10 ms·

Is It Better to Be Poor in Bangladesh or the Mississippi Delta?

105 points by miraj 10y ago

divbit 10y ago
How is the healthcare system in India? Google gives me conflicting answers.
- simonh 10y ago
  What's that got to do with Bangladesh?
  - virtuabhi 10y ago
    Because in the article Deaton uses India also ("...But if you had to choose between living in a poor village in India and living in the Mississippi Delta...").
    - simonh 10y ago
      Thanks, missed that.
  - divbit 10y ago
    I was thinking of Bangalore- sorry. I've been awake entirely too long and didn't go for the morning run to refresh yet.
- solutionyogi 10y ago
  I am originally from India and yummyfajitas's (Regular HNer) experience is very representative. https://www.chrisstucchio.com/blog/2015/medical_tourism.html https://www.chrisstucchio.com/blog/2015/medical_tourism.html
  - divbit 10y ago
    That's interesting. Some of my family in the US have done similar medical tourism in Slovakia.
    - geodel 10y ago
      It would be risky to rely on this single story. I have heard directly from 2 friends both have parents based in India hospitalized there. Once doctors got hint that people from US are coming to take care, medical bills skyrocketed. One colleague end up spending 15 lakh (USD 25K) as hospital would refuse to release body of his father and issue death certificate. They keep claiming patient is critical and need ICU. With other friends' mother doctors would keep ordering injections, each worth 20,000 Rs ($300) confident in the fact US based son can surely afford it. In the end he ended up spending about $35-40K for about 2 weeks of treatment which ended with mother's death. Medical council is in cahoots with doctors and hospitals. If anyone has grievance they can spend years in courts before they see any justice about medical malpractice.
- iamgopal 10y ago
  It's growing. It is seen as a business, so lots of new investment going in there. Quality of service where available privately is quite comparable or even better than their foreign counterparts.
- rgovind 10y ago
  Government runs hospitals in every town but only poor people use them(though they put up with bribes here). Rich and middle class typically use private health care as its generally better. Private health care in cities is excellent even by western standards. In towns, its decent. Poor also turn to private hospitals when time is important or when government doctors fail. One thing government does well is giving vaccines to new born and infants. Also, many times, you just walk up to a pharmacy and ask the pharmacist for a medicine instead of talking to the doctor. Saves money and time
- sremani 10y ago
  For most cases the price transparency in Indian medical system really really beats the American experience. If you have a Cadillac plan in America and you have really cutting edge advance needs that is when American system is both tolerable and better.
pizzetta 10y ago
The author of the question does not have a straightforward answer but puts this forward as a thought provoker. For example while Appalachians have higher income on average (PPP) than a typical Bangladeshi, Appalachian life expectancy is lower. So maybe the marginal increase in income is more impactful in a place like Bangladesh -where people are less able to commit self-harm (even unintended like poor diets). Maybe people in Bangladesh, not having much in the way of comfort do more with marginal incomes. Maybe we can learn from these social forces to take advantage of our higher income and provide better living for people who while not at extreme poverty levels do worse then people living in extreme poverty.
- thrownblown 10y ago
  Does Bangladesh have a systemic prescription opiate problem? How about an illegal heroin problem?
  - chimeracoder 10y ago
    > Does Bangladesh have a systemic prescription opiate problem? If you want to talk about the impact of opiates on Bangladeshi poverty today, you should go back much further in history. Bengal opium, being much higher quality than the product found in China and Afghanistan, was the major impetus behind the British annexing the territory back in 1757. They used this monopoly to extract exorbitant taxes from Bengal, causing widespread man-made famines which killed tens of millions of people. They then used this tax money and the opium to flood the Chinese market with cheap, high-quality opium, against the Chinese rulers' will, in an attempt to undermine the Chinese government as well by creating a widespread opiate epidemic. China did not come under explicit colonial rule the way Bengal did, but it came very close. Over this time period, Bengal went from being the richest region in the second-richest empire/region in the world (next to China) to one of the poorest, which it still is today, despite its rapid growth in recent years. This strategy isn't over, by the way. The opiate market was (and still is) a part of the US military strategy in Afghanistan - balancing the desire to "crack down" on heroin production and smuggling against the desire to provide Afghani civilians with an agricultural economy that doesn't rely on Taliban support. Bangladesh doesn't have a synthetic opiate problem, simply because people there are generally too poor to purchase synthetic opiates in the first place. Raw opium is still used in these areas due to its widespread availability, but it's much less addictive than the synthetic opiates, because pharmaceutical synthetics are obviously designed to be highly concentrated and potent. As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US, 0.8% in Italy, 2.65% in Afghanistan (the highest) and 0.004% in Singapore (the lowest).
