In no other democracy does the federal constitution impose a uniform structure, electoral system, and bureaucratic apparatus on states and local governments.
We need to allow each state to have its own model of governance, bureaucracy and local governments, but with firm safeguards.
The Union-state relationship has become one of the core issues ahead of the next general election. Part of the rhetoric is political hyperbole and electoral posturing, and it is sharpened by the Bharatiya Janata Party’s (BJP’s) continuing expansion of its political footprint, and its take-no-prisoners approach to electoral battles. However, this climate gives us an opportunity to examine our federalism beyond partisan politics. We are approaching the third phase of federalism since the founding of our republic.
The traumatic events surrounding the partition of India and fears of balkanization made our founding fathers opt for a highly centralized Union. States were given a well-defined legislative and executive jurisdiction in the Seventh Schedule of the Constitution. Institutions like the Finance Commission, Election Commission and Supreme Court were created to ensure some degree of fairness in dealing with the states. However, an appointed governor as head of state with discretionary powers, Article 356, the all-India services, Planning Commission, the introduction of licence-permit-quota-raj—all these eroded the states’ powers significantly. Habitual abuse of Union’s powers for partisan political gain, frequent dismissal of elected state governments, Union’s near complete control of public and private investments, excessive discretion of the Union in resource transfers, the internal emergency that made India a de facto unitary state, and mass dismissals of state governments in 1977 and 1980 led to serious friction.
In the second phase, powerful leaders like N.T. Rama Rao, Ramakrishna Hegde, Jyoti Basu, Biju Patnaik and M. Karunanidhi emerged to rally people around federalism and states’ rights. A series of developments—the S.R. Bommai case verdict (1994) making abuse of Article 356 largely a thing of the past, successive Finance Commission reports on resource transfer, end of licence raj, decline of discretionary public sector investments, rise of regional parties and abolition of Planning Commission—helped create a more balanced federal India. For example, according to revised estimates of 2017-18, half of the Union expenditure of around Rs22 trillion has been transferred to states. Of the total resource transfers, 69.4% is by Finance Commission devolution and grants, and the bulk of the rest is under centrally sponsored schemes. Indian federalism has matured quite a bit, and the states have far greater control of their economic and political management than in the earlier phase.
However, serious structural problems remain. States and local governments have responsibility for most of the things people need and expect from government on a daily basis—water supply, electricity, sanitation, drainage, police, courts, roads, traffic, schools, colleges, healthcare, and myriad public services. Our politics is centred around the states, and national verdicts are generally a mere aggregate of states’ verdicts. In all elections from panchayat to Parliament, people essentially vote for or against leaders and parties at state level, and punish them for failure to deliver. The national government is largely notional for most people most of the time. States exercise real power, and yet are severely constrained in delivering outcomes. In the first five decades after independence, federalism was eroded by the Union’s arbitrary and partisan exercise of power. Now, the Union government has much less discretion compared to the earlier period; and yet, states are severely constrained in fulfilling their obligations to people.
These fetters are no longer partisan political; they are structural and constitutional. A rigid, uniform political model imposed on all states and local governments disregarding local needs, a dysfunctional bureaucracy protected by Article 311, the generalist, all-purpose all-India services that do not bring specialized skills required to manage various services and enjoy a monopoly of all key public offices, the well-intentioned, but poorly drafted Part IX of the Constitution that created over-structured, under-powered local governments that failed to take root as the third tier of federalism, needless rigidity in Union legislation on subjects like education with resultant failure to improve outcomes despite vast expenditure, and the continuing archaic anachronistic role of nominated governors are making states and local governments dysfunctional.
The results of our governance failure are catastrophic. Despite our self-image, immense potential and many obvious strengths, our outcomes as a nation are far from satisfactory. Out of the 49 relatively large nations with gross domestic product (GDP) exceeding $200 billion, India ranks at near bottom on most indicators of basic amenities, infrastructure, education and healthcare, in the company of Pakistan, Bangladesh and Nigeria. Our people deserve more, and we as a nation have far greater potential unfulfilled. This calls for a more nuanced third phase of federalism while preserving and strengthening the nation’s unity and integrity, our constitutional freedoms, checks and balances and democratic accountability.
In no other democracy does the federal constitution impose a uniform structure, electoral system, and bureaucratic apparatus on states and local governments. Even in small unitary Britain, Scotland, Wales, Northern Ireland and London city have their own electoral systems different from the Westminster model. In the US, each of the 50 states have their own constitutions and structure of government. In Australia too, each of the six states and two self-governing territories have their own constitutions. In Germany, every Land (State) has its own constitution with the power and flexibility to design its own governance structure. In Canada, the 10 provinces have the right to decide on the electoral system, form of government and local governance structure.
