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India’s Deficient Healthcare System: Is Public Healthcare the Only Model?
Must India model its healthcare system on the vastly inefficient and costly healthcare system of the West?
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he Euro-zone health system costs the tax-payer close to a trillion dollars (two-thirds of total healthcare expenditure paid by the State; total healthcare expenditure by EU is 10% of EU GDP, that is US$ 15 trillion). Ditto multiplied by two for the US. One trillion and two trillion for EU and US respectively.
As a result of high tobacco consumption, aging problem, China’s expenditure on healthcare is expected to be a trillion dollars by 2020, due to proposed expansion of facilities, coverage.
The combined population of the US and EU is about the 800 million – versus the 1200 million of India. Even if due to lower costs, India were to replicate the EU and US systems, the expenditure will be US$3 trillion. That is 50% more than the Indian GDP.
Simplistic?
Sure. But, if we are going to throw around billions and trillions that belong to taxpayers, why worry?
These systems will collapse – and when that happens, there will be plagues and epidemics across the West.
Remember that less than a 100 years ago, the flu-epidemic killed tens of millions in the West. Conservative estimates start at 2 crores, go to realistic estimates of 4 crores (40 million) and some estimates go beyond 5 crores (50 million). This depletion in population, coupled with WWI deaths toppled the West into the Great Depression, ten years later.
As John M. Barry, author of “The Great Influenza,” has observed, “Influenza killed more people in a year than the Black Death of the Middle Ages killed in a century; it killed more people in 24 weeks than AIDS has killed in 24 years.”
The State as the natural and logical answer to every social problem is uniquely modern extension of Desert Bloc model of governance. The confidence that media and academia project in this model has no relation to reality.
We have seen the collapse of Spain, Portugal as imperial powers, Britain is at a tipping point – and many expect Pax Americana to follow.
Why must India duplicate this vastly inefficient and costly healthcare system of the West, as this recent article in the FT suggests.
Western governments could haul New Delhi to the WTO dispute panel to challenge its patent law as non-compliant with global trade rules, generics executives’ and health activists’ bigger worry is that the EU, and eventually the US, will secure provisions in new free-trade deals. These provisions would give western drugmakers more tools to stop Indian generic rivals.
Western pharmaceutical companies counter that India’s real health crisis is not the price of a handful of patented drugs but of a government that has abdicated its responsibility to ensure decent healthcare for its citizens. India’s government spends less than 1.2 per cent of gross domestic product on healthcare.
Some western companies, led by GlaxoSmithKline, are trying tiered pricing strategies in India to reflect the extremes of its wealth and poverty. Merck Sharp and Dohme sells its patented diabetes drug Januvia in India for about $24 per month, 80 per cent lower than its global price.
Still, the cut-rate price for Januvia has not deterred Glenmark, an Indian generics firm, from making its own version, which it sells for 30 per cent less than the discounted price. Last month MSD tried unsuccessfully to get a court order stopping Glenmark from selling its medicine, and protracted litigation lies ahead.
“You can parachute free medicine across the country but that will not improve access because you don’t the health infrastructure,” says Mr Shahani. “You don’t have doctors, you don’t have nurses, you don’t have nursing homes and you don’t have diagnostics.”
Shortages of nurses and orderlies meant young doctors had to do menial tasks such as carrying laboratory samples or wheeling patients into the operating theatre.
The junior doctors say the public hospital is so overstretched – and poorly managed – that they have to make snap decisions on how to handle patients, as if processing the wounded from a battlefield.
“This government doesn’t want patients to die, so our major concern is to prevent death, but what about proper management after that?” asks Sameer Prabhakar, a doctor at Safdarjung. “A doctor seeing 100 patients a day won’t have time.”
Safdarjung’s problems resonate across India’s public health system, which is starved of funds. Clinics struggle to cope with the flow of patients who can spend days queueing to see a doctor, only to be told they will have to wait months for treatment – even for potentially fatal diseases such as cancer.
India has just six doctors and nine hospital beds for every 10,000 people, compared with 15 doctors and 38 beds in China, and 24 doctors and 30 beds in the US, according to UN data. “The biggest question is: why is the government not building more hospitals and opening more medical colleges?” says Dr Prabhakar.
The emergence of swish upmarket private hospitals catering to India’s rich and middle classes is exacerbating the strain on public hospitals, as doctors, nurses and other specialists are drawn to the higher salaries and better working conditions.
With India spending just 1.2 per cent of gross domestic product on health – compared with nearly 3 per cent in China – the problems will not be resolved easily. Many poor Indians go to unqualified quacks. Lower middle-class patients are driven to private hospitals they cannot afford, clocking up debt to pay for essential treatment.
Related Articles
- World economy in a tizzy, but Indian pharma flying high (thehindu.com)
- Should pharma MNCs be peeved? (rediff.com)
- India’s Solution To Drug Costs: Ignore Patents And Control Prices – Except For Home Grown Drugs (forbes.com)
- Fortis Healthcare to raise Rs 322 cr via IPP (news.in.msn.com)
Exporting disease, making a killing

