October 1, 2009


Just a couple of weeks back, some tens of thousands of American citizens got together to protest US President Barack Obama’s healthcare plans. Obama has been trying his best to expand health coverage for American citizens, at the same time also trying to arrest the ever increasing healthcare costs in the US. As per his plan, healthcare is going to adequately cover as many as 97% of the American population. Currently, it is estimated that around 46 million Americans do not have health cover and around 25 million of them are not adequately covered. Now, on the face of it, the plan looks fine; but what has agitated an average American is the very fact that this plan (of adequately covering 97% Americans under health insurance) calls for a budget of $600 billion, which would be mobilized through higher taxes. This element of higher taxes has antagonized the Americans, coupled with the fact that they do not want the government to interfere into health affairs. Such is the fury among Americans that Obama’s popularity has taken a severe beating on account of his health plan initiatives!

What is interesting is the fact that sitting in India, an average Indian might be wondering why Americans are going wild over their President? Agreed, as per Obama’s new plan, an average American has to pay more taxes; but then, even that should not annoy them. Simply because out here in India, even after paying taxes, there is absolutely nothing in the name of health cover that a citizen gets! That too considering that an average Indian is at least 20 times poorer than the average American. And mind you, here we are talking about averages, wherein the reality is that almost 400 million Indians do not even make two dollars a day! Although healthcare costs are relatively lesser in India as compared to the US, but then in income parity terms, it is much higher. As per reports, on an average, healthcare costs in India are around one fifth to one tenth that of America, which makes Indian healthcare even more expensive (almost double of that of an American in America) for an average Indian. Also, it is a known fact that there is almost nothing in the name of health insurance. Currently, an abysmal 10% of the population is covered under health insurance. On top of that, there are no records whether this 10% population is adequately insured or not. To put it on record, with respect to health insurance, India is the worst performer in the category of large nations. No wonder why an Indian wonders when an American protests!

This, coupled with the fact that public health infrastructure is too poor, forces most Indians to resort to private treatment even for curable ailments. It is estimated that on account of poor public health infrastructure, the out of pocket expenses as a percentage of total health expenditure is a staggering 80% for Indians. A few years back, the World Bank had reported that health expenses are the single reason of driving a majority of Indians towards poverty! In fact, it is a known fact that we need to increase our budgetary allocations on health; but then, what is even more perilous is the fact that whatever budgets are being allocated are going in to pay salaries of existing doctors and administrative staff. There is hardly anything left for creating infrastructure or provisioning insurance. And mind you, this is all tax money; and so there is no reason why an average Indian should be amused when an American protests.

And the final icing comes when the large private players of the healthcare sector do not abide by the mandated requirement of provisioning world class health facilities to poor, absolutely free of cost. It has been recently reported that of the 38 private hospitals in Delhi, 22 have not been adhering to the norm of providing free healthcare (OPD) facilities to 25% people who are poor. This against the backdrop that in 2007, the Delhi High Court had directed all the 38 private hospitals to provide free treatment, against which they had been granted prime land by the Delhi Development Authority or the Land and Development Office. And these are big names including Max, Fortis, Gangaram et al. In fact, as per some reports, hospitals like Moolchand and Rajiv Gandhi Cancer hospital have been outrightly refusing to treat the poor. And what is even more interesting is the fact that Apollo has been charged with a fine of a meagre Rs. 2 lakhs for not adhering to this norm! In fact, as per the ruling, 10% of the beds were to be allocated to the poor. And it is no secret that there is a blatant abuse of the same by these hospitals.

If this is the state of affairs in Delhi, one wonders how it would be in other parts of the country. All this leaves an average Indian, who is poor, wondering as to why an American protests when their President is trying his best to provision healthcare for all in lieu of a higher tax. For that Indian knows the fact that the concept called universal healthcare is still a farfetched dream for him!!



sunny said...