The time has come for India to move to the third phase of federalism. Many of our states are larger than 90% of nations on earth. We need to allow each state to have its own model of governance, bureaucracy and local governments, but with firm safeguards to preserve national unity, separation of powers, fundamental rights and democratic accountability. The one-size-fits-all model cannot deliver the desired outcomes of prosperity, elimination of poverty and national greatness in a vast and diverse nation of 1.3 billion people. We need more flexible federalism, strengthening India’s unity and integrity, and allowing us to fulfil our potential.
Courtesy: Live Mint
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Showing posts with label LiveMint. Show all posts
Tuesday, March 20, 2018
Monday, December 5, 2016
More decentralization and more democracy
In India, for our size and diversity, we probably have the smallest number of final decision-makers—the prime minister, the chief ministers and occasionally the district magistrate or the Supreme Court.
India embraced universal franchise in a daring and unusual way. Until then, no other poor nation with no real experience of democratic institutions opted for universal franchise from its inception. It is a tribute to our leaders of the time that they successfully built functional democratic institutions. As a result, despite seemingly insurmountable obstacles, freedom has been preserved, peaceful transfer of power through the ballot has been institutionalized, a successful and mature federalism has evolved, unity has been strengthened in a complex, multi-ethnic, caste-ridden, multi-lingual society, and moderate economic progress has been witnessed.
However, we could have done a lot better. There is too much gap between our potential and our achievements, and relative to other comparable nations, we have fallen far behind. Some people tend to blame our failures on our democracy. They look at mighty China or successful Singapore or modern South Korea and lament that too much democracy and politics held us back.
They are wrong. There is no substitute to democracy, and the failings of democracy can only be overcome by more democracy, not extinguishing liberty.
Look at a residents’ welfare association: All households pay the maintenance cost (taxes), they expect commensurate services (security at the gate, proper parking, functioning elevator, regular water supply, decent internal roads, efficient drainages and sewerage and, in general, value for money), bring pressure to improve common amenities, elect competent people who can deliver, and hold to account the managing committee. In other words, clear links are established between vote and common benefits, maintenance costs (taxes) and services, and authority and accountability. Democracy works optimally and produces sensible outcomes.
It is said that the US has the largest number of final decision-makers; the sphere of authority may be limited, but it is finally subject to constitutional liberties. In India, for our size and diversity, we probably have the smallest number of final decision-makers—the prime minister, the chief ministers and occasionally the district magistrate or the Supreme Court. Such a centralized system in a democratic milieu is bound to be dysfunctional.
Every great accomplishment in India was a result of local or sectoral initiative and leadership, delegation of power and devolution of resources with accountability. Take the success of the Indian Space Research Organization, the milk revolution engineered by Verghese Kurien, the green revolution, the remarkably efficient conduct of elections, disaster relief, management of VIP visits or the many isolated successes of great innovators and public servants that serve as best practices for replication—all are products of horizontal or vertical delegation, local leadership, fusion of authority and accountability, and active and sustained participation of stakeholders.
Our lip sympathy for democratic decentralization has never reached full fruition. While states today are stronger and more autonomous in a federal polity than ever before, the governance structure of states is controlled by the Constitution with no local flexibility. In no other democracy does the federal Constitution dictate the manner of election of the executive or legislature and the structure of bureaucracy at state level, or the constitution of local governments.
While perfunctory efforts have been made to establish local governments, they only resulted in over-structured, underpowered, feeble and ineffective local governments. The state legislator and the senior bureaucrat have become arch enemies of local governments, feeling threatened by their rise. Even the otherwise impressive Finance Commission is only allocating paltry grants to local governments, and despite their constitutional status, there is no assured share of Union and state tax revenues to them.
There is no reason to have romantic notions about local politicians and bureaucrats. Rapacity, vote buying, corruption and incompetence are as pronounced at the local level as they are in larger tiers. The only answer is effective empowerment, devolution of adequate resources, and strong, independent local ombudsmen to enforce accountability. Only then will citizens value their vote, learn from their mistakes, pay the price for bad decisions and mature as real stakeholders in a democracy.
Decentralization is not merely for local governments; it extends to greater flexibility for states within the boundaries of constitutional freedoms and the unity and integrity of India, and the empowerment of all kinds of stakeholders from cooperatives to schools, local housing colonies to self-help groups.
Today, citizens often pay bribes for public services which are their right; our water, power, roads, drainage, education and healthcare are of appalling quality; most of our tax money is squandered and whoever is elected, there is no real perceptible change. Our leaders asked the British to leave on the ground that good government is no substitute to self-government. Today the struggle is between centralized, bad government and self-government. There is no contest.
Jayaprakash Narayan is the founder of the Lok Satta movement and Foundation for Democratic Reforms.
Published as part of a series on the book Liberalism in India: Past, Present and Future published recently by Centre for Civil Society. The book is a collection of essays written in honour of the late S.V. Raju.
India embraced universal franchise in a daring and unusual way. Until then, no other poor nation with no real experience of democratic institutions opted for universal franchise from its inception. It is a tribute to our leaders of the time that they successfully built functional democratic institutions. As a result, despite seemingly insurmountable obstacles, freedom has been preserved, peaceful transfer of power through the ballot has been institutionalized, a successful and mature federalism has evolved, unity has been strengthened in a complex, multi-ethnic, caste-ridden, multi-lingual society, and moderate economic progress has been witnessed.