How pharma lobby uses misuses money to subvert law, opinion and science!
Mental illnesses popular in the US, such as post-traumatic stress disorder (PTSD), anorexia and depression, in particular, are now spreading across the world with the speed of contagious diseases, says Watters, who went about investigating why this was happening although different cultures view mental illnesses through a complex prism of religious, scientific and social attitudes. In short, the West, primarily the US, has been homogenising the way the world goes mad.
Underlying this trend is the western assumption that human beings are innately fragile and should consider many common emotional experiences as illness that require professional intervention. There is also the dangerous assumption that certain types of events in a person’s life, such as being laid off, are certain to result in psychological trauma that requires psychiatric care and medication. Why is mental illness being globalised to such an alarming degree that different conceptions of the troubled mind in different cultures are being overridden by the dominant view and are fast vanishing? (via Exporting disease, making a killing).
View from a bridge
Many years ago, reading The Constant Gardener by John Le Carre, only confirmed suspicions and common knowledge about medical malpractices – at least in India. In the last 10-15 years, it has become commonplace for doctors to get beaten up at hospitals in India. Medical malpractice was, personally, never an issue as I have been off Western medicines for nearly 40 years.
But to see the exploitation, from a distance, by the combination of ‘doctor-pharma company’ is a study in nausea. Western medical system is the single biggest creator of disease! Apart from the cases of Japan-Paxil, Sri Lanka-PTSD-Pfizer, there is the well known case of how family planning activists misused quinacrine in India.
From being highly respected citizens, to being beaten up regularly is sad decline for the medical community.
But it had to happen.
Copenhagen Talks End With Agreement, But No Binding Deal – AlterNet

Too much money ... creating too much of maya
Environmental writer and activist Bill McKibben of 350.org voiced his disapproval. (and) summarized what Obama accomplished:
He formed a league of super-polluters, and would-be super-polluters. China, the U.S., and India don’t want anyone controlling their use of coal in any meaningful way.
QED
On Aug 14, 2009, a Quicktake post wondered if this entire climate change and global warming had something to do with coal-fired power plants.
This is too close to my dis-comfort zone
Bill McKibben’s peeve does prove that this is indeed the case.
Now, coal is the cheapest way to generate electricity. Looking at the shortfall in electricity, and Indian consumers’ ability to pay, coal is the answer.
To low costs, add the fact that India has coal reserves that will last for the next 100 years – at least. But, coal-generated electricity, will also makes India industrially competitive.
And we don’t want that, do we? Right, Billy Boy!
Inside Indian bedrooms
60years ago, an assault was made by foreign ‘observers’ into Indian bedrooms. Foreign ‘observers’
- Tied ‘development aid’ to India’s population control.
- Trained Indian ‘health workers’ to control India’s human reproductive behaviour.
- Paid for by Western Governments, soon after that, we had ‘health workers’ fanning out across the Indian country-side, conducting vasectomies /tubectomies on India’s (especially poor) population.

