India Insight

Privatising public healthcare in India, one report at a time

Public health experts and activists are attacking a proposal by India’s leading government think tank that recommends handing many of the country’s healthcare responsibilities to the private sector.

The document, written by India’s Planning Commission, proposes eliminating the government as the primary healthcare provider. Instead, it would focus on specific areas such as immunisation and HIV testing. Getting rid of many of its other responsibilities would amount to a shortcut to its goal of universal healthcare. Patients would get private healthcare at a cost that the government would negotiate with the private sector, and service providers could be reimbursed for each medical prescription.

The proposal, which is similar to the managed care system in the United States, caused such a ruckus that some of the major parties who contributed to the plan have distanced themselves from it. Members of the High Level Expert Group set up by Prime Minister Manmohan Singh, say that the commission has distorted their recommendations.

“Planning Commissions’ document calls for a ‘managed healthcare’ approach where the role of the government is reduced from a provider to that of a manager,” said Rakhal Gaitonde, a public health researcher and state coordinator for the government’s National Rural Health Mission in Tamil Nadu.

“Expert group’s report only calls for strengthening and expansion of public health system, and contracting private players to fill the gap in areas where expansion is not possible,” said Rakhal. “The commission in its proposal has distorted the recommendations of the expert group by portraying managed care approach as the best possible solution.”

The document also proposes competition between public and private healthcare providers. But with the Indian government spending not more than 0.9 percent of its gross domestic product on healthcare — the least among the emerging market BRIC countries (Brazil, Russia, India and China) – there is not much hope that government facilities will survive the competition.

Public health activists fear that with the collapse of government hospitals, private players might form cartels. But some medical experts say that more private players could improve the quality of healthcare for poor people.

Public health experts and activists are attacking a proposal by India's leading government think tank that recommends handing many of the country's healthcare responsibilities to the private sector. Join Discussion

Northeast Indians in Bangalore: aliens in their own land?

Irshad Hussain makes light of it. “I’m pretending to be a Jew from Bihar. They would not know what to make of that,” said the 27-year-old Assamese man, who works in Bangalore. Behind his humorous tone lies the fear of attack.

Rumours have been circulating that people from northeast India who live in Bangalore — nearly 2,000 miles (3,000 kilometres) — to the south, are about to be attacked en masse. This is because of violence that flared between Bodo tribes and Bangladeshi Muslim immigrants in Assam in July.

About 75 people have been killed, and more than 400,000 people are crowded into filthy refugee camps. This fear was based largely on an August 11 protest organised by Muslim groups in Mumbai against the attacks.

Two people were killed and more than 50 injured in the protest. After that, the nearby city of Pune, known for its colleges, witnessed attacks against students and professionals from the Northeast as retaliation for the perceived violence against the Muslim community. It was people from Manipur, a state near Assam, who seemed to have borne the brunt of the attacks. Why?

The attackers apparently thought that Manipuris — many of whom have facial features that more closely resemble their neighbours in Myanmar and southeast Asia — were Assamese. In Bangalore, there is uneasiness among the many workers who have come to India’s information technology capital from the Northeast. Thousands of them have reportedly tried to flee the city, fearing violence against them.

On Wednesday, almost 6,000 people had booked tickets to Guwahati.”I am really scared seeing today’s newspapers,” said Deepa Medhi, 26, an Assamese woman who works at a public relations company in Bangalore.

“My parents (back home) are also scared, and are asking me to come (home) … As of now, I haven’t heard (of) any attack on (a) fellow northeasterner … I know it’s all rumours, but it’s better to play safe. You never know, riot and violence start from some minor spark.”

Irshad Hussain makes light of it. "I'm pretending to be a Jew from Bihar. They would not know what to make of that," said the 27-year-old Assamese man, who works in Bangalore. Behind his humorous tone lies the fear of attack. Join Discussion

To pity or not to pity Vijay Mallya

Picture this – You run an airline that never made a profit, you need to pay off $1.4 billion debt from who-knows-where and airports, taxmen and oil companies are pursuing you to get their money back.

You still believe you can turn the airline around. You still believe you will find a white knight who will buy into your carrier and help it back on its feet. You are giving your best to convince investors that your brand-value is still strong, you can still attract passengers – all you need is some hard cash immediately.

And then, suddenly, your airline is forced to cancel dozens of flights because your pilots want their salaries before you are allowed to run the airline, or even negotiate with investors to save their jobs.

It must be frustrating to be in that position. It must be difficult being Vijay Mallya.

“Why should I spend every day to keep our airline afloat if the actions of our own colleagues lead to loss of guest confidence and lower income by cancellation of flights or low load factors that result from uncertainty?” a frustrated Mallya wrote in a strongly worded letter to employees on Thursday, according to local media. “What is the confidence that I can give to investors who I am in dialogue with?”

His sheer frustration is understandable.

He is so furious that he asked employees to quit if they do not believe in the company – Kingfisher Airlines, a carrier that was Mallya’s prized possession, his status symbol and until recently the perfect reflection of his high-flying five-star image.