However, we could have done a lot better. There is too much gap between our potential and our achievements, and relative to other comparable nations, we have fallen far behind. Some people tend to blame our failures on our democracy. They look at mighty China or successful Singapore or modern South Korea and lament that too much democracy and politics held us back.
They are wrong. There is no substitute to democracy, and the failings of democracy can only be overcome by more democracy, not extinguishing liberty.
Look at a residents’ welfare association: All households pay the maintenance cost (taxes), they expect commensurate services (security at the gate, proper parking, functioning elevator, regular water supply, decent internal roads, efficient drainages and sewerage and, in general, value for money), bring pressure to improve common amenities, elect competent people who can deliver, and hold to account the managing committee. In other words, clear links are established between vote and common benefits, maintenance costs (taxes) and services, and authority and accountability. Democracy works optimally and produces sensible outcomes.
It is said that the US has the largest number of final decision-makers; the sphere of authority may be limited, but it is finally subject to constitutional liberties. In India, for our size and diversity, we probably have the smallest number of final decision-makers—the prime minister, the chief ministers and occasionally the district magistrate or the Supreme Court. Such a centralized system in a democratic milieu is bound to be dysfunctional.
Every great accomplishment in India was a result of local or sectoral initiative and leadership, delegation of power and devolution of resources with accountability. Take the success of the Indian Space Research Organization, the milk revolution engineered by Verghese Kurien, the green revolution, the remarkably efficient conduct of elections, disaster relief, management of VIP visits or the many isolated successes of great innovators and public servants that serve as best practices for replication—all are products of horizontal or vertical delegation, local leadership, fusion of authority and accountability, and active and sustained participation of stakeholders.
Our lip sympathy for democratic decentralization has never reached full fruition. While states today are stronger and more autonomous in a federal polity than ever before, the governance structure of states is controlled by the Constitution with no local flexibility. In no other democracy does the federal Constitution dictate the manner of election of the executive or legislature and the structure of bureaucracy at state level, or the constitution of local governments.
While perfunctory efforts have been made to establish local governments, they only resulted in over-structured, underpowered, feeble and ineffective local governments. The state legislator and the senior bureaucrat have become arch enemies of local governments, feeling threatened by their rise. Even the otherwise impressive Finance Commission is only allocating paltry grants to local governments, and despite their constitutional status, there is no assured share of Union and state tax revenues to them.
There is no reason to have romantic notions about local politicians and bureaucrats. Rapacity, vote buying, corruption and incompetence are as pronounced at the local level as they are in larger tiers. The only answer is effective empowerment, devolution of adequate resources, and strong, independent local ombudsmen to enforce accountability. Only then will citizens value their vote, learn from their mistakes, pay the price for bad decisions and mature as real stakeholders in a democracy.
Decentralization is not merely for local governments; it extends to greater flexibility for states within the boundaries of constitutional freedoms and the unity and integrity of India, and the empowerment of all kinds of stakeholders from cooperatives to schools, local housing colonies to self-help groups.
Today, citizens often pay bribes for public services which are their right; our water, power, roads, drainage, education and healthcare are of appalling quality; most of our tax money is squandered and whoever is elected, there is no real perceptible change. Our leaders asked the British to leave on the ground that good government is no substitute to self-government. Today the struggle is between centralized, bad government and self-government. There is no contest.
Jayaprakash Narayan is the founder of the Lok Satta movement and Foundation for Democratic Reforms.
Published as part of a series on the book Liberalism in India: Past, Present and Future published recently by Centre for Civil Society. The book is a collection of essays written in honour of the late S.V. Raju.
Thursday, June 2, 2016
Telangana and Andhra Pradesh: Two states united by the same political culture
Telangana state was formed two years ago after decades of aspirations and political movements. As the two state governments of Andhra Pradesh and Telangana are nearing the middle of their first term, this is a good time to take stock of the political developments in both states.
The most happy feature of the past two years is the complete disappearance of the bitterness, animosity and polarization that marked the events leading up to the partition of the state. People in both states have realized that life goes on as usual irrespective of political drama and manufactured emotions. The leaders, too, deserve credit for this return of goodwill and bonhomie between the Telugu-speaking people of both states. In particular, Telangana chief minister K. Chandrashekar Rao played a crucial role in dousing the flames of parochialism and restoring amity among the people of both states.
The unhappy feature of the past two years is that both states are increasingly mired in a crass, monopolistic, feudal political culture, treating public office as personal fiefdom and exercising arbitrary, despotic power. The dominance of vote-buying and money power in Telugu politics has been well known for nearly two decades. But the one common feature of legislative politics in both states amply illustrates the completely amoral and cynical approach to public office. In both states, most of the elected opposition has been decimated with wholesale defections to the respective ruling parties. These defections are partly because of the private economic interests of the politicians who need government patronage to participate in plunder.
