Bangladeshis spend over $5b abroad for medical purposes annually: BB governor

Bangladeshi citizens spend over $5 billion annually on medical treatment abroad, primarily in India and Thailand, where the healthcare systems are advanced, said Bangladesh Bank Governor Ahsan H Mansur.

He said this expenditure, often taken unofficially, creates significant pressure on the country's balance of payments.

The growing trend of medical tourism reflects the desire for specialised treatments not readily available or affordable within the country, he added.

"The spending can be reduced to $1 billion if we develop our hospital system," Mansur said at a workshop titled "Cross-Border Data Flow: A Bangladesh Perspective," organised by the Policy Research Institute (PRI) and the World Bank in Dhaka.

"However, we haven't achieved this so far. We must blame, of course, the government first. Second, the associations that are resistant to bringing in foreign doctors and specialists to improve quality," he added.

"Unless we address these issues, FDI in the sector will not arrive. We can try to bring in international hospitals, but they will not come unless they are assured that they can bring in their experts when needed. They need to bring their nurses to educate and train our nurses here and provide the best quality service that one can get in Singapore or Bangkok."

He said, otherwise, it will not generate confidence in the minds of the people. "We often go abroad for treatment, and the only reason is that we don't trust our own system. It's very unfortunate, but that's the reality. So, we need to grow out of it," he added.

Mansur, who assumed the role of governor after the political changeover in early August, suggested a legal framework for data processing so that data can be easily shared both locally and across borders.

Mentioning the need for national investment in digital infrastructure, storage, data centres, and cloud services, he said, "We have not developed a national depository or national architecture system where we can store all this data yet."

He said that currently, each bank is creating its own data centre, data recovery centre, and disaster recovery centre, which is very costly. Individual banks cannot have the enormous resources required for data storage, protection, and cybersecurity, which a collective system could provide.

"So, we need to think about creating a national depository system that effectively establishes national data centres, either publicly or privately owned. There is significant scope for broadening the scope of CIB operations and even making it a private operation," he added.

The governor explained that collaterals need to be attached to loans in data centres. The collateral assets of borrowers need to be stored so that there is a built-in valuation system. Banks can review and share this information between themselves.

"There is a lot more that can be done to enhance the Credit Information Bureau (CIB) system. It needs to be more effective so that we don't end up in a situation where once collateral has been sold to 20 banks, and every bank is happily giving money to the same borrower," he said. "We need a mechanism to check and ensure that this does not happen."

"The central information system needs to clear those issues that people are abusing for their personal interests," he continued. "I believe we have enough data in our country, but we are not using it effectively for marketing, internal analysis, or assessing individuals' creditworthiness."

Although Bangladesh has a large amount of data, the country is not using it effectively, he pointed out.

Subrata Paul, focal point of the Health Economics Unit of the Ministry of Health and Family Welfare, said the main obstacle to data sharing and management is the lack of digital infrastructure.

"The creation of a national healthcare card is not necessary because the National Identity (NID) card is sufficient to address the healthcare system. The problem, however, is that the NID lacks a lot of basic information," he said.

"The national healthcare insurance system cannot be established in the country yet because more than 87% of the economy is informal, which is a common issue in all third-world countries except Ethiopia and Rwanda."

Md Sabbir Hossain, deputy managing director of BRAC Bank, said institutions must work to make data management easier. He noted that trading blocs like NAFTA and ASEAN have been sharing quality data and making good business, but the SAFTA region is still lagging behind.

"Also, banks here still cannot produce quality data. The quality of data in Bangladesh needs to be improved, and digitalisation is still lacking," he added.

Although no estimates are available to assess the contribution of smooth data flows for Bangladesh, a recent estimate suggests that a restrictive data regime could hinder imports, raise import prices, and negatively impact economic growth, said Ashikur Rahman, principal economist at PRI.

In the open discussion session of the workshop, the speakers agreed that while the banking and telecom sectors possess a lot of data, they cannot share it due to privacy and national security concerns. However, data from the tourism and healthcare sectors are not as risky, and this data can be shared both within and outside the country.