Let us teach our young children in school that true science is learning from the workings of nature as our best teacher. Let us change our educational system from rote learning and memorizing to creative curiosity in every child where it is dormant
“Whosoever would be a man must be a non-conformist”— Ralph Waldo Emerson
Science is all about telling stories about how this wonderful wonder, nature, works. Each storyteller understands nature in his/her own way. Naturally, science will have differences of opinion and keeps changing from time to time. That which does not change does not qualify to be called science. Naturally, we have had our share of surprises as also misunderstandings. All this is fine. The Big Bang Theory, the Relativity Theory, Quantum Mechanics, as also many others that followed do have their share of misunderstandings in built into them as long as scientists just rely only on their five senses to study and understand this enigma, nature.
Medicine, which follows the natural sciences of physics, chemistry and biology has to, per force, have the same degree of uncertainties and possibly more, as the human body is a greater wonder than many the other aspects nature. Human mind seems to be unfathomable, at least, for the time being. Applying the faulty reductionist science to the dynamic chaotic human physiologic laws leads the medical world into the bottomless pit of misunderstanding resulting in human suffering, making our interventions worse than his/her disease. Our whole edifice, built on the concept of individual diseases and their treatment, seems to be getting torn apart.
Having said that, I must explain in simple terms the difference between the usual reductionist science that we use and the chaotic holistic science that nature follows. Let me simplify that without losing the essence. Let us say that one wants to know the taste of a nice chocolate. If one goes to analyse the chocolate for its contents as is done in reductionism, one comes up with sugar, cocoa, and milk as the main ingredients. Then we study the tastes of the three separately. If, in conclusion, we pronounce that the chocolate should taste like sugar, milk or cocoa, even a child, which has tasted chocolate in the past, will disagree. Similarly, while studying the effect of fresh garlic on human health one goes by studying its individual constituents like anti-oxidants and the SH group that gives its smell; one comes up with wrong conclusions. Just as chocolate tastes as a whole, garlic will be an effective drug only when eaten whole, that too after chewing in the mouth for the saliva to activate its vital action. The last two actions are called holistic actions vis-à-vis the reductionist ideas of tasting sugar as chocolate!
The hot topics in science today are the moon journey and stem cell research. Both these efforts are trying to bend nature’s laws to suit our convenience and not trying to understand nature. I shall avoid the moon journey for this article because of space constraints. Stem cell research has become a money-spinner. In fact, that is the bane of scientific research. Societal respect for science seems to depend on the quantum of grant money that one gets. Knowing how one gets these grants, etc, I need not tell the readers that only those that know the ropes do get those grants. Lesser mortals who are not in the loop might find it hard to get in. Research institutes, coming up like mushrooms all over the country, are vying with one another to get into to either AIDS or stem cell research, where plenty of research funds are available.
One could manipulate the stem cells in vitro in any way one likes but, when they are inside the human body they do not necessarily follow what the scientists want them to do. They might have their own compulsions of holism to do what they do depending on the environment. In short, there are innumerable imponderables inside the human body that we are not able to account for and manipulate from outside. The same holds good for genetic engineering. One could do anything in vitro to engineer the genes but once inside the system gene penetrance depends on the environment to a great extent! I wonder why people do not talk about the audits on the outcomes of the first trials of genetic engineering in patients with leukaemia. What matters at the end of the day is healing outcomes, as all our “so-called” science is to help patients in distress. Predicting the unpredictable outcomes based on our reductionist thinking is akin to giving respectability to astrological predictions.
