Wednesday, April 27, 2016

Away from battle of ballot, not from people

A few years ago, farmers in Andhra Pradesh declared a crop holiday. Farming became non-viable not only due to crop failures or natural calamities, but also, more tragically, due to market manipulations and non-remunerative prices. Even when there was a bumper crop, farmers were not able to break even. These forced them to go in for crop holiday, which shocked the society which rued the tragedy that befell the farmers.

Today, when Loksatta declared an ‘Election Holiday,’ friends and well-wishers are expressing the same sort of anguish, and many questions are raised in right earnest about the sagacity of this step. Loksatta believes in letter and spirit that while the party is above individuals, country’s interests are far more important than that of a party. Hence, in the present circumstances, this decision is inevitable. 

When dynastic succession, cronyism and nepotism are ruling the roost in the arena of Indian politics, Loksatta introduced a new political culture focusing on people’s involvement and empowerment. The Loksatta Movement which started in 1996-97 ushered in a new political lingo, which is embraced willy-nilly even by the traditional mainstream parties, albeit for sloganeering purpose, if not for real change for betterment.

It may not be out of place to recall how the Loksatta Movement started with a seemingly innocuous step to end malpractices at petrol stations.  This simple project saved the nation an estimated three lakh crores of rupees till date on the one hand, and, on the other, it made the consumers more aware of the potential power of participatory democratic action. 

The core philosophy underlying the vision of Loksatta, be it as a movement or a full-fledged political party, is absolutely the same. Loksatta and its founder Dr Jayaprakash Narayan had to work against many odds to build a viable organisational framework for the party without a sizeable cadre at the grass-roots level. When it came to fighting elections, it became impossible to fight against the brute power of money, muscle, liquor and freebie-based culture of the mainstream political parties. Loksatta could not get the expected 15-20% of the vote share.  

A question is posed by many whether this is a valid reason to declare an Election Holiday. Several opine that organisational lacunae should be rectified to get the desired results. Even if Loksatta were to build a wonderfully strong organisational framework, ground reality is not conducive to bring in the much desired change in the political ethos for some time to come.

Loksatta took a strong and well-thought out decision to distance itself from elections and work with like-minded people to achieve its cherished goals. The most immediate agenda of Loksatta 2.0 is: Decentralisation of power and devolution of funds to States and local bodies, taking care, at the same time, to keep national unity and integrity and the responsibilities of the Central government, intact; and reforms in education and health sectors on an urgent footing.

From Delhi to galli, there is no issue concerning the well-being of the people of India that is not addressed in-depth by Loksatta. Working simultaneously on all these aspects, Loksatta has decided to focus its immediate attention on education, health and devolution of power to States and local bodies. At the cost of sounding repetitious, it may be stated that even if Loksatta were to continue to fight in the arena of electoral process, the winds are not favourable. 

Though there are good people in all the mainstream political parties who want to put a stop to the rotten system of spending crores and crores in elections, they remain isolated and helpless. Loksatta can never compromise its core values either for personal aggrandisement or for short-term power.  

Loksatta’s definition of ‘real politic’ is to put in place a system in which every child gets an equal opportunity to develop its potential full well, without facing any discrimination because of  caste, gender, region, language, poverty and so on. This is the first and foremost goal of Loksatta and hence the decision to declare an Election Holiday. 

Loksatta’s motto ‘Antidote to bad politics is good politics and not no-politics’ is being accepted by more and more people, especially the youth. To some extent at least, it could kindle a hope in many hearts that politics can be a sacred vocation. It elevated the standards of public debate quite considerably.

It seeks the blessings of people for its decision to declare an Election Holiday and work for with a greater urgency to achieve decentralisation and devolution of power, and to reform health and education sectors, which will lead to empowerment of the most vulnerable sections of our society. 

Courtesy: The Hans India By Srinivas Kusampudi

Tuesday, April 26, 2016

ఉచిత వైద్యం ప్రజల హక్కు

NITI Aayog meet seeks reforms in public healthcare system

India’s public health system could be in for an overhaul if the government agrees to proposals on universal healthcare discussed at a meeting of the NITI Aayog, the think tank that has replaced the Planning Commission, on Monday.

The proposals call for outsourcing primary healthcare to private doctors and promoting competition between government and private hospitals at the secondary level, which involves services of medical specialists.

Access to healthcare for all Indians is possible through this model with a nominal increase in the health sector’s share of the Union budget if the Indian economy continues to grow 7-7.5% in the next few years.

The proposals, discussed at the at the NITI Aayog by the Hyderabad-based Foundation for Democratic Reforms (FDR) and the Mumbai-based non-governmental organization Loksatta Movement, were based on the experiences of the UK’s National Health Service, the government-run health programme.

The proposal recommends that all MBBS doctors in rural India should be trained as family physicians and be paid by the government for each patient they treat.

“Every area will have a select number of family doctors. Patients will have the choice to contact any of them as they will be paid by the government. Doctors’ merit will be based on the number of patients that they attract and will be promoted within the public health system accordingly,” said Surendra Srivastava, national president of the Loksatta Movement.

The primary health centres (PHCs) will carry out government initiatives such as immunization and provide laboratory services and free medicines.

This is a radical shift from the current system where the government funds pays salaries to physicians and specialists only in the PHCs.

At the secondary level, choice and competition are seen as the most cost-effective options. Community health centres and private nursing homes will both be offered incentives by the government for efficient treatment and whoever provides better services will get a more attractive compensation.

In the current system, the government is responsible for strengthening only district hospitals. It pays private doctors only when a public-private partnership (PPP) is announced for specific services such as institutional deliveries.

“At the tertiary level, we believe a mix of AIIMS (All India Institute of Medical Sciences)-like institutions and low-cost private models such as Sankara Nethralaya, Chennai, and Narayana Hrudayalaya should be promoted. Corporate hospitals with high-cost treatment should not be promoted,” said Srivastava.

This, too, is a radical shift because the model discourages any relationship between corporate hospitals and the government, which is the norm currently.

Most joint ventures and PPPs for tertiary care exist between the government and corporate hospitals, in addition to them being on the list of empanelled hospitals for government employees.

The proposal estimates that if the said model is put in place, primary and preventive healthcare would cost Rs.80,000 crore-1.2 trillion per year by the year 2022. Secondary care will cost Rs.40,000 crore, while tertiary care will cost Rs.93,000 crore, making it a total of Rs.2.18-2.53 trillion. Assuming a cost escalation of 50%, the amount needed will be Rs.3.27 -3.80 trillion.

“If India’s real growth rate continues to be 7% and nominal growth 11%, the country’s gross domestic product (GDP) will be Rs.240 trillion. Through our model, universal health care will be achieved by spending 1.67% of GDP,” said Jayaprakash Narayan, general secretary, FDR. Currently, India spends approximately 1.3% of GDP on the health sector.

“The officials at NITI Aayog were positive about the proposal made,” said Narayan, who was present at the meeting.

Although universal health care was a promise under the 12th Five Year Plan (2012-17), it has not taken off as the Union and state governments have not reached a consensus on the model it should be based on and the services it would offer.

The meeting at NITI Aayog is seen as beginning of a process of dialogue towards consensus.

Courtesy: Live Mint

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