a vital step towards reducing healthcare disparities and ensuring that all citizens have access to medical services regardless of their financial situation.

This card would function as a social safety net, providing free or subsidized medical services to those who need it most. By targeting citizens with a monthly income below 20,000 Taka, the government can ensure that the benefits are directed towards the most vulnerable groups.

The NSSF membership card would cover a range of services, including outpatient visits, hospitalization, diagnostic tests, and even prescription medications. This comprehensive coverage would alleviate the financial strain on low-income families and improve their overall well-being.

The Case for an NSSF Membership Card Introducing an NSSF membership card for citizens earning less than 20,000 Taka per month would be a significant step towards universal healthcare coverage in Bangladesh. This card would function as a gateway to essential healthcare services, ensuring that all citizens, regardless of income, can access the medical care they need without the fear of financial hardship.

The NSSF card could be modelled on successful initiatives from other developing countries, where similar programs have been implemented to protect low-income populations from the high costs of healthcare. These examples provide valuable lessons for Bangladesh as it seeks to establish a more equitable healthcare system.

The Potential Impact in Bangladesh The introduction of an NSSF membership card in Bangladesh would not only align with global trends in social security and healthcare but also address specific challenges faced by the country. Firstly, it would help reduce the high out-of-pocket healthcare expenditures that currently plague low-income families. According to a 2020 World Bank report, out-of-pocket health spending in Bangladesh accounted for nearly 74% of total health expenditure. This heavy financial burden often leads to a cycle of debt and poverty, particularly for those already struggling to make ends meet.

Secondly, the NSSF card could foster greater trust in the healthcare system among the general population. In Bangladesh, public hospitals are often perceived as underfunded and overcrowded, while private hospitals are seen as unaffordable. By providing a mechanism for low-income citizens to access private healthcare services, the NSSF card would create a more balanced and equitable healthcare system. This, in turn, could lead to better health outcomes and increased public confidence in the country's healthcare infrastructure.

Moreover, the NSSF card would promote social cohesion by reducing inequalities in healthcare access. In a society where income disparities are widening, ensuring that all citizens have access to essential services like healthcare is crucial for maintaining social stability. The card could also serve as a tool for monitoring and improving public health by enabling the government to track healthcare usage patterns and identify areas where additional resources are needed.

(Dr. Mohd. Mizanur Rahman, MBA (HM) ,MC Optom, PhD is an Assistant Professor & Research Fellow Management & Science University , Malaysia)