xyzzy4 10y ago
The poor in Bangladesh are at least allowed to have shelter in slums. Anywhere in the US it would be highly illegal and violate many regulations.
- amalag 10y ago
  It is true, poor people in those places really don't need much. You can live, eat grow for almost nothing. People can have happy lives without much money.
  - magic_beans 10y ago
    It's even true in city outskirts (e.g. the homeless encampments around San Francisco, Skid Row in LA).
    - vkou 10y ago
      The thing about homeless encampments is that (frequency depends on the city) every few months/years, the police raid them, evict the residents, and steal/burn everything that the residents can't carry out. The mayor claps his hands, makes a press release about how great it is that we've finally cleaned up this den of filth/violence/drug abuse, while the homeless get to sleep under bridges for a few months.
- mrob 10y ago
  People downvoting this, did you also approve of UC Berkeley deleting videos because they were not captioned for deaf people? Setting minimum standards on housing quality without guaranteeing affordable housing availability seems very similar to me.
- jschwartzi 10y ago
  Why is this being downvoted? It's objectively true in every place I've lived.
- thrownblown 10y ago
  I don't understand the downvotes. Rent is just theft based on the monopolization of land. Forcing the poor to pay to live in government approved ghettos is more extortion of their limited resources by those who monopolize the commons.
empath75 10y ago
I noticed when traveling through Central America, that while extreme poverty is everywhere, homelessness seems to be quite rare (with the caveat that I didn't spend much time in the capital cities, so the situation there may be different). I think there are two reasons for it: 1) People don't seem to be as mobile, in general, and you'll find 3 generations of family living very close to each other quite often. I was hanging out with a local in Leon, Nicaragua and met like a dozen of her family members walking around a couple of blocks. People who are having hard times seem to just take up with family. We found one drunk lying on the side of the road, and she insisted we stop and find out what was wrong with him and take him back to his family. I had barely registered that he was there. 2) There don't seem to be as many zoning or construction safety laws, so building a shelter by yourself with almost no money seems to be quite easy. It might be a shack on the side of the road with no water or electricity, but it's better than sleeping on the street. I was also struck by how jovial even people with very little seemed to be. Like having cable tv, food, friends and family was enough for people to be satisfied with where they are with life. They also seemed relatively fatalistic about health and safety issues. When you don't really have any expectation that someone is looking out for you, the idea that you could die from an accident or sickness any day doesn't seem to be that unlikely. People there in general just seem to take it in stride. I guess you have to if you want to get out of bed in the morning. I think it made me realize that loneliness might be worse than poverty, and that the lack of social support for poor people in the us is worse than the lack of money. We could do more for people by creating social connections than we could be just giving them a check. I don't really know what the answer is there. I don't think it's a problem at either the market or government can solve.
- mmsimanga 10y ago
  Your observations are correct with respect to the part of Africa I come from. When you come of age you just pick an empty piece of land next to your family and build your home. We used to use wood from trees you cut down yourself but now the trend is to use bricks. The bricks are "home made", and don't go through any quality checks. All in all there are few homeless people. It is also possible for a whole family to live in two rooms. I don't come from a family that does that but it happens. Everyone sleeping on the floor with a bed for the parents.
mmsimanga 10y ago
I was born in an African village, literally in a mud hut. I spent the first 9 years of my life in a village. The town I grew up in wasn't far from the village so I spent holidays in the village too. I now work in IT and try keep up with the latest frameworks. That is I am not concerned with starving to death and I have health insurance. If I compare my upbringing with my daughter's, there is nothing to compare. We walked around barefoot, unsupervised, climbed trees, ate wild fruit, made spears from wood and once you were four you had to take your two year old sibling with you and look after them. There were no nannies. Here is the interesting thing, none of us ever had to see an occupational therapist to help us with our hand eye co-ordination. Falling out of a tree was enough incentive to figure it out on your own. I digress, the point I am trying to make is that I remember my childhood as a happy time. Full of activity and adventure. I would have been classified as poor because I we slept on the floor, shared blankets as kids. Kids ate from the same plate, grouped roughly by age group. No toys except ones we made ourselves. I am not advocating returning to the village. Running water and healthcare are good things. I often wonder about who is better off, me in town with access to water and health but with all manner of rates and taxes and social pressures? Edit: typos
- cmdrfred 10y ago
  Off topic but I view success as not where you are in life but how far you've come. You've got to have a pretty high score of life's leaderboard.
