India's health-cover problem

 

The Indian government has just launched its much anticipated heathcare scheme :Pradhan Mantri Jan Arogya Yojana (PMJAY). Maybe they got the idea from the US, where the debate around a government funded/susbsidized public healthcare system has been going on for decades, leading up the current right-wing government cancelling the Affordable Care Act. One of the reasons why half of the US, thats the republicans, was against it was because there was no clear mention of how such a large program would be funded. They were clearly against the idea of funding the programme from taxes of the rich, inorder to pay for the health of the poor. The US remains the only OECD country which does not have universal healthcare, while even developing countries like Brazil, Mexico and Sri Lanka have UHC.

 

And so the idea of the world's largest democracy too achieving this goal of UHC is being beaten out of proportion. This is going to be the incumbent government's flagship contribution, if one slyly omits the demonitization fiasco. But the fact remains, not everyone is going to benefit from it. And no-one is questioning how such a programme will be funded.

The governmen says 50 crore individuals will benefit from it. Ok. As of now, the total population of India is 1,354,051,854. Thats 135 crore. 50 crore  of that rounds down to 37% of the population. Just about a third of the burgeoning population. And if one looks at the eligibility criteria, that is only the poorest of the poor of the society stands to be eligible. For the urban areas, they actually mention eligible occupations as rag pickers and beggars among others ! So clearyly, this is not a 'universal' program, and instead aims to provide a minimum for the section of the society that needs healthcare the most.

But the even more murky area is regarding how they plan to fund this. Healthcare in India is not cheap. Even with all the copy-cat medications and unlicensed drugs and doctors, quality healthcare still works out to be expensive. Combined with malnutrition, India is facing direct threats on two fronts – infectious diseases like tuberculosis, malaria, H1N1 and drug-resistant TB and the emergence of non-communicable ‘lifestyle’ diseases like heart ailments, diabetes and cancer.This has put the country’s arbitrarily distributed healthcare sector under pressure. It’s exacerbated by the fact that out-of-pocket expenditure on healthcare drove 55 million people in poverty in 2017. 

It may be recalled that PMJAY is one of the two components of Ayushman Bharat, the Modi government’s flagship health initiative. The other component is the creation of 1,50,000 “health and wellness centres”. The finance minister allocated Rs 1,200 crore for these centres in 2018-19. That comes to Rs 80,000 per centre. Essentially, it is just a new coat of paint for the old primary health centres, which are being renamed for the occasion.

At the moment, the fund allocated is 2000 crore, to cover 50 crore Indians. That works down to 40 rupees per  person for the whole year. According to recent media reports, NITI Aayog experts anticipate the annual PMJAY budget to rise to Rs 10,000 crore or so in the next few years, or something in that range. But Rs 10,000 crore (more than five times the current PMJAY budget) is still chickenfeed for the purpose of providing health insurance to 10 crore families. It comes to Rs 1,000 per family, or Rs 200 per person. For the whole year.

How would you feel if you were told you that your budget for health care this year is Rs 200? An illusion has been created that putting this money in an insurance premium has some sort of multiplier effect. This is not the case at all. Insurance can help to redistribute health expenditure towards those who need it most, but it cannot turn Rs 200 into more. If the government spends only Rs 200 per person on health insurance, that’s the amount of health care an average person gets.

True Universal Healthcare in India is still a long time away. Maybe this election gimmick is one step in that long-term direction.

Time to De-Link

 

The Supreme court of India yesterday ruled…well…50-50, on the validityvalidity of the Aadhaar act. Politicians are busy still discussing which side won, but one thing is clear: Private entities can no longer ask for Aadhaar related data of Indians. Aadhaar is now meant to be used for government benefits. So basically Aadhaar has now become one of the fifteen thousand other documents in India that are compulsorily optional.

 

 

So no need to provide aadhaar number for services like mobile phone connections, bank accounts and school admissions. All those private players who depended on the system for easy-KYC have been left in the open now. They will have to find a backup plan or go back to old school KYC. I am specially chuckling at how SBI mandated that a person can have only a single account via Aadhaar linking.

So now, its time to de-link. Coming to think of it, I have provided my own aadhaar number to about a dozen private companies for services. Time to follow up and get them all un-linked..

..if that is even possible now.

Sour apples

 

 

Its that time of the year again. Happens every time. Luxury electronic brand Apple announces their next series of overpriced, mostly re-used technology. And the world reacts in surprise to the new price. But not before they drool over the new design features. And sometime after that, the general public split into two. The fanboys and those who cannot afford to be fanboys.

Every year, there come articles where in 'experts' sit and debate as to why the new prices are exaggerated. Thats its not worth it. And how it is the best time to buy the previous version of Apple devices, which have just become a tad more affordable. Indian media is full of such articles. Its pathetic, how the media publish articles which they know people will search for. With the ever-falling Indian rupee, and heavy taxes from the government, the devices are now are as expensive as what was once the price of the cheapest car in the world.

Indians on twitter and facebook continue to rant the overpriced devices, creating new memes and trolls going into overtime.

I hate this, mainly becauses it messes up my news feed this time of the year. For some reason, google thinks I would be interested in these kind of news articles. I am not.

Grow up, Indian media. With only a 2% market for Apple products, that is a minority to cater to. India will always be the prime market for cheap Chinese products.

So what else can you get for over a thousand US dollars ? You could get a short term work visa to Australia for less than 500 USD !

Now ain't that something worth investing in ?

Excited about ‘First Man’

 

I love space. And after that, I love space movies. Apollo 13 is my second favourite movie, right after the dinos. I was always surprised that they made a movie about the  'successful failure' mission, but not the 'successful success' of Apollo 11. Of course, many other movies have touched upon Apollo 11, eg: The Right Stuff, and it is also the subject of numerous documentaries, no one ventured to give the story a full hollywood treatment. My personal guess is that the subject matter is equally political as it was inspiring, given that it occurred during the height of the cold war during the 60s. There is no way a studio could give it a unbiased treatment without declaring it as an American achievement.

So imagine my surprise, when someone did put a foot forward to address and tell the story of this historic moon landing. And that was the most unlikely person one would expect. Damien Chazelle, who has so far made movies in music and dance subjects, is going to take this giant leap. I hope nobody decides to break into dance on the moon, you know, with lower gravity. A few more days wait till it hits the theatre.

But already, the film has ruffled a few feathers. Some american politicians have found problem with how the film does not show the actual scene where the astronauts hoist the american flag on the moon. The creators have addressed the controversy diplomatically, saying the giant leap was for entire mankind, and not just for USA. Its hilarous reading these king of news articles even before the movie has fully released. But not surprising. Because we Indians have been seeing these kind of complaints against movies for decades.

So you see, this is a deeply political subject. Possibly precisely the reason other directors have been reluctant to tell this story on the big screen.

But although that mission was a success, it could very well have gone down in history as a great failure as well. Nobody had ever done it. And on a limited technology and the deadlines of those days, there was a very small chance of success. For all we know, Neil Armstrong and crew were on their very last mission. They could have very well crashed into the moon. Or the Apollo 11 could have been stranded on the moon, if they could not launch back into space. They could have failed to get back into orbit. They could have burnt up on re-entry. There were thousands of tiny reasons why the mission could have ended in a disaster. The pressure of expectations on the team was huge.

And that is why this story is so inspiring. And has to be told. People only the stories of successful expitions, without pausing to look at how narrow their chances were.

So , thats it. Supercharged for the movie. Ready to back in time and (hopefully) re-live mankind's first journey to somewhere else.

 

PS: Also Apollo 11 put the Futura font on the moon. And in space.

One more revolution

 

 

 

Ariyamo ?