Picture this – You run an airline that never made a profit, you need to pay off $1.4 billion debt from who-knows-where and airports, taxmen and oil companies are pursuing you to get their money back. Join Discussion

from Breakingviews:

India begins the post-Mukherjee clear-up

By Jeff Glekin

The author is a Reuters Breakingviews columnist. The opinions expressed are his own.

Pranab Mukherjee’s reign as Indian finance minister was stained by economic meddling and political favouritism. Now he is gone, and some of his excesses are being reversed. An enemy has been pardoned and a friend has not received a plum job. This could be the beginning of a better era.

Imagine if Tim Geithner had been accused of putting pressure on the securities regulator to protect some political friends. The U.S. Treasury Secretary would be in serious hot water. But when the former number two at the Securities and Exchange Board of India (SEBI) accused Mukherjee of something similar – putting pressure on the SEBI chairman to “manage” some high-profile corporate cases – there was little attention.

Rather, in a move that was all too typical of the Mukherjee regime, the finance ministry countered with allegations against the whistle-blower, K.M. Abraham. But the post-Mukherjee government is different. Prime Minister Manmohan Singh has cleared Abraham.

In another development, the board of UTI, Asia’s oldest asset management company, is set to appoint a new chief executive. The position has been vacant for the past year and a half as the finance minister put pressure on the company, 26 percent owned by U.S. fund manager T. Rowe Price, to appoint the brother of one of Mukherjee’s most powerful advisors. The former political favourite, Jitesh Khosla, hasn’t made the new shortlist.

India’s new finance minister, P. Chidambaram, is also shaking up his own team. On Sunday he announced that the top officials in the revenue and expenditure departments would swap jobs. That seems to be a signal of a shift in the tax department’s priorities. It might pave the way for a reversal of Mukherjee’s damaging retrospective tax grabs.

The former Indian finance minister’s reign was stained by economic meddling and political favouritism. Now he is gone, and some of his excesses are being reversed. An enemy has been pardoned and a friend has not received a plum job. This could be the beginning of a better era. Join Discussion

Time to look beyond Rohit Sharma

Indian cricket has always been blamed for persisting with players on account of reputation — and in some cases experience. But the way Rohit Sharma, who currently lacks both, was handed game after game on the recently concluded tour of Sri Lanka shows a new trend emerging — one that of selecting players on the basis of “unrealised potential”.

Rohit may have it in him to succeed at the highest level but the Indian team management must decide how many is too many, for now at least, especially with Manoj Tiwary and Ajinkya Rahane waiting in the wings.

Rohit had a wretched run against Sri Lanka, scoring just 13 runs in five matches, the least by a recognised Indian batsman in a series of five matches or more. He was late on the ball, had his feet anchored to the crease — signs of a batsman short on form and confidence.

On the contrary, Tiwary, who just got two games, justified his selection by scoring a half-century in the fifth ODI. Rahane also got a game but failed to make a mark.

Rohit’s selection for the tour itself was a questionable call, with the batsman having passed the fifty mark only once in his last eight outings.

Last year, Rohit was outstanding against the West Indies — both home and away — leading many to believe that the right-hander has finally come of age, and more importantly it was his consistency that caught the eye.

But after eight months, self-doubt has engulfed him again.

Indian cricket has always been blamed for persisting with players on account of reputation -- and in some cases experience. But the way Rohit Sharma, who currently lacks both, was handed game after game on the recently concluded tour of Sri Lanka shows a new trend emerging -- one that of selecting players on the basis of "unrealised potential". Join Discussion

Why Team Anna’s political plunge deserves India’s vote

Members of Team Anna, the group whose anti-corruption mission last year became one of India’s biggest social movements, will form a political party to try to fix the system from the inside.

The move follows the group’s latest and perhaps least effective hunger strike in New Delhi to try to force the government into accepting their demand of creating an anti-corruption ombudsman post. Such a move looks unlikely at best.

With signs of agitation fatigue among the public and a government refusing to play ball, the movement led by Gandhian activist Anna Hazare has decided to provide a “political alternative”. Hazare on Monday officially disbanded the team to pave the way for the formation of this as yet unnamed party.

Panelists on TV debates accuse them of being naïve because Indian politics dictate that they will need huge sums of money (of which a substantial portion is “black money”) and vast political connections if they want to win elections.

Others say Team Anna has lost its moorings by changing course mid-way, with some volunteers quitting the movement and some even burning posters of Anna Hazare.

Eminent personalities who supported the movement, such as activist Medha Patkar and Justice Santosh Hegde, have misgivings about the move.

The risk of failure may be huge, but even the improbable vision of people voting en masse for someone running on an anti-corruption plank rather than on caste, community, subsidies and reservations is tempting.

Team Anna should not fear the unknown. If they play their cards right, they could change the political fabric of the country. Join Discussion

from Anooja Debnath:

In India, what goes up must keep going up

With a faltering economy, political gridlock, high interest rates, delayed monsoons and an epic power outage that has plunged half its 1.2 billion population into darkness, optimism is a sparse commodity in India.

Just not when it comes to rising house prices.

'What goes up a lot must keep going up' was the conclusion from the very first Reuters Indian housing market poll this week. And it sounded very familiar.