  - mmsimanga 10y ago
    You make a very interesting point. I would say I am able to adapt to my surroundings pretty well. At work it is all about databases and SQL. When I am back in my home country, conversations are about the rain. Rain determines how crops fare and how much food is available for the livestock. Trying to describe what I do is a none starter. The interesting thing is how easy it is to adapt and to also get caught up in the environment you are in. Suddenly the next great framework is the thing that occupies your mind the most. At that moment I am just like any other person in IT. I go home once a year because it keeps me grounded. Makes me realise I have come far but life is a bit slower there and people have genuine smiles but own less.
charles-salvia 10y ago
I think a lot of the resentment felt by the rural American poor has to do with their perception that they are constantly ignored or overlooked, while similarly impoverished inner-city minorities are at least given some kind of institutional sympathy. It's hard to say how true this really is, or how much of it is simply further fuel for pre-existing racism, but apparently this perception is ubiquitous enough that it can be leveraged to win national elections. I will say the events of the last year have definitely opened my eyes to the situation. The thing I've noticed is that it actually is harder to sympathize with the white, rural poor than it is with the inner-city minorities, at least for me - even though I want to sympathize and I acknowledge their suffering is probably more or less equal to the inner-city minority poor. I suppose the reason I find it more difficult to feel equivalent sympathy is that it's hard to get over the fact that the white rural poor seem to constantly cling to counter-productive political/world-views that perpetuate their poverty and act against their interests. I mean it's just really hard to allocate significant sympathy towards a large voting-bloc that seems to blame all their problems on terrorism and immigration. But then again, perhaps I am generalizing - I mean I'm just a clueless liberal living in my NYC bubble so what do I know anyway?
- gmarx 10y ago
  charles-salvia- the following is not directed against you because you seem to have some insight into your own prejudices. Just about everyone is bigoted against some group or other. The fascinating thing is that this now has a meta-component, that is, the perceived bigotry of an out group is one of the rationales for the moral acceptability of bigotry against them. Of course to most people who have such bigotry they would never call it such. I do hope down voting this comment helps others deal with the cognitive dissonance.
- rtx 10y ago
  Would you sympathise with someone who blames his problems on slavery?
  - exolymph 10y ago
    The distinction is that slavery is actually bad — a human rights atrocity with centuries of fallout — whereas globalization is (according to the liberal worldview) good. I mostly share the liberal worldview.
sremani 10y ago
The answer is simple, don't take what I say seriously, take what I do seriously. 7 out 10 times you are better of in Mississippi delta. The other 3 times are both cultural and relative wealth.
nafizh 10y ago
I am a Bangladeshi who is now a grad student in US. Perhaps I can give a generalized peek view of the health system of Bangladesh. I feel much more safe being in Bangladesh if I were to have some urgent/serious health problems. There are public hospitals where doctors are always available. You go and buy a ticket which is very cheap(in the order of 1-2 dollars in BD currency) and you get to see a doctor. Sure, there are lots of people, you might have to wait for 2 hours, but it beats the insurance system here in US any day. In fact, the concept of having a health insurance is so alien in BD that I feel there will be riots if someone wanted to introduce that. Also, the quality of the doctors in the public hospital is almost on par with the private hospitals. Because for any up and coming doctor, if they want to gain recognition, they first have to get a job at a public hospital. Then they may also practice at a private hospital at their extra hours. If you do not want to wait and you have the money(which is in the order of 10 dollars in BD currecy) you can visit the same doctor at a private hospital. Medicines are really cheap mostly too. This is one of the reasons many Bangladeshi green card holders or US citizens would go to BD for health care if they have some serious issues. I feel there is a huge cultural difference regarding the solution of healthcare between US and BD. The public in BD expects the government to take care of its people through public hospitals. That is why when I came to US and got acquainted with the system of healthcare here it was a huge shock to me.
- mmsimanga 10y ago
  Very interesting perspective. Thanks for sharing. In South Africa you get both private and public. Some public hospitals are very good. Particularly those attached to medical schools. However you have to be referred and your case prioritized if you have something wrong. Private medical aids are big business. It gets more expensive by the year and the benefits seem to be less and less. Its a grudge purchase. How much money is in medical aid in SA, take a look at this story. The CEO of the biggest medical aid made enough to [buy a top notch property](https://therealdeal.com/2014/01/06/south-african-insurance-mogul-adrian-gore-buys-737-park-condo-for-11m/ https://therealdeal.com/2014/01/06/south-african-insurance-m...) in New York. Bear in mind exchange rate is 1US$ = 13ZAR