As election expenditure in both states has reached alarming proportions, with candidates for the assembly election often spending Rs.5-10 crore, and as the maintenance of a mercenary political infrastructure has become frightfully expensive, most legislators feel orphaned and helpless in opposition. The sole purpose of getting elected to the legislature is to have a direct or indirect role in the executive branch of the government. The job of a legislator has paradoxically very little to do with legislation and holding the government to account. It is the executive clout that enables massive corruption in contracts, transfers and postings, land allotments, allocation of natural resources, and extraction of tributes in police cases or private disputes.
As a result, there is a desperation to be with the ruling party in order to earn multiples of investment in electoral politics. The other factor promoting defections is the total disregard of elected governments to the rule of law, equity and fairness. By a variety of stratagems, the sections suspected to have voted for the opposition legislator and the constituencies electing opposition parties are denied equal access to many welfare or developmental programmes. Even the relatively public-spirited legislators not seeking earning opportunities through proximity to power feel compelled to defect in order to nurture their constituencies. As a result, in both states, there are wholesale defections with virtually no legislative opposition left.
The third feature of both states is a continuation of pre-2014 populism and policies. On the one hand, both states have fallen prey to reckless freebies and short-term populism at the cost of long-term public good; there is hardly any serious strategy to promote equity through quality education and healthcare. On the other hand, both states are also following pragmatic economic policies to boost private investment, vying with each other to attract entrepreneurs. This combination of populism with pragmatism is somewhat similar to many other states in contemporary India. But the real reform of deregulation, elimination of discretion and arbitrariness, fair competition for natural resources, bureaucratic accountability, efficient delivery of services and effective delegation and empowerment are either absent or glacially slow.
Finally, a brief mention must be made of Andhra Pradesh’s grievance against the centre in respect of the special status promised. The “special status” was a code for three outcomes: meeting the revenue deficit arising out of the partition of the state; assistance for infrastructure, institutions and a new capital city; and tax incentives for a definite period for new investments.
With the 14th Finance Commission awarding revenue deficit grant, and with assistance for many institutions, the capital city and the Polavaram project in the pipeline, the first two promises have been honoured. The tax incentives promise remains unfulfilled. The central government and Andhra Pradesh should act with wisdom and restraint to address the thorny issue in a complex federal system. A special provision can be made to provide tax incentives for investment in the two backward regions of Rayalaseema and north coastal Andhra Pradesh. One way to make it palatable is to identify 100 backward districts of India and give similar tax incentives to all of them for a finite period.
Either way, this thorny issue must be addressed with sensitivity and fairness before politics of grievance holds Andhra Pradesh in its grip, and leads to alienation and unrest.
Jayaprakash Narayan is the founder of Lok Satta movement and Foundation for Democratic Reforms.
Courtesy: Live Mint
The most happy feature of the past two years is the complete disappearance of the bitterness, animosity and polarization that marked the events leading up to the partition of the state. People in both states have realized that life goes on as usual irrespective of political drama and manufactured emotions. The leaders, too, deserve credit for this return of goodwill and bonhomie between the Telugu-speaking people of both states. In particular, Telangana chief minister K. Chandrashekar Rao played a crucial role in dousing the flames of parochialism and restoring amity among the people of both states.
The unhappy feature of the past two years is that both states are increasingly mired in a crass, monopolistic, feudal political culture, treating public office as personal fiefdom and exercising arbitrary, despotic power. The dominance of vote-buying and money power in Telugu politics has been well known for nearly two decades. But the one common feature of legislative politics in both states amply illustrates the completely amoral and cynical approach to public office. In both states, most of the elected opposition has been decimated with wholesale defections to the respective ruling parties. These defections are partly because of the private economic interests of the politicians who need government patronage to participate in plunder.
As election expenditure in both states has reached alarming proportions, with candidates for the assembly election often spending Rs.5-10 crore, and as the maintenance of a mercenary political infrastructure has become frightfully expensive, most legislators feel orphaned and helpless in opposition. The sole purpose of getting elected to the legislature is to have a direct or indirect role in the executive branch of the government. The job of a legislator has paradoxically very little to do with legislation and holding the government to account. It is the executive clout that enables massive corruption in contracts, transfers and postings, land allotments, allocation of natural resources, and extraction of tributes in police cases or private disputes.
As a result, there is a desperation to be with the ruling party in order to earn multiples of investment in electoral politics. The other factor promoting defections is the total disregard of elected governments to the rule of law, equity and fairness. By a variety of stratagems, the sections suspected to have voted for the opposition legislator and the constituencies electing opposition parties are denied equal access to many welfare or developmental programmes. Even the relatively public-spirited legislators not seeking earning opportunities through proximity to power feel compelled to defect in order to nurture their constituencies. As a result, in both states, there are wholesale defections with virtually no legislative opposition left.