The million dollar question is: could we learn from nature about the working of such cells which are pluri-potent in nature. My good friend, Bart Flick, a noted orthopod at the University of Georgia, could answer at least a part of this question along with another great researcher, Professor Rustum Roy at Penn. State. Bart was lucky to have had training under that great electric man of medicine, Robert Becker in New York University in the 1950s. Whereas a household salamander could re-grow its cut tail in a few days, a frog or you and I can not do that! Why does this happen? How could the salamander, a less evolved animal, do that while higher evolution comes in the way? It reminds me of how snakes can suck their myocardial blood directly from the ventricles through small holes in the endocardium that spread the blood through fine meshwork of vessels all over, while we, the higher evolved creatures, need a separate circulation—the coronary tree, which seems to be the best business where we claim to improve their blood supply with our interventions (going in between with malice)!
Silver is a great healer of human ills from “times out of mind” in Indian Ayurveda. Rustum Roy could get nano-silver particles in water to heal many ills. Bart did similar experiments on wound healing. In place of the conventional dressing, Bart dressed wounds with silver mesh that got a small current from a DC source. The latter might do two things: a) it might get the silver deposited as nano-particles on the wound thereby avoiding any infection, and b) also reverse the cell wall polarity at the cut ends for the cells to grow. The wounds heal! He has even healed fingers with the terminal digit cut off to re-grow to full fingers with finger nails and fingerprints! That is not my story today. Bart did something wonderful which tickled me. He learnt a great lesson from nature as a bonus!
He was fascinated to see some gelatinous glistening debris on the healing wounds stuck to the inside of the silver mesh. He cleverly sent the material to the laboratory without telling them where it came from! Lo and behold, the report said that it was from the bone marrow with many blast (mother) cells that are pluri-potent. I understand that as a great lesson that nature had to teach us, but we did not learn up until Bart came up with his innovations. If the environment is created that is conducive, nature can produce pluri-potent cells (akin to stem cells) at the site, without our expensive stem cell research, to repair the cuts without any effort on our part. This is called observational research and learning science from nature. This is not trying to teach nature a lesson or two as our moon voyagers and stem cell researchers are trying to do and achieve the impossible with their grants. I do not think Bart got any grant for this serendipitous research outcome. I strongly feel that this kind of research of carefully observing nature as to how it tries to keep man (or any other creation) alive on this planet deserves the best Nobel Prize.
Field energy could stimulate the ischemic myocardium to re-grow new perforating vessels to relieve anginal pains as also to increase the left ventricular ejection fraction. My friend, Glen Gordon, who invented this simple device was himself a patient waiting for a heart transplant after a massive heart attack from which he survived by the skin of his teeth. His ingenuity from his dying bed did the trick and made him walk out of the hospital with his own heart remodelled to bicycle through half of the United States to convince his doctors at Mayo Clinic that he was alive and kicking.
Click here to access other articles by Prof BM Hegde.
Let us teach our brilliant scientists, our young children in school, that true science is learning from the workings of nature as our best teacher. Let us change our educational system from rota learning and memorizing to creative curiosity in every child where it is dormant. Every new born child is but a genius waiting to be allowed to blossom. (e=out, ducare=deliver). Let not their schooling come in the way of their education! While a good teacher teaches, a better teacher preaches, the best teacher reaches the child’s heart! Thank God for giving me such great friends like Rustum Roy, Bart Flick and Glen Gordon.
“Consistency is the last refuge of the unimaginative”—Oscar Wilde.
(Professor Dr BM Hegde, a Padma Bhushan awardee in 2010, is an MD, PhD, FRCP (London, Edinburgh, Glasgow & Dublin), FACC and FAMS. He is also Editor-in-Chief of the Journal of the Science of Healing Outcomes, Chairman of the State Health Society's Expert Committee, Govt of Bihar, Patna. He is former Vice Chancellor of Manipal University at Mangalore and former professor for Cardiology of the Middlesex Hospital Medical School, University of London.)
The Indian sugar industry is once again in the spotlight despite higher sugar production as losses mount due to higher imports, especially from Pakistan
The misery and woes of the Indian sugar industry continues as the industry is facing fresh losses despite record production. This puts the spotlight on millions of farmers who make a livelihood growing sugarcane. A couple of years ago, India turned into a hotspot due to farmer suicides when majority of them took loans to sell their produce to make ends meet. This time, it is a bumper produce for sugar farmers and yet they are not able to sell their produce. This is worrying indeed.