105 points by miraj 10y ago

divbit 10y ago

How is the healthcare system in India? Google gives me conflicting answers.

simonh 10y ago
What's that got to do with Bangladesh?
- virtuabhi 10y ago
  Because in the article Deaton uses India also ("...But if you had to choose between living in a poor village in India and living in the Mississippi Delta...").
  - simonh 10y ago
    Thanks, missed that.
- divbit 10y ago
  I was thinking of Bangalore- sorry. I've been awake entirely too long and didn't go for the morning run to refresh yet.
solutionyogi 10y ago
I am originally from India and yummyfajitas's (Regular HNer) experience is very representative. https://www.chrisstucchio.com/blog/2015/medical_tourism.html https://www.chrisstucchio.com/blog/2015/medical_tourism.html
- divbit 10y ago
  That's interesting. Some of my family in the US have done similar medical tourism in Slovakia.
  - geodel 10y ago
    It would be risky to rely on this single story. I have heard directly from 2 friends both have parents based in India hospitalized there. Once doctors got hint that people from US are coming to take care, medical bills skyrocketed. One colleague end up spending 15 lakh (USD 25K) as hospital would refuse to release body of his father and issue death certificate. They keep claiming patient is critical and need ICU. With other friends' mother doctors would keep ordering injections, each worth 20,000 Rs ($300) confident in the fact US based son can surely afford it. In the end he ended up spending about $35-40K for about 2 weeks of treatment which ended with mother's death. Medical council is in cahoots with doctors and hospitals. If anyone has grievance they can spend years in courts before they see any justice about medical malpractice.
iamgopal 10y ago
It's growing. It is seen as a business, so lots of new investment going in there. Quality of service where available privately is quite comparable or even better than their foreign counterparts.
rgovind 10y ago
Government runs hospitals in every town but only poor people use them(though they put up with bribes here). Rich and middle class typically use private health care as its generally better. Private health care in cities is excellent even by western standards. In towns, its decent. Poor also turn to private hospitals when time is important or when government doctors fail. One thing government does well is giving vaccines to new born and infants. Also, many times, you just walk up to a pharmacy and ask the pharmacist for a medicine instead of talking to the doctor. Saves money and time
sremani 10y ago
For most cases the price transparency in Indian medical system really really beats the American experience. If you have a Cadillac plan in America and you have really cutting edge advance needs that is when American system is both tolerable and better.

