A Call For Reform: An Economist's Look into Dhaka Medical College Realities

 

“A nation that cannot heal its people cannot build its future.” On a recent visit to Dhaka Medical College, I witnessed not only overcrowded wards and exhausted staff, but a clear economic pathology: poor health infrastructure and financing choices that erode both individual wellbeing and national productivity.

In one of the wards, I met a man recovering from a severe neural injury. Clinically, he needs prolonged, intensive care to have a reasonable chance at functional recovery. Financially, his family cannot sustain a year of inpatient treatment. Without public insurance or a targeted safety net, discharge after a few weeks is being seriously considered and not because medicine permits it, but because pocketbooks force the decision. This is not only a personal tragedy. It is surely a market failure with macroeconomic consequences.

Bangladesh spends around 2.8% of its GDP on healthcare, among the lowest in South Asia (World Bank, 2023). Public hospitals like Dhaka Medical College carry the burden of mass healthcare with minimal resources. And the obvious result is overcrowded wards, doctor burnout, and poor patient outcomes. According to WHO, Bangladesh has only 0.8 hospital beds per 1,000 people, far below the global average of 2.9. That’s not just a health issue. It's a supply-demand mismatch straight out of an economics textbook. When beds are scarce, care becomes rushed. Recovery is compromised. People return to the system again and again, creating a vicious cycle of inefficiency and hidden costs for the entire economy.

Sanitation and infrastructure are not aesthetic concerns; they are efficiency inputs. Dirty wards and unreliable water supply increase post-treatment complications and readmissions. Doctors and nurses working under such conditions face higher stress and burnout, reducing the effective supply of clinical care. At the household level, high out-of-pocket payments for diagnostics and drugs push vulnerable families into debt, reversing any short-term gain from GDP growth into long-term losses in human capital.

The inequality within public wards is striking. I observed patients with identical diagnoses receiving markedly different care trajectories depending on family finances. The better-off access private diagnostics or buy medicines that should have been supplied whereas the less fortunate wait in queues, sometimes missing windows where early intervention would change outcomes. A public health system meant to be the great equalizer instead amplifies inequality when underfunded and under-resourced.

What should policy do? The reforms do not require magic, just a bit of political will and pragmatic sequencing. One key step would be to pilot a targeted public insurance scheme covering catastrophic inpatient care in Dhaka. This would protect households from ruinous medical bills while ensuring that patients who need prolonged care aren’t discharged prematurely due to financial distress.

Equally important is prioritizing infrastructure and infection control in public hospitals. Grants dedicated to sanitation, reliable water, waste management, and ventilation can yield immediate dividends in both health outcomes and operational efficiency. The retention of skilled clinical staff must also be addressed. Rather than focusing only on wage increases, non-monetary incentives, safer workplaces, and smarter rotation policies could reduce burnout and improve service continuity.

The government can also build smart partnerships with the private sector for services like diagnostics and hospital management. That way, capacity can increase without putting too much strain on public funds. Alongside that, setting a clear, medium-term target for health spending is crucial, one linked to visible indicators such as the number of hospital beds, infection rates, and how much people still pay out of pocket. Tracking and publishing this progress regularly would help keep the system accountable and ensure that reforms don’t fade away after a few months of attention.

Economics is about choices, and those choices reveal priorities. A nation that allows patients to be discharged early because families cannot pay is choosing short-term savings over long-term capacity. Investing in sanitation, targeted insurance, and staff retention is not charity, it is prudent economic policy. When people are healthy and financially secure, productivity follows. When they are not, growth stalls.

If our policy compass points toward stronger, more inclusive health financing and infrastructure, Dhaka Medical College and hospitals like it can be the engines of recovery rather than sites of repeated failure.

Md. Safwan Hossain Dibbo 
is an undergraduate student 
in Economics Department, University of Dhaka.