Is this the science we are talking about?
It did not matter then, who the ‘observers’ were – foreign or Indian. Neither does it matter now. What matters is someone’s monitoring. And I don’t like that at all.
Even if the monitors have brown skins (my liking for brown skin notwithstanding). Even if it comes with a recommendation from Nobel prize winner, Amartya Sen. How Indian power producers generate electricity is our business.
Getting a handle on the Indian economy is the second and related part of the agenda.
An agenda, I don’t like.
All that nice, fresh, white newsprint …
Wasted!
Just the amount of newsprint that has been devoted to climate change and global warming must have raised temperatures (going by the ‘warmers’ calculations and estimates) enough to make this debate of questionable value. To that add, the amount of gimmickry and media overdrive (through slick PR) that raises many doubts and questions.
Hush, boy! Do not even mention ‘scientific manipulation’.
Just look at the record.
The most prominent and vocal votary of Climate Change was Al Gore – who was promptly awarded the Nobel Prize. The recruitment of Maldives and the positioning of President Mohammed Nasheed was again a very slick operation. The underwater Maldives cabinet meeting had a interesting story.
Maldivian officials said the idea to hold the attention-grabbing underwater cabinet meeting came from President Mohamed Nasheed when he was asked by an activist group to support its “environmental day” action on October 24.
“The 350.org group asked if the Maldives can hold an underwater banner supporting environmental day,” an official from the president’s office said.
“The president thought for a while and then came up with the idea to have an underwater cabinet meeting.” (via Maldives cabinet rehearses underwater meeting).

Is this the problem?
Propping up Maldives as ‘fifth’ column was done over the last more than 20 years. Based on excellent PR and media management skills, the Maldives was the trojan horse loosed on the G77+Basic grouping.
350.org is rather well armed on the PR front – with a specific agency for South Asia itself. The PR agency for the Maldives Travel and Tourism Authority McCluskey International does seem to either bask in reflected glory – or is hinting at the authorship of this stunt. The Maldives climate change campaign seems to be headquarted in Britain also.
Been there and done that
The hallmark of the Maldives’ climate change campaign has been it slick PR. Dramatic statements, intriguing sound bites, the Maldives’ campaign was beyond the common bureaucratic ‘creature’ – much less a Maldives’ bureaucrat. This is consistent and in line with Al Gore’s media and public relations management – which won the PR agency, the campaign of the year award. And Al Gore the Nobel Prize.
All this is much like, how from the early 1950’s to the late eighties, the Western world created hysteria regarding ‘population explosion’ in India and China. Enormous pressures were brought onto the Chinese and Indian Governments to ‘control’ their populations.
Same game, different name! Doesn’t wash. Just like last time.
Related Posts
- Climate change – How India is falling for propaganda
- Climate Change at Copenhagen – Britain mounts a Trojan operation
- Indian cows were blamed for global warming!
- US Euro Clubs hobble Third Wold
- Climate head steps down over e-mail leak
- NASSCOM wakes after 15 months
- PR Stunts – The Maldives underwater meeting
Climate change – How India is falling for propaganda

Polluter cleans ... and Pollutor pays and gets away
I have been surprised by the number of reasonable Indians who have come to accept the proposition, advanced by equally reasonable but perhaps nationalistically-motivated Americans, that the acceptance of internationally-mandated restrictions on carbon emissions by India is in its own national interest. Some have even come to argue that India should actively seek a climate change treaty at the Copenhagen conference in December 2009.
If the big and largely rich emitters of today were to take mitigation in the immediate future seriously, they could achieve emission cuts commensurate with the recommendations of the Intergovernmental Panel on Climate Change (IPCC) without denying the poor in India (and Africa) the prospects of a humane existence. With abject poverty eliminated and electricity and water provided to all, India could join the mitigation effort by 2040. (via India and climate change talks).
Acquisitive Indian companies making US nervous?What if
The entire global warming debate is just a facade to keep up demand for oil from India and China. The opposition to coal fired power plants is to stop India and China from reducing the growth in oil consumption.
After all practically all of British GDP today is declining North Sea oil and British Petroleum. Apart from Chinese money, the other source of liquidity, which keeps the US afloat is petro-dollars. And, remember, US future is so closely linked to Arctic oil. If India and China were to reduce their reliance on oil, leading to a price collapse, the biggest losers will be the Anglo Saxon bloc.
Makes one think!

