Economy
Governance deficit makes access to healthcare elusive
Access to healthcare is important in developing countries like India. This is because apart from treatment of ailments and diseases and the well-being of citizens, a productive population is the basis of economic growth.
 
Part IV of the Indian Constitution talks about the directive principles of state policy. Article 47 lists the "Duty of the state to raise the level of nutrition and the standard of living and to improve public health". Despite this, successive governments have not been able to cater to the nutrition and standards of living of a large section of citizens. There are four principal reasons for this.
 
First, the overall system seems inadequate to cater to India's vast population. For example, the total number of hospitals, public health centres (PHCs) and the private healthcare sector together seems inadequate to cater to the demand in spite of being big in absolute numbers. This is also true about healthcare professionals -- be they doctors or nurses or other professionals in the sector.
 
Together, the system is simply inadequate to cater to demand. The private healthcare sector has developed as the public healthcare system was overburdened and thus inefficient. Also, experts and policymakers have been contemplating solutions to look at healthcare from the "reduction in demand" perspective. This includes improving hygiene as well as the environment to prevent ailments and diseases. But despite efforts, the present system is inadequate for the demand that India has for healthcare services.
 
Second, the shortfall in healthcare infrastructure and healthcare demand arose due to funding constraints. Funding in the healthcare system is another issue, which results in low healthcare access. The healthcare expenditure as a percentage of GDP by the government is one of the lowest in the world. Here, another issue is the way funds are disbursed to the states and spent. Often the funds are delayed and this results in non-utilisation in critical schemes and programmes of the union and state governments. As a result, a majority of the people bear healthcare costs with high out-of-pocket spending, as insurance penetration is low.
 
Allied to the problem of government funding is the problem of up-skilling professionals and human resources in the sector, especially rural areas, as a major portion of funds are not utilised because there is a lack of skilled healthcare professionals.
 
Third, there seems to be the issue of governance deficit and regulatory capture. A lot of the problems arose because of too many laws and regulations impeding the normal development of the sector. For instance, for each segment of producers/institutions and care providers like doctors, equipment manufacturers, drugs and medicine producers and hospitals there are a host of laws and regulations which have traditionally inhibited access.
 
Thus, a large number of healthcare providers are today not formally recognised by the states. It is important to see what can be done to help them provide access which is both greater in number and more effective. The governance deficit arises with inefficiency and corruption being rife in both the public and the private sector.
 
Fourth is the issue of awareness and monitoring in the context of diseases as well as in terms of what needs to be done to eradicate them. A classic case in point in this regard is polio, which has been eradicated from the country. This was a result of awareness campaigns as well as active participation from people and all other stakeholders. Monitoring was also a regular feature of the effort to eradicate polio. But despite this, a large number of diseases still exist and are proliferating in India.
 
The problem is acute in India as it is one of the very few countries where both communicable and lifestyle diseases exist in such large numbers. The changing disease patterns also contribute to the challenge of healthcare access. The focus from the industry should be on innovating to find drugs that are able to cure most diseases prevalent in India.
 
Over the next few decades, all the stakeholders should work in a collaborative spirit to enable healthcare access to all people. Such an effort would lead to outcomes that would be in line with Article 47 of the directive principles of state policy.
 
Disclaimer: Information, facts or opinions expressed in this news article are presented as sourced from IANS and do not reflect views of Moneylife and hence Moneylife is not responsible or liable for the same. As a source and news provider, IANS is responsible for accuracy, completeness, suitability and validity of any information in this article.
  

 

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Will Piracy through Torrents Reduce?
In July, the US authorities arrested Artem Vaulin, the alleged boss of world’s biggest online piracy site, Kickass Torrents, which sent shockwaves among file-sharers. Vaulin is facing criminal charges, with the US accusing him of distributing illegally copied films, music and other content worth over $1 billion. While the action resulted in shutting down of several sites related with Kickass, more famously known as KAT among users, it lasted only for few days. According to media reports, about a dozen of the domains related with KAT are still active; but these do not contain useful torrents (read latest). Torrent users can still use The Pirate Bay and Extratorrents, in addition to several mirror sites of KAT, to download files from the Internet. However, beware; this activity is illegal in several countries, including India. Also, there is always a danger of downloading malware along with the file that may have disastrous consequences for you and your PC or laptop.
 
What exactly is a torrent? Or how does it work? As you may be aware, there are limitations like bandwidth that prevent us from downloading a file from a single location from the Internet. But the same file can be downloaded in parts from several locations, thus increasing download speed as well as reducing the load on the single file location on the server. For example, collecting Rs10,000 from one individual would be difficult task, but if you request 10 people for Rs1,000 each, you may find it easy to garner the required amount. 
 
This same principle is used in torrent file-sharing. The only difference is that there are protocols for sharing parts of the file from different locations and then making it into a single file for the end-users. For this, there are servers, like Torrentz, that track each peer (a user who is downloading or has downloaded the file). A torrent file does not contain the content to be distributed; it only contains information about those files, such as their names, sizes, folder structure, and cryptographic hash values for verifying file integrity. Depending on the context, a torrent may be the torrent file or the referenced content.
 
A torrent program, like BitTorrent or uTorrent, connects with this server and with peers after obtaining a list from the server. Based on the popularity of the file (for example, the latest movie), there may be thousands of peers (seeders—who will share parts of the file). The users, or downloaders, are called as leechers. When there are more seeders, you can download the file speedily. 
 