For instance, it is estimated that losses faced by Uttar Pradesh (UP) sugar mills, India’s largest sugar producing state, are expected to be over Rs2,500 crore. The losses meant that more sugar mills would be forced to close down and put livelihood of thousands of workers and farmers at stake. In fact, according to Indian Sugar Mills Association (ISMA), the country is operating with 12 lesser number of sugar mills in comparison to last year. This may not be a big number, but it could be become bigger if losses continue.
P Ramababu, co-chairman, Confederation of Indian Industry (CII) Task Force on Sugar and chairman, Lakshya Strategic said, “In Uttar Pradesh, due to higher State Advised Price (SAP) of Rs280 per quintal, manufacturing cost of sugar is around Rs36,000 per tonne while the market price of sugar is around Rs32000 to Rs33000 per tonne, leading to a net loss of approx Rs4,000 per tone. The government should also consider that price of sugar has not increased so much in the last 10 years as compared to other food items whereas the production cost including raw material has increased drastically. Marginal rise in sugar prices would not affect the consumer so much as only 30% of the total production is used by housewives directly, whereas rest of the production goes to the bulk users. On an average, a family uses maximum 4-5 kg of sugar per month. A rise of even Rs 5 per kg would affect the family budget by Rs 25 only per month whereas it would help the millions of farmers. “
According to ISMA, lower realization from sugar sales, by Rs3.50 to Rs4 per kilogram, sugar mills in UP are facing upheaval task in clearing off the sugarcane dues, which is hovering around Rs2,987 crore, as arrears pile up, adding to the plight of farmers.
The sugar industry is one of the most government-controlled sectors in the country. One by one, the Indian government has been trying to deregulate the industry by removing shackles. One such measure was to address demand concerns. For instance, to address demand concerns in 2009, when there was massive shortage, the government slashed import duty to just 10% to facilitate imports. Unfortunately, this led to price arbitrage, as international sugar prices trended down and became cheaper in relative to Indian prices, which led to a flood of imports of raw and processed sugar into the country from abroad, mostly notably from neighboring country Pakistan. Now, Indian farmers are unable to sell cane to mills because the latter are unable to sell their produce in the market place. This has led to a glut in the sugar supply situation.
Raising the issue, Ajit Shriram, co-chairman, CII Task Force on Sugar and deputy managing director, DCM Shriram Consolidated said, “Indian sugar industry, one of the main drivers of country’s rural economy, is already suffering owing to excessive controls of the central and state governments, coupled with recent hikes in cane price across the country. Inexpensive import due to low import duty is adding to the heavy losses to the industry which may result into huge cane price arrears. Government should increase the import duty immediately from existing 10% to 30% or more to create a level playing field for the domestic industry”
According to the ISMA, till 15th January 2013, the country has produced 10.8 million tonne of sugar which is about 3% more than last year during same time when 10.5 million tons were produced. Total 507 sugar mills have crushed more than 113 million tonne of sugarcane with recovery percentages looking similar to last year.
P Ramababu, co-chairman, CII Task Force on Sugar and chairman, Lakshya Strategic said, “This year at least 24 million tonnes of sugar production is expected against the domestic demand of 22.5 million tones. Presently, due to imports of processed sugar from Pakistan and raw sugar mainly from Brazil, the industry in India is passing through a hard time to maintain its viability. The government should take immediate measures to curb the imports and save the domestic industry from losing its interest in the sector.”