- India’s pharma exports
Three things…
First, many of the regulatory bodies are actually a US-Euro Club – to fool the world, with token actions and steps to demonstrate inclusion and fairness to the developing world.
And second, these token actions divert the attention of the developing world. For instance, World Bank list of banned entities were significantly, from two sectors - Software and Pharma. These are the two sectors where the US still has a lead – and the Indians are its biggest challengers. Generic pharma firms from India have become world beaters - and the Indian software companies have built up US$50 billion a year business, in less than 10 years. These 50 billion dollars have come out of (arguably) US pockets.
At least, the actions against Wipro and Nestor Pharma were pathetic excuses to ban a business – and no third party arbiter will uphold these actions.
Third, on January 9, Standard & Poor’s announced that Greece, Spain and Ireland were on review for a possible downgrade, indicating that a Euro-zone country could default. The cost of the US bailout is likely to exceed US$3 trillion. Current US budget deficit is likely to break all records and estimates.
Not so long ago …
In 1999, an employee of an auto-components manufacturer, Autolite, was arrested in France for trademarks and copyright infringement – based on a complaint by the car manufacturer PSA Puegeot Citroen. The French police, on similar complaints, arrested two other nationals, a Belgian and a Taiwanese woman also.
The Belgian was of course granted bail – and the Indian and the Taiwanese were denied bail - ‘The lawyers representing the Indian businessman offerred to deposit his passport and the sum of 100,000 French Francs claimed by Peugeot in the custody of the court as bailbond, pending the trial of the case on November 12′.
French court procedures took nearly 1 month and the Indian executive was finally granted bail after being in prison for 1 month. After two years of appeals and expensive litigation, the complaint was found to be without any merit – and dismissed.
When the North Pole greens over
More recently …
A shipment of medicines destined for Brazil, from India, was detained at Rotterdam. The Dutch Customs used a complaint from a local Dutch company, to detain this shipment, based on local patent laws. After a few months of ‘negotiations’, the shipment was sent back to India. An expert writes, what
‘EU is doing is using Council Regulation (EC) No. 1383/2003 to impound drugs that are suspected of violating patents registered in member-countries even if these are simply in transit. The regulations permit customs to hold these goods for a minimum of 10 working days while informing the patent holder of the seizure. The patent holder then applies to a civil court to initiate legal proceedings in order to prove that infringement has taken place.’
Whats the Quicktake
These seem like offensive actions from the EU and the US – to undermine their competitors and to bolster Euro-US businesses. It makes me doubt the Satyam saga. To carry the conspiracy theory thread forward, was there a Merrill Lynch-Ramlinga Raju ‘deal’?