The splitting of files across several locations is the main reason why law enforcement agencies are finding it difficult to completely shut these file-sharing services. In 2014, The Pirate Bay was taken off for a while. It allowed piracy websites, search engines and torrent sites to grow many times. Shutting Kickass may also have a similar impact. 
 
So what is the solution? Two things need to work simultaneously so that we can reduce the instances of piracy and illegal sharing of software, movies and music. One is cost. The cost of authorised files for downloading needs to be reasonable. In fact, cost is the main factor for people to go for pirated versions of software and entertainment content. For entertainment content, over-the-top (OTT) and video-on-demand (VOD) players are trying to make an inroad, using the cost factor effectively. 
 
The second point is bandwidth speed. Despite huge claims by the service-providers and government, the common user is not at all happy with the Internet speed she receives. So, unless there is substantial improvement in Internet speed, downloading or viewing content online will not go up. This will continue to help pirates and torrent sites.

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Benjamin Rush and His Prophecy
“Unless we put medical freedom into our constitution, a day will come when medicine will organise itself into an undercover dictatorship. To restrict the art of healing to doctors and deny equal facility to others will constitute the Bastille of medical science. All such laws are un-American and despotic.” Benjamin Rush wrote this in 1776, but did not get enough support to enact this as law. The world is paying for that today as medicine has become the protector of drug companies’ interests against the hapless patient and his safety. 
 
The man on the street and even the educated lot blame the poor doctor who works at the frontline. He is the bad face of medicine. Some doctors might be greedy but the majority of them are honest and want to do good to patients. Poor chaps are brainwashed in medical school, to begin with. Little do they realise that the basis of their craft is faulty. Time-honoured Western dead sciences of physics and chemistry are used to explain the biological processes in a dynamic human system, which works as a whole, and as a part of this universe.
 
While the human system is a closed one with an in-built mechanism to correct most ills, the doctor is never taught this in medical school. S/he is taught to think that drugs and surgery are the panacea for all ills. Medical research is not interested in finding the root cause of many ills, while it spends all the time in drug discovery or vaccine manufacture. Natural remedies, of which there are thousands out there, are shunned by the medical establishment with all their might, as they cannot be patented to help one company and its shareholders. Potent chemicals in their sub-lethal doses are being pushed down the gullible patients’ throats. 
 
While chemicals could possibly help relieve symptoms, they can never heal. This is most dangerous in the field of mental illnesses. Whereas the human mind is not in the human brain, chemical psychiatric drugs act on the human brain producing two important side-effects—provoking suicidal tendencies and, eventually, resulting in dementia which is reaching almost an epidemic proportion. When we are confused, and are not sure of the cause of the symptoms, we suppress that with heavy dose of steroids. What on earth is its rationale?  Steroids have so many side-effects; some of them are even deadly!
 
There were more than 4.6 million visits to emergency services in the USA in 2009 alone, most of which are a result of legally prescribed drugs by the establishment. The unseen hand that makes the health workers—doctors, nurses and the rest—dance to their tunes, like the puppeteer, seems to be very powerful. They are neither seen by the patients nor do they let the truth about their intentions come to light. Unfortunately today, the medical establishment seems to be the leading cause of mortality and morbidity in the hospitals. 
 
Many surgical procedures have not had their proper audit before being let loose on poor patients. Many corporate hospitals survive on income from surgery, indicated or otherwise. English physician Thomas Sydenham’s advice—‘above all first do no harm’—primum non nocere—has been forgotten. The common saying, that a man becomes a patient when he sees a doctor, has now been stretched to man goes to heaven if admitted to the intensive care unit of a large corporate hospital! 
 
We need to educate the common man and demystify diseases so that the patient gets empowered to be a partner in his own management. The misinformation that one gets on the Internet is another enemy of man as most of that enhances his/her anxiety levels and makes them succumb to fear of death and disability. 
 
Last, and the most important, is the need to remodel medical education based and health and health preservation in place of diseases and drugs. Doctor should be trained to preserve the health of the people. The disease model of medical education, which starts with illness and ends with disease, is not healthy for society. The faulty science base of medical education needs a complete overhaul based on quantum world view and evolutionary systems biology.

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COMMENTS

kapil bajaj

3 months ago

I agree with Dr. Hegde.
Benjamin Rush's warning, in my opinion, implies cultural freedom because all human cultures have throughout history developed ways of maintaining health and alleviating and curing illnesses.
Then came Western imperialism and colonialism -- instigated and initiated by 'true religion' of Christianity -- in all its ethnocidal fury.
Communities and cultures across the world were brought to submission to the knowledge system imposed by the Western imperialists.
The entire world was divvied up into fake 'nation states' that have since continued with the ethnocidal framework of the West.
The Western-controlled complex of these 'nation states' that we call the 'world' continues to pulverize the autonomy of communities and cultures across the globe and replace it with the heteronomy of homogenised knowledge system of the Empire.
Only autonomous human cultures -- which the ethnocidal West militates against -- can evolve knowledge systems that take a holistic view of health.
The problem is that the ethnocidal West is now increasingly inside our blood stream and bone marrow.
Thanks to the Western-controlled complex of 'nation states,' the whole world has become the imperial West.
We are all the 'West' now!
Let's now kill whatever little remains of cultural freedom and wisdom on the face of the Earth!

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