pizzetta 10y ago

The author of the question does not have a straightforward answer but puts this forward as a thought provoker. For example while Appalachians have higher income on average (PPP) than a typical Bangladeshi, Appalachian life expectancy is lower. So maybe the marginal increase in income is more impactful in a place like Bangladesh -where people are less able to commit self-harm (even unintended like poor diets). Maybe people in Bangladesh, not having much in the way of comfort do more with marginal incomes. Maybe we can learn from these social forces to take advantage of our higher income and provide better living for people who while not at extreme poverty levels do worse then people living in extreme poverty.

thrownblown 10y ago
Does Bangladesh have a systemic prescription opiate problem? How about an illegal heroin problem?
- chimeracoder 10y ago
  > Does Bangladesh have a systemic prescription opiate problem? If you want to talk about the impact of opiates on Bangladeshi poverty today, you should go back much further in history. Bengal opium, being much higher quality than the product found in China and Afghanistan, was the major impetus behind the British annexing the territory back in 1757. They used this monopoly to extract exorbitant taxes from Bengal, causing widespread man-made famines which killed tens of millions of people. They then used this tax money and the opium to flood the Chinese market with cheap, high-quality opium, against the Chinese rulers' will, in an attempt to undermine the Chinese government as well by creating a widespread opiate epidemic. China did not come under explicit colonial rule the way Bengal did, but it came very close. Over this time period, Bengal went from being the richest region in the second-richest empire/region in the world (next to China) to one of the poorest, which it still is today, despite its rapid growth in recent years. This strategy isn't over, by the way. The opiate market was (and still is) a part of the US military strategy in Afghanistan - balancing the desire to "crack down" on heroin production and smuggling against the desire to provide Afghani civilians with an agricultural economy that doesn't rely on Taliban support. Bangladesh doesn't have a synthetic opiate problem, simply because people there are generally too poor to purchase synthetic opiates in the first place. Raw opium is still used in these areas due to its widespread availability, but it's much less addictive than the synthetic opiates, because pharmaceutical synthetics are obviously designed to be highly concentrated and potent. As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US, 0.8% in Italy, 2.65% in Afghanistan (the highest) and 0.004% in Singapore (the lowest).

xyzzy4 10y ago

The poor in Bangladesh are at least allowed to have shelter in slums. Anywhere in the US it would be highly illegal and violate many regulations.

amalag 10y ago
It is true, poor people in those places really don't need much. You can live, eat grow for almost nothing. People can have happy lives without much money.
- magic_beans 10y ago
  It's even true in city outskirts (e.g. the homeless encampments around San Francisco, Skid Row in LA).
  - vkou 10y ago
    The thing about homeless encampments is that (frequency depends on the city) every few months/years, the police raid them, evict the residents, and steal/burn everything that the residents can't carry out. The mayor claps his hands, makes a press release about how great it is that we've finally cleaned up this den of filth/violence/drug abuse, while the homeless get to sleep under bridges for a few months.
mrob 10y ago
People downvoting this, did you also approve of UC Berkeley deleting videos because they were not captioned for deaf people? Setting minimum standards on housing quality without guaranteeing affordable housing availability seems very similar to me.
jschwartzi 10y ago
Why is this being downvoted? It's objectively true in every place I've lived.
thrownblown 10y ago
I don't understand the downvotes. Rent is just theft based on the monopolization of land. Forcing the poor to pay to live in government approved ghettos is more extortion of their limited resources by those who monopolize the commons.