No-claim-bonus for mediclaim or car insurance is given as an incentive for not making a claim. Car insurance NCB can be transferred to the new insurer. Resist the temptation to save on premium by faking the NCB while moving to a new insurer, else you will face problems when a genuine claim is filed
Amit Kumar (name changed) had a car insurance with Royal Sundaram in 2009-10 and 2010-11. There was one claim in each year. He says, “When I renewed it with HDFC ERGO in the third year (2011-12), I was told by the insurance agent, that he will give No-Claim-Bonus (NCB) and bring the insurance premium amount down. When I told him that I had made an insurance claim that year, he said, nothing to worry as I am switching the insurance company and he will manage it. So, I was offered a 20% NCB by the new insurer. Fortunately there was no accident in the third year. In the fourth year (2012-13), I purchased online insurance from Royal Sundaram. I was offered 25% NCB as there was no accident or claim in that year and also there was 20% NCB mentioned in my HDFC ERGO policy.”
Kumar met with a small accident in last week of Nov 2012 and was in for a shock. The Royal Sundaram executive called up after a good five days and told him that he had wrongly claimed NCB, for which he was not eligible from HDFC ERGO in his third year. HDFC ERGO had gone back and checked the claims made in prior years and unilaterally reduced his insurance tenure from 12 months to 10 months to adjust for the NCB claim. In effect, says Kumar, “My insurance with HDFC ERGO ended in August 2012 itself. After I made claim in December 2012, I was told by the Royal Sundaram executive that I had misrepresented the facts when buying online policy in October 2012.”
Clearly, Amit Kumar fell for a glib-talking sales agent who said he could fix the problem. However, on the face of it the fact is simple—Kumar knew he had claimed insurance and was still claiming a NCB. Remember, buying car insurance with fake NCB is as good as not having any insurance. You may be tempted to ask for NCB when changing your insurance company in the hope that the new insurer will not find out and that you get a clean slate going forward. After all, NCB can give up to 50% discount on Own Damage premium. But someone who is in the habit of claiming insurance almost every year ought to be even more careful.
Faking NCB is like washing away the sin of being involved in an accident. Today, insurers share far more data than they did in the past and it is easy to get caught. This is supposed to happen at the time of underwriting and not really when a claim is made, but don’t be surprised if insurance companies share data only when there is a claim.
The NCB rule is clear—“You can avail of the NCB facility if you change the insurer on renewal. You would have to produce proof of the NCB earned by way of renewal notice from the current insurer. Alternately, you can produce your original, expiring policy along with a certification that you have lodged no claims on the expiring policy. For this, the proof can be in the form of a renewal notice or a letter confirming the NCB entitlement from the previous insurer.”
Manipulation of NCB is a major cause of claims denial. Don’t get lured by agent to ‘fix’ your NCB and give good premium rates. The insurance company may just play dumb until there is a claim even though they should validate the NCB claimed by customer at underwriting. It is as though the insurance company is underwriting with understanding that they don’t have to pay the claim. Giving any amount of discounts in this case is still profitable for company. There cannot be anything more risk-free for the insurance company!
The customer is supposed to have signed the insurance contract in utmost good faith. Amit Kumar is clearly at fault, but does it completely absolve HDFC ERGO and Royal Sundaram? Did they do the necessary due diligence?
There are five points worth pondering –
• Do insurance companies really do underwriting or accept the NCB desired by the customer to make a quick sale?
• How did the HDFC ERGO agent manipulate the system? Did HDFC ERGO also mis-sell the policy?
• Did HDFC ERGO realise the misrepresentation and reduce the policy term from 12 to 10 months?
• If Amit Kumar (policyholder) knowingly misrepresented facts, what happens to the pending claim with Royal Sundaram and the status of existing insurance cover (2012-13)?
• Was Royal Sundaram aware that Amit Kumar availing 25% NCB (2012-13) was already insured by it in 2009-10 and 2010-11 and had claims in both the years?
Agents represent insurance company while brokers represent you. Brokers have more responsibility than agents in case of mis-selling. What are the steps taken by some brokers to ensure that NCB is not manipulated by their client? In the second part of the article we will talk about it and give current status of the case.