Past experience shows that respondents to housing market polls - whether they be independent analysts, mortgage brokers, chartered surveyors - tend to cling to an optimistic tone even as trouble clearly brews below the surface.

That was the case before the historic U.S. housing market crash that sent prices plummeting by more than a third and triggered the financial crisis. Five years later the market is still trying to find its footing.

Spin the globe over to South Asia.

India's two biggest cities, Mumbai and Delhi, have become prohibitively expensive for average people to purchase property without stretching themselves financially. Average Indian house prices have doubled over the past five years.

With a faltering economy, political gridlock, high interest rates, delayed monsoons and an epic power outage that has plunged half its 1.2 billion population into darkness, optimism is a sparse commodity in India. Just not when it comes to rising house prices. ‘What goes up a lot must keep going up’ was the conclusion from [...]

Join Discussion

from Photographers Blog:

Solar power nightlight

By Adnan Abidi

Near my house in Delhi at Deenu bhai’s tea stall, I noticed a very young visitor; 7-year-old Sohail. He was Deenu bhai's relative visiting him from Aligarh for the summer breaks. Before leaving for work, I enjoyed a cup of tea at Deenu bhai’s, and as usual, I was sipping a steaming hot cup of tea with a snack when I saw Sohail with a drawing book.

Hot summer mornings keep away a lot of lazy lads who otherwise are found gossiping at Deenu bhai’s place. I was finding no such company, so I asked Sohail what he’s been up to. He showed me a few landscape drawings, which were mostly village scenes with huts and animals, with the sun rising at a location painted in yellow.

GALLERY: SOLAR INDIA

I am no art critic, and couldn’t actually make out anything in those drawings. But I recalled my childhood days, and compared it with Sohail’s to figure out a similar thought process in both of our generations. Neither of us have ever imagined a typical Indian village scene during or after sundown.

I come from a village named Baharpur in the North Indian state of Uttar Pradesh and I recall we used to get up at 5a.m. and play until 4p.m. As darkness enveloped the entire village, oil lanterns were the only source of light. Join Discussion

from The Human Impact:

Prostitution: their bodies, their rights

It is seen as a job no woman would want to do. A job no woman would willingly do.

Yet, spending time in one of Asia’s largest red light districts gives a view of prostitution that jars with what many feminists, gender rights activists and, in fact, society in general believe.

The Sonagachi district – a labyrinth of narrow bustling lanes lined with tea and cigarette stalls, three-storey brothels, and beauty parlours – in the east Indian city of Kolkata raises eyebrows with many who know this place.

It is a place for “fallen women” or “potita” as they say in Bengali, the local language.

Here, heavily made-up women clad in bright saris stand outside dark doorways, leading up narrow staircases into small rooms furnished with just a bed and perhaps a television.

Earning an average of 15,000 rupees ($270) a month, living in often unhygienic conditions and having sex with random men who wander the alleys looking for “love” doesn’t sound like much of a job.

Asia’s largest red light districts offers a view of prostitution that jars with what many feminists believe Join Discussion

from Breakingviews:

India’s power vacuum needs to be filled

By Jeff Glekin

The author is a Reuters Breakingviews columnist. The opinions expressed are his own.

Perhaps Manmohan Singh and Sonia Gandhi got trapped in the Delhi metro yesterday. If the two leading Indian politicians were indeed victims of the world’s largest electricity blackout ever, they would at least have an excuse for their lack of public response to this clear sign of policy failure. Actually, there was a response, but it was not what might be expected. The power minister was promoted to Home Minister and replaced with a part time substitute.

The promotion was not really a reward for failure; it was part of a planned reshuffle prompted by the move of Pranab Mukherjee from finance minister to the ceremonial role of President. Mukherjee’s tenure in the finance ministry was basically disastrous. He overturned the Supreme Court’s tax ruling in the Vodafone case and tried to retrospectively tax foreign investors. And he appears to have pursued these policies without consulting Singh, the prime minister.

Mukherjee and Singh have been playing mutually destructive power politics for years. The former appointed the latter as Governor of the central bank almost three decades ago, and seems never to have accepted fully that Singh had become his boss. The strained relations between the two politicians were made even more debilitating by the murky role of Sonia Gandhi, who holds no public office but has inherited the leading role in the ruling Congress Party. As they say in New Delhi, Gandhi has power without responsibility and Singh has responsibility without power.

Actually, the new cabinet provides one reason for hope, the re-appointment of Palaniappan Chidambaram as finance minister. In his previous four-year tenure, from 2004, Chidambaram worked well with Singh – and GDP growth averaged about 9 percent. He’s likely to appoint a new team in the Finance Ministry including the highly respected Raghuram Rajan, the ex-chief economist of the International Monetary Fund.

Chidambaram and Singh have less than two years to go before the next election. They won’t find it easy to make India’s government more effective and deft. On the other hand, it will be hard to do much worse than it did on Tuesday.

You couldn’t make this up. As the country suffered from the largest blackout in history, the government promoted the power minister and replaced him with a part time substitute. Delhi badly needs to turn the economy around, but it suffers from a gigantic leadership deficit. Join Discussion