'demmed' Indian cows
Modern day protectionism, huh?
This also furthers the importance of having non-Western bodies, which are sponsored by the Third World, which will regulate and govern international laws. To depend on the West, is to further dig the hole that the Third World finds itself in.
And in case you forget, remember that for some time Indian cows were blamed for global warming!
US Euro Clubs hobble Third Wold
Rich nations are using every forum available to step up intellectual property curbs on developing country exports. India needs to wake up.
… if a group of developed countries and their rights holders are successful in pushing through a clever initiative at the World Customs Organization (WCO) to lay down global norms and model laws for heightened protection of IP rights. Unsurprisingly, the majority of developing countries have been caught off guard by the move to push SECURE (Standards to be Employed by Customs for Uniform Rights Enforcement) … (as) they did not expect WCO to be looking at IP issues … SECURE was not a member-driven initiative but put together by the secretariat of the 174-member organisation based in Brussels. SECURE, says the WCO, will be a set of standards, procedures, and best practices to coordinate the “global effort to suppress all kind of IP rights infringements”. (via Latha Jishnu: Policy of encirclement).
This article goes onto mention how
1. That ‘rights holders are not obliged to provide adequate evidence to show that there is prima facie an infringement to initiate action.
2. Brazil, as usual, has been the rare developing country to be alert to the dangers posed by SECURE, and is the only one actively taking part in the SECURE working group discussions … Brazil along with Argentina, China, Cuba, Ecuador, and Uruguay has sent a report highly critical of the SECURE draft and also that it “departs from the member-driven nature that should guide the process.”
3. India is once again missing in action. Bureaucratic and political apathy have been characteristic of India’s approach to critical trade negotiations.
4. … more than a dozen initiatives by the US, EU and OECD which shift forums both horizontally and vertically to achieve their goals. Since voluntary agencies and developing countries are active in the WTO, WIPO, and WHO, these are no longer the arena for IP maximalists, she says.
Acquisitive Indian companies making US nervous?
Three things…
First, many of the regulatory bodies are actually a US-Euro Club – to fool the world, with token actions and steps to demonstrate inclusion and fairness of the developing world.
And second, these token actions divert the attention of the developing world. For instance, World Bank list of banned entities were significantly, from two sectors – Software and Pharma. These are the two sectors where the US still has a lead – and the Indians are its biggest challengers. Generic pharma firms from Indiahave become world beaters - and the Indian software companies have built up US$50 billion a year business, in less than 10 years. These 50 billion dollars have come out of US pockets.

India's pharma exports
At least, the actions against Wipro and Nestor Pharma were pathetic excuses to ban a business – and no third party arbiter will uphold these actions.
Third, on January 9, Standard & Poor’s announced that Greece, Spain and Ireland were on review for a possible downgrade, indicating that a Eurozone country could default.
The cost of the US bailout is likely to exceed US$3 trillion. Current US budget deficit
Not so long ago …
In 1999, an employee of an auto-components manufacturer, Autolite, was arrested in France for trademarks and copyright infringement – based on a complaint by the car manufacturer PSA Puegeot Citroen. The French police, on similar complaints, arrested two other nationals, a Belgian and a Taiwanese woman also.
The Belgian was of course granted bail – and the Indian and the Taiwanese were denied bail - ‘The lawyers representing the Indian businessman offerred to deposit his passport and the sum of 100,000 French Francs claimed by Peugeot in the custody of the court as bailbond, pending the trial of the case on November 12′.
French court procedures took nearly 1 month and the Indian executive was finally granted bail after being in prison for 1 month. After two years of appeals and expensive litigation, the complaint was found to be without any merit – and dismissed.
More recently …
A shipment of medicines destined for Brazil, from India, was detained at Rotterdam. The Dutch Customs used a complaint from a local Dutch company, to detain this shipment, based on local patent laws. After a few months of ‘negotiations’, the shipment was sent back to India. An expert writes, how
‘EU is doing is using Council Regulation (EC) No. 1383/2003 to impound drugs that are suspected of violating patents registered in member-countries even if these are simply in transit. The regulations permit customs to hold these goods for a minimum of 10 working days while informing the patent holder of the seizure. The patent holder then applies to a civil court to initiate legal proceedings in order to prove that infringement has taken place.’
Whats the Quicktake
These actions seem like offensive actions from the EU and the US – to undermine their competitors and to bolster Euro-US businesses. It makes me doubt the Satyam saga. To carry the conspiracy theory thread forward, was there a Merrill Lynch-Ramlinga Raju ‘deal’?
Modern day protectionism, huh?
This also furthers the importance of having non-Western bodies, which are sponsored by the Third World, which will regulate and govern international laws. To depend on the West, is to further dig the hole that the Third World finds itself in.










Exciting new series. From 1 Mar, 2010.