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Lack of consumption discipline in country’s healthcare system

Health minister says that though healthcare services are completely free, it’s time for people to acknowledge this and act responsibly

Bhutan’s health minister, Lyonpo Dechen Wangmo has raised concerns over the country’s health care system, stating that while health care is free in the country, there is a need for people to be disciplined in using the services. The minister pointed out that free and quality health care does not go hand in hand, and at some point, the country will have to realize that a lot is being spent on health care services.

According to the minister, there is a lack of consumption discipline in the country when it comes to health care. The minister highlighted how people often visit hospitals and get prescribed medication, only to forget the prescription at home the next day, leading to the wastage of paper.

 The minister also pointed out that the more educated a person is, the more health care services they consume, which often leads to unnecessary demands for services such as Magnetic Resonance Imaging (MRI).

“People in urban areas, who are better educated, will demand for the MRI even for a little headache, without the recommendation from the doctors, but individuals in rural areas will not demand for one if it is unnecessary,” said the health minister.

The minister also underlined the challenges the country’s health financing faced, including escalating healthcare costs, low health literacy, and overcrowding at secondary and tertiary health care facilities. Despite these challenges, the Bhutanese government currently funds 80% of the country’s health care financing, with 15% coming from out-of-pocket payments and 5% from external financing.

According to the Ministry of Health’s (MoH), records, in fiscal years 2018-19 and 2019-20, the government spent a total of Nu. 7212 million and Nu. 8705 million, respectively, on health care services. The largest share of health expenditure was on curative care services (54%), followed by preventive care (14%), noncommunicable diseases (38% and 41%), reproductive health care (22% and 23%), and infectious diseases (18% and 19%).

 The minister emphasized the need for prioritization and discipline in the country’s health care system to ensure its sustainability. While infrastructure development is essential, the priority should be on sending patients to referrals rather than spending money on hospital infrastructure.

“We recommend about 1000 patients for treatment outside, so improving hospital infrastructure and all that is not vital compared to the patient’s health,” she continued, saying that even if it meant spending more money to build and upgrade the hospital’s infrastructure overall or losing one person, the choice would be the latter. 

 The government faces the challenge of ensuring quality health care while managing costs, ensuring access, and balancing the needs of urban and rural populations. With the country’s health care system facing significant challenges, there is an urgent need for policy changes and reforms to ensure the sustainability of Bhutan’s health care services.

Tshering Pelden from Thimphu