Yes i myself wonder because i belong to the same class who cant earn even a dollor daily. But the people who protested this plan were rich tax payers. I must tell you the poor of america could not protest the plan
you stated this matter well and exhibited your duty to convey matters to us . Thanks a lot

simranjeet kaur said...

the basic diference between the people in power here and in america, is there commitment towards there nation.which is hardly found here in our country.it really makes us wonder that country as developed as america is also working on its healthcare reforms wherein its average citizen is 20 times better than an average Indian citizen financially and ironically our country hardly takes such issues as passionately as building of memorials,where in huge amount of money is spent(wasted).
its hard to understand why this money cant be used for building better infrastructure and dealing with other health issues.
as a citizen of India i want to ask people sitting in power,even after paying huge amounts of taxes,dont we have the right to better health services?

V.V.S.A.TRIDEEP said...
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V.V.S.A.TRIDEEP said...

Well apart from Magazines, its great that you blog also very well Sir.Cheers to you for that..I am ur student from IIPM MUMBAI. These topics of discussions are often missed out in the media and are overshadowed by larger issues. My viewpoint to this blog is that the concern highlight is present across all sectors too where in the common man bears the brunt for a meagre of a result. Good blog Sir..

V.Muthuswami said...

When it comes to basic life needs - healthcare, food security, potable drinking water, human-shelter, basic education and a decent and dignified job commensurate with knowledge and skills: all these basic human survival needs are still dreams for over 40 per cent of Indians!
Comparing to available resources incl. huge tax collection, it is not difficult to understand the rulers we have inherited and their model of governance: it is all AIG - arrogance, incompetence and greed. So, there is nothing good available to "aam aadmi".
When are we fellow Indians going to realise that poverty is not inherited Karma, but manipulated and manifest inequity - pure and simple lack of human values "caring and sharing".
Can we hope the next generation (incl Rahul-baba)will come with some kind of "patriotic" genes and try to eliminate what I would call much of "remediable injustices".
Jai Ho!

MOHIT said...
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MOHIT said...

I liked the way you have narrated the story. I would like to share some facts with you and your (blog) readers - Barack Obama election Campaign was the best example of how one can lead users to the highest level of engagement by using social media. Now Mr. Obama not only has a political base, but he has built a database of millions of names of supporters who could be engaged almost instantly and he is doing just that using his http://barackobama.com site. I will be writing a blog post on this very soon on http://mohitvermablog.com.

Sri Naagu said...

u r very correct saying that the poor man in the country is not cared for. anyhow the govt these days started giving a thought over this issue during election campaigns. recently in AP Late YSR is back for the second term bcoz of his arogyasri prog., which is the health insurance to the rural poor. I have come across an article in which Dr devi prasad shetty of narayana hrudayala group came up with an excellent thought of providing free medical insurance to the poor at a low cost by the govt. , which was being implemented in karnataka. its really beneficial for the poor and the govt. such schemes may be implemented in other states too, if we want to see our country moving ahead in health care .

V.Muthuswami said...

Many may not agree 100% with Arundhati Ray, but her description of growing inequity in India will be very difficult to refute. The "old society has curdled and separated into a thin layer of thick cream - and a lot of (waste) water. The cream is India's market of many million (reckless) consumers (of cars, cell phones, computers, Valentine Day cards), the envy of international business. The water is of little consequence." Please understand that the socalled NREGA (now named in memory of Mahatma Gandhi), even when implemented faithfully and honestly, cannot lift these poorest of the poor from the bare minimum of USD 2 per day income. It is no excuse saying that our democracy is still young (at 60+!?), still to mature and become a perfect model of governance. Good citizens and those passionate about India can no longer believe in our brand of secular democracy - it is unfortunately a fake model window dressing for the world to admire, but empty inside of empathy and compassion for those who face daily life challenges of "remediable injustices". Just move 50 km out of any metros and you will not fail to see what I just described. As a retiree (with reasonable means of livelihood) I have committed to use a minimum of 1-3% of my annual pension income in helping to give a dignified life in their evening hours for the poor and needy in my neighbourhood old age homes. I am ashamed to be a law-abiding tax-paying citizen witnessing life manifesting itself with all the wrongs of our epic Mahabharata, displaying open envy, hate, guile prejudice, and revenge.

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Health care plans are broken down into two totally different classes of coverage; the indemnity healthcare plan sometimes called fee-for -service and also the more common managed health care plan. Both have their pluses and minuses, as you'll soon discover.

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