With the promise to launch priority signage (for 65 years and above and people living with disabilities) and a health and wellbeing handbook, we took a leap in the progress of our health system. Are we losing more than saving lives? Yes, Bhutan offers free universal healthcare for all citizens since the 1970s – the Constitution provides that “The State shall provide free access to basic public health services in both modern and traditional medicines.” The expenses are overwhelming. It is also true most people only come to the hospitals just when they are sick, or as they enter the last stage. Bhutan must start routine regular check-ups to detect and prevent diseases at the earliest, it will comparatively cut the cost. Bhutan’s total health expenditure (THE) is at 3.6 per cent of GDP, Nu 2,847 per capita and Nu 2,000 million or higher in a month, which is predominantly government financed. The finances are - recurrent costs (salaries, drugs, medical equipment, utilities, maintenance, etc.) and capital costs (buildings, equipment, vehicles) as yearly depreciation. Routine regular check-ups is the answer – it will ease the burden on the health coffers too as it reduces costs of health provisions including costs of hospitalization, treatment, drug consumption and referrals. In line with the Global Goals for Sustainable Developments to win the fight against almost every disease and to prevent major diseases to breed in our body and to cut expenses – as a way of public health promotion, Bhutan can take up a small project to regularly check all its’ citizens. This group could be our young doctors and nurses that are yet to be employed by relevant agencies – and that private medical practice is not encouraged, they can be given the task under the guidance of senior medical practitioners. In the absence of such a system, Bhutan is spending an astonishing amount of money and resources on treating illnesses that are surprisingly easy to prevent. We have 32 hospitals across the country – employing 300 young doctors and nurses will easily fill the gap to fulfil the role to give people of Bhutan regular check-ups. Routine regular check-ups will also help achieve Global Goals of reducing maternal mortality (by 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births; fight communicable diseases (by 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases); prevent and treat substance abuse (strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol); and, universal access to sexual and reproductive care, family planning and education (by 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes). It is also time for Bhutan to focus on SMART health goals - specific, measurable, attainable, realistic and time-bound – the answer is routine regular check-ups, a practical initiative for a populace of 700,000.
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