Cacophony

What a year ?! Election years have always been 'politically violent' in India. All of the top liars descend upon the masses, making up imaginary claims and promising even loftier ones in future. But lately the focus has shifted from development and progress to the nation's security and religion. And the poor citizens are receptive. It seems people would rather practise their religion , than worry about the next day's income.

This year , there is a third party in the political game. Apart from the two main contenders, the third party is the Election Commission. They too have now been affected by the virulent strain. Double standards galore. On one hand, they have been disqualifying independent candidates , but they also let major parties lie blatantly, and have failed to take action more than once.

And into this politically charged nation , comes nature's fury. Cyclone Phani ravaged parts of the country, killing some  and turning thousands homeless. Loss of life and property was minimal this time, but more details are sure to emerge.

The media is still actively churning out articles highlighting the incumbent party's multiple failures, the top two being demonitisation and GST. But this narrative is drowned by fake news running on social media. And the economy, is clearly slowing down.

We still have to wait till the end of the month to end this cacophony.

Please end. Soon.

Unhealthy country

I have been binge watching the second season of 'Laakhon mein Ek' on Prime over the long weekend. Never knew about it. Don't care about the first season. Its one of those new millenial online docu-drama series. This one places a young, extremely positive, and a little out-of-touch young student of medicine in the middle of a political imbroglio. I was hoping for a happy ending. Alas, like anything else Indian , this one too does not have any.

The sad reality is that the story in this series can never be tagged historic. It will be contemporary , even about 50 years from now. By the way things are going, hardly anything is going to improve. Therefore one can't say that the timing of such a story is relevant. Any Indian will be able to relate to this story, anytime.

Students of medicine in India have to undergo what is called 'rural service'. After 5 years of theory, and 1 year of internship, they have to serve 1 or 2 years working at remote hospitals or health centres deep inside Indian villages. Sometimes these places are in or near reserved forests, or up in the hilss, with no easy access or communication with the outside world. It is the exact opposite of a plush seat job, in an air conditioned clinic. The education is considered complete only after completion of this service, and is required to secure the degree. And this way, the system ensures that there is always a steady stream of young healthy energetic young doctors standing by to serve the section of population who are in most need of dependable health care.

The students hate it. The administration struggles with it. But milllions depend on it.

I have met my share of shady quacks and doctors deep in Indian villages. Have been very fortunate to escape the system. With the government providing the medicine, and them providing the hospitals and doctors, one would think it would all go along swimmingly. One could not be more wrong. The system corrupts everyone involved. And the patients are most affected.

Its pathetic. And there are thousands of stories of people trying to fight the system. Legally and otherwise.

And this is one of those attempts.

Violent Times

We live in strange, violent times. And nowhere is this more evident than on current news. This has lately caused me to intentionlally lose track of news from India. I wonder if India has always been like this, or is it because nowadays these kind of news gets reported more often ?

The number of domestic violences reported has spiked. From incidents of stalking, to confirmed cases of assault, leading to murder. Dissed lovers used to splash acid as revenge,  now they set their ex-partners on fire. Out in the daylight. Rising counts of sexual violence against minors. More rapes and murders being reported, specially from inner villages. Crime is rising, and democracy is decaying.

What is leading to these spikes in pre-meditated crimes ? Apart from a false sense of superioty by the preprator, it is lack of crime control. Lack of an efficient justice system. And lack of fear. The law in the country is so slow and backward, it takes decades for a court case to come ot conclusion. And the increasing bribery in the government does not help either.

One can only hope, foolishly, that humanity will come to its senses sooner, than later.

India in 2019, summarized

Over the years, I have seen all kinds of experts trying to summarize the political situation in India into a few minutes. And failed. This is a big year for India. And trying to explain it to an outsider is a futile attempt. Until I saw this.

Wait a lot more

It is February. The doomsday came, and went. Nothing happened. The Supreme court of India reserved its judgement on the matter of tradition vs constitution. Everyone who waited this far, well, will have to continue to wait for a concrete answer.

But that has not really stopped people. It is hilarious to see all the comments people post on social media to vent their anger. Specially on twitter where people use the same hashtag to debate opposing sides. By the way, why are people on twitter so angry ? Even without the all caps, its clear they are just using the platform to shout, angry at the way things have turned up.

Saving for posterity.

All the time and energy being wasted on these platforms, all for nothing. It does not matter what these individuals think. This is one of those topics only people in power or authority can decide. The timing could not have been worse. Being an election year, political parties are trying to appeal to people's sentiments , and manipulating their own stance for prospective votes.

These are uncharted waters. And no shore in sight.

Politricks

 

It is an election year in India. The hype and hoopla are building up. This will be a landmark election, or it could also all go down south.

Just get it over with now.

Small Victory

 

There is a blue wave small blue-ripple going through the US today. A small victory for the other side. While the senate remains with the Republicans, the Democrats have taken over the house of representatives.

Will this change anythign ? Hope so. Will have to wait and watch if the system really works, or was it broken permanently.

 

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.