empath75 10y ago

I noticed when traveling through Central America, that while extreme poverty is everywhere, homelessness seems to be quite rare (with the caveat that I didn't spend much time in the capital cities, so the situation there may be different). I think there are two reasons for it: 1) People don't seem to be as mobile, in general, and you'll find 3 generations of family living very close to each other quite often. I was hanging out with a local in Leon, Nicaragua and met like a dozen of her family members walking around a couple of blocks. People who are having hard times seem to just take up with family. We found one drunk lying on the side of the road, and she insisted we stop and find out what was wrong with him and take him back to his family. I had barely registered that he was there. 2) There don't seem to be as many zoning or construction safety laws, so building a shelter by yourself with almost no money seems to be quite easy. It might be a shack on the side of the road with no water or electricity, but it's better than sleeping on the street. I was also struck by how jovial even people with very little seemed to be. Like having cable tv, food, friends and family was enough for people to be satisfied with where they are with life. They also seemed relatively fatalistic about health and safety issues. When you don't really have any expectation that someone is looking out for you, the idea that you could die from an accident or sickness any day doesn't seem to be that unlikely. People there in general just seem to take it in stride. I guess you have to if you want to get out of bed in the morning. I think it made me realize that loneliness might be worse than poverty, and that the lack of social support for poor people in the us is worse than the lack of money. We could do more for people by creating social connections than we could be just giving them a check. I don't really know what the answer is there. I don't think it's a problem at either the market or government can solve.

mmsimanga 10y ago
Your observations are correct with respect to the part of Africa I come from. When you come of age you just pick an empty piece of land next to your family and build your home. We used to use wood from trees you cut down yourself but now the trend is to use bricks. The bricks are "home made", and don't go through any quality checks. All in all there are few homeless people. It is also possible for a whole family to live in two rooms. I don't come from a family that does that but it happens. Everyone sleeping on the floor with a bed for the parents.

mmsimanga 10y ago

I was born in an African village, literally in a mud hut. I spent the first 9 years of my life in a village. The town I grew up in wasn't far from the village so I spent holidays in the village too. I now work in IT and try keep up with the latest frameworks. That is I am not concerned with starving to death and I have health insurance. If I compare my upbringing with my daughter's, there is nothing to compare. We walked around barefoot, unsupervised, climbed trees, ate wild fruit, made spears from wood and once you were four you had to take your two year old sibling with you and look after them. There were no nannies. Here is the interesting thing, none of us ever had to see an occupational therapist to help us with our hand eye co-ordination. Falling out of a tree was enough incentive to figure it out on your own. I digress, the point I am trying to make is that I remember my childhood as a happy time. Full of activity and adventure. I would have been classified as poor because I we slept on the floor, shared blankets as kids. Kids ate from the same plate, grouped roughly by age group. No toys except ones we made ourselves. I am not advocating returning to the village. Running water and healthcare are good things. I often wonder about who is better off, me in town with access to water and health but with all manner of rates and taxes and social pressures? Edit: typos

cmdrfred 10y ago
Off topic but I view success as not where you are in life but how far you've come. You've got to have a pretty high score of life's leaderboard.
- mmsimanga 10y ago
  You make a very interesting point. I would say I am able to adapt to my surroundings pretty well. At work it is all about databases and SQL. When I am back in my home country, conversations are about the rain. Rain determines how crops fare and how much food is available for the livestock. Trying to describe what I do is a none starter. The interesting thing is how easy it is to adapt and to also get caught up in the environment you are in. Suddenly the next great framework is the thing that occupies your mind the most. At that moment I am just like any other person in IT. I go home once a year because it keeps me grounded. Makes me realise I have come far but life is a bit slower there and people have genuine smiles but own less.