The third feature of both states is a continuation of pre-2014 populism and policies. On the one hand, both states have fallen prey to reckless freebies and short-term populism at the cost of long-term public good; there is hardly any serious strategy to promote equity through quality education and healthcare. On the other hand, both states are also following pragmatic economic policies to boost private investment, vying with each other to attract entrepreneurs. This combination of populism with pragmatism is somewhat similar to many other states in contemporary India. But the real reform of deregulation, elimination of discretion and arbitrariness, fair competition for natural resources, bureaucratic accountability, efficient delivery of services and effective delegation and empowerment are either absent or glacially slow.
Finally, a brief mention must be made of Andhra Pradesh’s grievance against the centre in respect of the special status promised. The “special status” was a code for three outcomes: meeting the revenue deficit arising out of the partition of the state; assistance for infrastructure, institutions and a new capital city; and tax incentives for a definite period for new investments.
With the 14th Finance Commission awarding revenue deficit grant, and with assistance for many institutions, the capital city and the Polavaram project in the pipeline, the first two promises have been honoured. The tax incentives promise remains unfulfilled. The central government and Andhra Pradesh should act with wisdom and restraint to address the thorny issue in a complex federal system. A special provision can be made to provide tax incentives for investment in the two backward regions of Rayalaseema and north coastal Andhra Pradesh. One way to make it palatable is to identify 100 backward districts of India and give similar tax incentives to all of them for a finite period.
Either way, this thorny issue must be addressed with sensitivity and fairness before politics of grievance holds Andhra Pradesh in its grip, and leads to alienation and unrest.
Jayaprakash Narayan is the founder of Lok Satta movement and Foundation for Democratic Reforms.
Courtesy: Live Mint
Tuesday, April 26, 2016
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
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
Tuesday, June 2, 2015
Andhra’s partition, federalism and the future
Andhra Pradesh and Telangana are interdependent and complementary to each other. Drawing a line on a map does not have to lead to a disruption of the economy
- Dr. Jayaprakash Narayan
One year after the partition of Andhra Pradesh (AP) and the creation of Telangana state, the visceral passions and parochial polarization have subsided to some extent. Several states have been created after Independence; but the partition of Andhra Pradesh aroused the strongest passions on both sides, creating a surcharged atmosphere in all three regions of the state—Telangana, coastal Andhra and Rayalaseema. The first-ever division of a large non-Hindi linguistic state, and Telangana, containing the vibrant, large Hyderabad city being separated, have led to profound political, economic and psychological consequences. Hyderabad had a government surplus of Rs.13,000 crore per year, and residual AP feels obviously impoverished with the loss of the city.
But the greater issue of national importance is the manner of division. Until 2014, every state formation was by consensus—either by a universally acclaimed commission’s report (eg. States Reorganisation Commission), or a consensus in the state and a resolution in the state legislature seeking a partition of the state.
Political scientists regard non-extinguishability of a state as the key principle of federalism. If the boundaries of a state could be redrawn at will by the federal government without the state’s express consent, then the polity becomes a de-facto unitary one. The Andhra Pradesh legislative assembly adopted a resolution opposing the Andhra Pradesh Reorganisation Bill, 2013, reflecting the serious misgivings of the majority of the people of the state. Nevertheless, both the then ruling Congress and opposition BJP joined hands in Parliament to enact the law dividing the state.
Over the past 25 years, our federalism has matured significantly. A quasi-unitary nation evolved into a truly federal nation.
The partition of Andhra Pradesh without the state’s consent had the potential to undermine the very existence of states and destroy federalism as we knew it. Happily, the 2014 verdict in both AP and Telangana safeguards our federal polity. The decimation of the Congress in AP, and the rejection of both the Congress and the BJP in Telangana despite their claims of being instrumental in the formation of the new state ensured that no major party will indulge in reckless adventurism for short-term political gains in dealing with the complex and sensitive issue of formation of new states.
It is now almost certain that the earlier position of building a consensus in the state and obtaining its consent before redrawing its boundaries has been restored. But the creation of the new states was also an opportunity to rethink governance, correct past mistakes and chart out a new course. Here, the record in both states is mixed, thanks to the high propensity for centralization and arbitrariness displayed by the two chief ministers—K. Chandrasekhara Rao and N. Chandrababu Naidu.
In both states, governments deliberately indulged in partisan rhetoric calculated to rouse regional sentiments and score cheap political points. The Union government’s ineptness and passivity added to the woes of the people of both states.
The allotment of officers and staff has been acrimonious and prolonged, and is still not completed. On the management of irrigation projects—notably Srisailam and Nagarjunasagar on the Krishna river—there is heightened tension and rhetoric. In fact, the police of the two states fought a pitched battle in Nagarjunasagar, an unprecedented event in modern India. Even officials of all-India services have failed to exercise restraint and balance—cases are registered against each other, and officials often talked out of turn in public to play to the gallery or please their political masters.
