A patient from Khulna arrives at Dhaka Medical College carrying a plastic bag. Inside are prescriptions written in fading ink, diagnostic reports folded and unfolded too many times, and referral notes from doctors he may never see again.
He does not know his full diagnosis. He cannot explain his treatment history in sequence. Yet he has spent money he does not have to travel hundreds of kilometres to a hospital that is already overwhelmed because the system gave him no better option.
My wife is a government oncologist. I have watched this scene repeat itself more times than either of us can count. In 2026, this is not a medical problem. It is an information problem. And Bangladesh already has many of the tools needed to solve it.
Bangladesh’s out-of-pocket health expenditure stands at around 73 per cent of total health spending, one of the highest rates in the region. While neighbouring countries have gradually reduced the burden on patients, Bangladesh has moved in the opposite direction.
For decades, public spending on healthcare has remained among the lowest relative to GDP in the developing world. The result is a system where families finance treatment from savings, loans or the sale of assets, and where illness can push households into poverty.
The challenge is not simply a shortage of money. It is the shortage of transparency and accountability. The White Paper on Bangladesh’s economy found that the country lost an average of $16 billion annually between 2009 and 2023 to illicit financial flows and poorly managed public finances, with healthcare identified as one of the sectors most vulnerable to corruption and undocumented transactions.
Too much of the healthcare economy still operates beyond meaningful visibility.
This is why a seemingly simple policy intervention deserves serious attention – making Bangla QR mandatory across every licensed healthcare touchpoint in Bangladesh.
Every government hospital, medical college, diagnostic centre, private chamber and pharmacy should be required to accept digital payments through a standardised, interoperable platform. Bangladesh Bank has already made Bangla QR mandatory for banks and MFS providers, with penalties under the Payment and Settlement Services Act 2024 for non-compliance.
The Ministry of Health has equivalent authority over every institution holding a licence from the Directorate General of Health Services. Using it is a policy choice, not a technical challenge.
The importance of digital payments extends far beyond convenience. Patients are frequently directed toward particular diagnostic centres, pharmacies or service providers without understanding the financial relationships behind those recommendations. Cash makes the entire arrangement invisible, and invisibility is the business model.
Every Bangla QR payment, by contrast, creates a record: a merchant, an amount, a date and a time. When pricing anomalies emerge, they become visible. When patterns of overcharging appear, they become measurable. Transparency does not eliminate misconduct, but it makes it significantly harder to sustain.
Consider that 71.7 per cent of all transactions in Bangladesh were still cash-based as recently as December 2024, costing the economy approximately Tk 20,000 crore annually in cash management alone, and the figure does not begin to account for what cash conceals in healthcare billing.
More importantly, payment data can become the foundation of something Bangladesh desperately needs: a connected health information system. Once healthcare transactions are digitised, it becomes far easier to build patient records that travel with the individual rather than remaining trapped in paper files.
A doctor in Jessore could review the same history that a specialist in Dhaka accessed months earlier. Duplicate diagnostics ordered simply because records are unavailable could be reduced. Referral pathways and continuity of care could become practical realities rather than policy aspirations.
Every unnecessary trip to Dhaka carries hidden costs. Patients lose working days. Families pay for travel, accommodation and repeat tests. Major hospitals become congested with cases that could be managed closer to home. Better information flows would improve healthcare outcomes while reducing the financial strain that currently falls hardest on those least able to bear it.
This is not a technology story. It is a governance story. Healthcare is the moment when citizens are most vulnerable and most dependent on systems they cannot control. To allow that moment to remain opaque, undocumented and exploitable is a collective failure.
As citizens, as professionals, as Muslims, we are capable of building systems that treat a sick person with dignity and transparency. That is not an aspiration. It is the minimum standard we owe each other.
Over the past two decades, Bangladesh has built an impressive digital infrastructure. We created a national identity platform, expanded mobile financial services, introduced interoperability and launched Bangla QR.
The question is no longer whether we possess technology. The question is whether we are willing to deploy it where citizens need it most.
A patient entering a hospital should not have to carry their medical history in a plastic bag. Healthcare should heal.
The system around it should not make people poorer. Bangla QR will not solve every problem in Bangladesh’s healthcare sector, but it may be the first step toward a more transparent, connected and accountable system, one that finally serves patients as effectively as it should.
The author is a Digital Banking and Fintech Strategist working at the intersection of financial inclusion, platform economics and digital transformation in Bangladesh, and author of From Cash to Code. Views expressed in the article are solely those of the author.