charles-salvia 10y ago

I think a lot of the resentment felt by the rural American poor has to do with their perception that they are constantly ignored or overlooked, while similarly impoverished inner-city minorities are at least given some kind of institutional sympathy. It's hard to say how true this really is, or how much of it is simply further fuel for pre-existing racism, but apparently this perception is ubiquitous enough that it can be leveraged to win national elections. I will say the events of the last year have definitely opened my eyes to the situation. The thing I've noticed is that it actually is harder to sympathize with the white, rural poor than it is with the inner-city minorities, at least for me - even though I want to sympathize and I acknowledge their suffering is probably more or less equal to the inner-city minority poor. I suppose the reason I find it more difficult to feel equivalent sympathy is that it's hard to get over the fact that the white rural poor seem to constantly cling to counter-productive political/world-views that perpetuate their poverty and act against their interests. I mean it's just really hard to allocate significant sympathy towards a large voting-bloc that seems to blame all their problems on terrorism and immigration. But then again, perhaps I am generalizing - I mean I'm just a clueless liberal living in my NYC bubble so what do I know anyway?

gmarx 10y ago
charles-salvia- the following is not directed against you because you seem to have some insight into your own prejudices. Just about everyone is bigoted against some group or other. The fascinating thing is that this now has a meta-component, that is, the perceived bigotry of an out group is one of the rationales for the moral acceptability of bigotry against them. Of course to most people who have such bigotry they would never call it such. I do hope down voting this comment helps others deal with the cognitive dissonance.
rtx 10y ago
Would you sympathise with someone who blames his problems on slavery?
- exolymph 10y ago
  The distinction is that slavery is actually bad — a human rights atrocity with centuries of fallout — whereas globalization is (according to the liberal worldview) good. I mostly share the liberal worldview.

sremani 10y ago

The answer is simple, don't take what I say seriously, take what I do seriously. 7 out 10 times you are better of in Mississippi delta. The other 3 times are both cultural and relative wealth.

nafizh 10y ago

I am a Bangladeshi who is now a grad student in US. Perhaps I can give a generalized peek view of the health system of Bangladesh. I feel much more safe being in Bangladesh if I were to have some urgent/serious health problems. There are public hospitals where doctors are always available. You go and buy a ticket which is very cheap(in the order of 1-2 dollars in BD currency) and you get to see a doctor. Sure, there are lots of people, you might have to wait for 2 hours, but it beats the insurance system here in US any day. In fact, the concept of having a health insurance is so alien in BD that I feel there will be riots if someone wanted to introduce that. Also, the quality of the doctors in the public hospital is almost on par with the private hospitals. Because for any up and coming doctor, if they want to gain recognition, they first have to get a job at a public hospital. Then they may also practice at a private hospital at their extra hours. If you do not want to wait and you have the money(which is in the order of 10 dollars in BD currecy) you can visit the same doctor at a private hospital. Medicines are really cheap mostly too. This is one of the reasons many Bangladeshi green card holders or US citizens would go to BD for health care if they have some serious issues. I feel there is a huge cultural difference regarding the solution of healthcare between US and BD. The public in BD expects the government to take care of its people through public hospitals. That is why when I came to US and got acquainted with the system of healthcare here it was a huge shock to me.

mmsimanga 10y ago
Very interesting perspective. Thanks for sharing. In South Africa you get both private and public. Some public hospitals are very good. Particularly those attached to medical schools. However you have to be referred and your case prioritized if you have something wrong. Private medical aids are big business. It gets more expensive by the year and the benefits seem to be less and less. Its a grudge purchase. How much money is in medical aid in SA, take a look at this story. The CEO of the biggest medical aid made enough to [buy a top notch property](https://therealdeal.com/2014/01/06/south-african-insurance-mogul-adrian-gore-buys-737-park-condo-for-11m/ https://therealdeal.com/2014/01/06/south-african-insurance-m...) in New York. Bear in mind exchange rate is 1US$ = 13ZAR