What is more, both chief ministers have been in a reckless race for competitive populism, potentially undermining the future of their states. Free power, free rice, loan waivers, the highest ever rise in wages of government employees (45%), and a plethora of ‘gifts’ to people on every occasion at great cost to the exchequer and with no lasting wealth-creation have become endemic in both states.
Andhra Pradesh has special problems because of the loss of revenue as well as job opportunities on account of losing Hyderabad. The Union government gave a commitment to make special grants to help meet revenue deficits, and the 14th Finance Commission made a provision. But the Union government can only give grants to fill the gap arising out of a state’s partition, not to compensate for fiscal profligacy after the partition. Unless the state learns to exercise fiscal prudence, the resource crunch will worsen with time, and will retard the growth of a region with immense potential. Despite the loss of Hyderabad, AP has great advantages—a hunger for education, high-quality human resources, low birth rates, water and mineral resources, agricultural surplus, a culture of entrepreneurship and risk taking, and a long coastline.
However, the AP government is excessively focused on building the new capital Amaravathi as a mega city on par with Hyderabad. The needs of other regions are neglected. Administration is highly centralized with little devolution to local governments or various ministries.
Election expenditure in AP and Telangana are among the highest in India—Rs.5-10 crore per candidate for assembly and Rs.25-50 crore for Lok Sabha elections is common. As a result, massive retail corruption in transfers and postings, contracts and tenders, and land, sand and mining has become endemic. Caste polarization is deepening as parties, particularly in AP, shamelessly use politics as a means of caste domination, or mobilizing vote banks on caste lines. Both states are now witnessing dynastic politics and the rise of political fiefdoms.
However, all is not lost. Both states can compete in a healthy manner. Particularly, improving power distribution and management and infrastructure will help the whole region. In a region with tremendous demand for quality education and healthcare, a focus on quality outcomes in both sectors will unleash great energy and pave the way to prosperity.
Power and resources need to be devolved to local governments with adequate safeguards to enforce accountability. And at least a few steps to reduce the burden of corruption—a service guarantee law, citizens’ charters with penalties, strong, empowered Lokayukta and local ombudsmen—should be taken immediately.
AP and Telangana are interdependent and complementary to each other. Drawing a line on the political map does not have to lead to a disruption of the economy. Nor does a state border affect the liberties of all Indians. AP and Telangana have immense potential for growth, but parochial and power-centred politics must first give way to enlightened leadership.
Courtesy: Live Mint
- Dr. Jayaprakash Narayan
One year after the partition of Andhra Pradesh (AP) and the creation of Telangana state, the visceral passions and parochial polarization have subsided to some extent. Several states have been created after Independence; but the partition of Andhra Pradesh aroused the strongest passions on both sides, creating a surcharged atmosphere in all three regions of the state—Telangana, coastal Andhra and Rayalaseema. The first-ever division of a large non-Hindi linguistic state, and Telangana, containing the vibrant, large Hyderabad city being separated, have led to profound political, economic and psychological consequences. Hyderabad had a government surplus of Rs.13,000 crore per year, and residual AP feels obviously impoverished with the loss of the city.
But the greater issue of national importance is the manner of division. Until 2014, every state formation was by consensus—either by a universally acclaimed commission’s report (eg. States Reorganisation Commission), or a consensus in the state and a resolution in the state legislature seeking a partition of the state.
Political scientists regard non-extinguishability of a state as the key principle of federalism. If the boundaries of a state could be redrawn at will by the federal government without the state’s express consent, then the polity becomes a de-facto unitary one. The Andhra Pradesh legislative assembly adopted a resolution opposing the Andhra Pradesh Reorganisation Bill, 2013, reflecting the serious misgivings of the majority of the people of the state. Nevertheless, both the then ruling Congress and opposition BJP joined hands in Parliament to enact the law dividing the state.
Over the past 25 years, our federalism has matured significantly. A quasi-unitary nation evolved into a truly federal nation.
The partition of Andhra Pradesh without the state’s consent had the potential to undermine the very existence of states and destroy federalism as we knew it. Happily, the 2014 verdict in both AP and Telangana safeguards our federal polity. The decimation of the Congress in AP, and the rejection of both the Congress and the BJP in Telangana despite their claims of being instrumental in the formation of the new state ensured that no major party will indulge in reckless adventurism for short-term political gains in dealing with the complex and sensitive issue of formation of new states.
It is now almost certain that the earlier position of building a consensus in the state and obtaining its consent before redrawing its boundaries has been restored. But the creation of the new states was also an opportunity to rethink governance, correct past mistakes and chart out a new course. Here, the record in both states is mixed, thanks to the high propensity for centralization and arbitrariness displayed by the two chief ministers—K. Chandrasekhara Rao and N. Chandrababu Naidu.
In both states, governments deliberately indulged in partisan rhetoric calculated to rouse regional sentiments and score cheap political points. The Union government’s ineptness and passivity added to the woes of the people of both states.
The allotment of officers and staff has been acrimonious and prolonged, and is still not completed. On the management of irrigation projects—notably Srisailam and Nagarjunasagar on the Krishna river—there is heightened tension and rhetoric. In fact, the police of the two states fought a pitched battle in Nagarjunasagar, an unprecedented event in modern India. Even officials of all-India services have failed to exercise restraint and balance—cases are registered against each other, and officials often talked out of turn in public to play to the gallery or please their political masters.
What is more, both chief ministers have been in a reckless race for competitive populism, potentially undermining the future of their states. Free power, free rice, loan waivers, the highest ever rise in wages of government employees (45%), and a plethora of ‘gifts’ to people on every occasion at great cost to the exchequer and with no lasting wealth-creation have become endemic in both states.
Andhra Pradesh has special problems because of the loss of revenue as well as job opportunities on account of losing Hyderabad. The Union government gave a commitment to make special grants to help meet revenue deficits, and the 14th Finance Commission made a provision. But the Union government can only give grants to fill the gap arising out of a state’s partition, not to compensate for fiscal profligacy after the partition. Unless the state learns to exercise fiscal prudence, the resource crunch will worsen with time, and will retard the growth of a region with immense potential. Despite the loss of Hyderabad, AP has great advantages—a hunger for education, high-quality human resources, low birth rates, water and mineral resources, agricultural surplus, a culture of entrepreneurship and risk taking, and a long coastline.
However, the AP government is excessively focused on building the new capital Amaravathi as a mega city on par with Hyderabad. The needs of other regions are neglected. Administration is highly centralized with little devolution to local governments or various ministries.
Election expenditure in AP and Telangana are among the highest in India—Rs.5-10 crore per candidate for assembly and Rs.25-50 crore for Lok Sabha elections is common. As a result, massive retail corruption in transfers and postings, contracts and tenders, and land, sand and mining has become endemic. Caste polarization is deepening as parties, particularly in AP, shamelessly use politics as a means of caste domination, or mobilizing vote banks on caste lines. Both states are now witnessing dynastic politics and the rise of political fiefdoms.
However, all is not lost. Both states can compete in a healthy manner. Particularly, improving power distribution and management and infrastructure will help the whole region. In a region with tremendous demand for quality education and healthcare, a focus on quality outcomes in both sectors will unleash great energy and pave the way to prosperity.
Power and resources need to be devolved to local governments with adequate safeguards to enforce accountability. And at least a few steps to reduce the burden of corruption—a service guarantee law, citizens’ charters with penalties, strong, empowered Lokayukta and local ombudsmen—should be taken immediately.
AP and Telangana are interdependent and complementary to each other. Drawing a line on the political map does not have to lead to a disruption of the economy. Nor does a state border affect the liberties of all Indians. AP and Telangana have immense potential for growth, but parochial and power-centred politics must first give way to enlightened leadership.
Courtesy: Live Mint
Tuesday, September 6, 2011
Demographic dividend turning into a demographic nightmare
Jayaprakash Narayan, a doctor of medicine by training, left a 16-year career in public administration in 1996 and went on to start the Lok Satta (people’s power) movement to promote political reform and good governance. In 2006, he entered politics by founding the Lok Satta Party with a similar agenda. He became a member of the Andhra Pradesh assembly in 2009—in a campaign that was noteworthy for eschewing the use of money and liquor as incentives. In an interview, the 55-year-old activist-politician talks about the campaign against corruption led by Anna Hazare that captured the public imagination and issues related to Andhra Pradesh. Edited excerpts:
On the campaign against corruption and for the Jan Lokpal Bill:
The importance of what has happened in the past few weeks is not so much the law itself, but mobilizing the public, giving them a sense of confidence that they actually matter. That we can bring about change, we can persuade the political system to respond.
In a genuinely functioning democracy, there is no place for this kind of an effort; it should not be necessary in a sensible democracy. But having said that, we also have a very flawed democracy. Oftentimes it’s generally believed, I think with good reason, that persons in power don’t listen if we actually follow the straight and narrow approach... The last 20 years have seen a significant improvement in the economic conditions of a certain class of Indians. Young people and the middle class are now demanding improvements, which is the normal case in many countries once a nation reaches middle-income status. India is not yet a middle-income nation, but in the lower edge of the middle income...
What is impressive to me is the way Parliament has responded. The debate on 27 August—I really felt proud... The challenge now is how to channelize this energy constructively and creatively... How do you respect each other, agree to disagree, and find that middle path and find the reconciliation, and find a constitutional way of dealing with these challenges and a durable way of dealing with these challenges?
On the perceived trust deficit between a youthful society and the political class:
That kind of a judgemental approach is very unwise in democracy. This kind of a mistrust must give way to mutual respect. I am sure, if the youth are discerning, if they are not self-absorbed, they would have noticed that on 27 August, in the debate in Parliament, how maturely Parliament handled it. There was not one word of abuse or calumny... It took a lot of strength and character on their (parliamentarians’) part, across the (political) spectrum. They stuck to the job on hand. And if you don’t respect what the Parliament of India is capable of, the political process is capable of, if we view them as villains and ourselves as angels, that is an extremely short-sighted analysis.
On the perceived frittering away of gains by the United Progressive Alliance after back-to-back election victories in 2004 and 2009:
I think three things have gone wrong.
Firstly, a slew of massive scams. While everybody knew there was corruption—there is an elephant in the room; we all as a system, as a country, occasionally acknowledge the elephant, but generally we ignore it. Now the elephant is so pronounced, it is making so much noise that you can’t ignore it—the 2G spectrum (case), Commonwealth Games (corruption), Adarsh housing scam, (illegal) mining in Andhra Pradesh and Karnataka, could no longer be ignored.
Second is, probably they became complacent, also overly partisan. See, the party in power in democracy is not a monopoly. You have a duty to reach out. I think that effort was not there. A sense of triumphalism (set in) after the 2009 elections.
There is a third thing, in a fundamental sense there is a failure of communication. Even when the government is on occasion attempting to do some good things, they have not reached out to the country, they have not explained what they are doing or why they are doing them, they did not feel the obligation to. There is no real communication.
That probably would not have mattered 20 years ago. These (past) 20 years have been remarkable years in India. With the rise in telecommunications, 24-hour television—and even newspaper subscription has gone up in last 20 years—and of course, now we have the social media, mobile telephone, Internet, so on and so forth...
On the political situation in Andhra Pradesh, which has been rocked by dissidence in the ruling Congress party amid a campaign for the creation of a separate Telangana state and a probe into alleged corruption by rebel member of Parliament Y.S. Jagan Mohan Reddy, son of late chief minister Y.S. Rajasekhara Reddy:
One (problem) is vote-buying—a cynical, manipulative vote-buying with money and liquor. You see it in massive proportions in Karnataka, Andhra Pradesh and Tamil Nadu.
If that doesn’t work—because everyone is buying the vote anyway—there is competitive populism. Freebies are offered. If that doesn’t work, you have the politics of division. I hope it won’t work in the country for long—division on the basis of caste, region, religion, language and loyalty. If you see the political crisis of Andhra Pradesh, you can see elements of all these three...
On the agitation for Telangana, from which the Lok Satta Party has distanced itself:
The point is—if everything is about electoral success, not about the good of the people of Telangana, good of the people of Andhra Pradesh, good of the people of India, then we will have what we have had so far. Lok Satta is a party of the future... A party of the future must be able to reconcile conflicting interests. For me, politics is about three main things —promoting human happiness, reconciling limited resources and unlimited wants, reconciling conflicting interests...
On the Centre’s handling of the Telangana crisis:
It’s the government of India’s duty, apart from politics and which party is in power, to protect the Constitution and to ensure the unity and integrity of India. It’s their duty to reconcile conflicting interests... Instead, parties in power at the national level, just as parties in power at the state level, have used it as a cynical, manipulative political game, unconcerned about the consequences to the state and the country. Now the price is being paid. Now that you have created a hungry tiger, to dismount the tiger is a problem. How do you address this challenge?
You can resolve the issue by either dividing the state, but in a manner that interest (of other) areas are protected, or you can keep the state together, again in a manner that interest (of all) areas are protected. Unless you use this language of reconciliation, and common sense and reason, and be ready to pay the short-term political price in Andhra Pradesh, unless that political courage and wisdom are shown, we will always have a problem. Unfortunately, that political courage and wisdom is in short supply. To that extent, the government has totally failed.
On the roots of the Telangana movement:
There are deeper issues here. It may be Telangana here, something else somewhere else. Basically we have a growing number of young people, increasingly aspirational. They want a better life, entitlement of jobs. If our young people don’t aspire for a job, better standard of living, and want to live in poverty, it will be a shameful thing. Their families work hard, they get a degree, get education from some college, some school, and suddenly many of them discover that they are not employable. The demographic dividend is turning out to be demographic nightmare… We haven’t addressed these problems. We are busy with our political games and the street is now talking. And the street doesn’t talk the way you want it to. The street has its own momentum.
On the Andhra Pradesh economy:
There is an undermining of confidence, more than the real numbers, that may or may not tell the story of state. But the confidence is a little lower now; I think many enterprises in the state are not very aggressive about expansion, forget new investment… In the hard manufacturing sector or software sector, I don’t see much of a serious plan for expansion, because they feel already if I have money, why (expand) here? If I place an order with a company in Hyderabad, I don’t know if they supply in time. A prudent industry seeking raw materials, what will they do? I will go to some other more assured supplier. Ultimately, in business, money talks… Who is there to pat you on the back and give you some reassurance, confidence, inspire you, encourage you? That’s not really happening. Next, there is fear of violence. If one person is affected in one million, the rest of the one million people would identify themselves with that one person. But I would not like to also overstate this because we can recover quickly, and there are some good signs. For instance, government revenues have not dwindled significantly. That shows that economic vibrancy continues, even as we are not investing new capital and, therefore, we are not protecting the future.
Courtesy: Livemint.com
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