Category: Global recession

High GDP but low GDP per capita – Time to give a public explanation – the Congress and the Opposition


If we see , India’s GDP is growing but the majority of the population is not prospering . Why ??

Let us consider this

The quarterly growth report card shows that Mining and Manufacturing contributed between 18-22 % of the GDP  in the Q 1 , 2010 numbers released last week.( Remember mining is concentrated in a few government PSU’s or some mining barons like Reddy’s of Karnataka etc )

Exports are roughly 13  % of the GDP

Agriculture contributes 20 % of the GDP  ( Supporting 60 + % of the population )

My view is that,  the decline in agriculture & growth in mining can be related directly to the growth of Naxalism , as one creates a naxalites and the other nurtures it !!

Rate of growth of yields per unit area in Agriculture  has fallen in:

Food grains from 3.39 % in 1992-93 to 1.39 % in 2001-02

Non-Food grains from 3.19 % to -0.57 %

According to the Economic survey between 1980-81- 2001-02 the capital formation in agriculture has fallen from 3.4 % to 1.3 %

FDI in Agriculture was never encouraged or focussed – Announcements does not matter Dr. Manmohan Singh ji ?

Between 2002-08, population growth has been 1.4 %  and the labour force has been growing at 1.9 %

According to the World Bank Development report

Between 1988 to 2008( 20 years ) as a percentage of GDP the :

Agriculture sector decreased from 30.5 % to 17.3 , whereas 65 % of the population depends on agriculture

Industry grew from 26.2 % to 28.8 % ( Population & people employable has been growing faster )

Manufacturing decreased from 16.2 % to 15.1 %

Services increased from 43.4 % to 54.6 % ( Private sector contributed to this )

Household final consumption expenditure decreased from 65.8 % to 54.1 %

Imports of goods and services increased  from 7.5 % to 28 %

Yesterday , in the Times of India , the Finance Ministry’s chief Economic Advisor said that GDP growth of 8.9 % in the Q 1 of 2010-11 was due to robust growth in capital goods and consumer good production

Does it not look like some Middle eastern countries , where the GDP is very high but GDP per capita is less,  as the high GDP is due to mineral oil wealth , and low GDP per capita is due to the fact that the oil wells are in the hands of a few royal families !! In India , Mining , Exports and trade is in a few hands and the focus , incentive and investment is maximum from the government !! For Agriculture , we all do not depend on the government but on the Rain Gods !!

BJP must act as a responsible opposition . The current state of affairs is not just a failure of the ruling front,  but of the entire opposition . Public demands an explanation from both !

What is government doing ? Bhopal Gas tragedy GOM’s is just an issue to divert the attention from real burning concerns of the public

Politicians are addressing 90 % urgent matters and 10 % important matters.

Time to act responsibly and explain or else both Congress and the opposition would be damned in the next election

Rajendra Pratap Gupta

Email: office@rajendragupta.in

Demystifying the Congress Report card


Clueless government

The 3G auction was expected to raise about Rs.32000.00 crore and it raised about Rs.69000.00 crore !! Normally , the statistical error is expected to be + or – 5 % , and that is the standard accepted level of error. If the government’s projections were left behind by a whopping 100 % , what do you call such a government ? Pranab da can rejoice , but not because of his colleagues or his planning !!

Same happens for inflation : Since the UPA government has taken over in May 2009, the inflation has touched double digits , Government talks like an astrologer that the inflation will come down in the next 6 months ( and this has been the talk for the last one year !! ). It does not tell why and how will the inflation come down ? Also, what is the government doing to bring the inflation down ? The government is heavily depending upon the divine intervention ( rain God’s ). When government launched the Maoist offensive , it was clueless that the entire battalion would be wiped off !! It just expressed its regrets !!

All this goof up when our PM is an Economist from Oxford, Home Minister from Harvard and Montek from World Bank  + we have a lot of professors from Cornell etc. ……………….All theory and no practicality !!

Education reforms : How many people in India actually use or even remember the knowledge of what they study from 10th class till their graduation ? I for sure , did not use my B.Sc degree ( except that for some weird reasons , since graduation was the basic requirement , i have done both the B.Sc and B.A. (Hon’s, Social Sciences ) and even M.A. Prev !! ). I talked to a good number of my ‘well placed’ friends, and they had the same response . That that qualifications did not matter or help them professionally . Majority of the Indian population study for the sake of getting degrees which finally , makes them either ‘highly qualified’ or ‘not with relevant experience’ category . We must look at mapping the ‘Knowledge gaps’ and ‘Skill gaps’ and then do the reforms in education . We are just manufacturing Degree holders and not creating any knowledge pool that has monetary value . Some degrees in graduation should be scrapped totally . We are wasting our time & killing our talent !! Time to understand what India needs ? In most of the company boards i sit , i find that my CEO / M.D. is not able to find the right ( competent ) talent at the lowest level for the job ? Because of this , all major companies lose out . On one side , we talk about unemployment and over a billion population , and on the other side , we are having acute shortage of skilled manpower ? Do we need educational reforms or ‘Skill development programs’ ? Countries like Finland , Israel etc with just a population between 5 to 7 million have more productivity per capita (PPC – sorry if you did not hear this word before !! I coined it in Indian  context ) than India . Unless , India addresses PPC in education reforms , churning out more degrees holders will just add to ‘Educated Naxalites’ in the next 5 years

Demystifying BPL or the Below Poverty line : According to Suresh Tendulkar committee report , poverty line for the rural areas is Rs. 15 and Rs. 19 in Urban areas. Whereas , according to Arjun Das Gupta , any one earning less than Rs. 20 per day falls below the poverty line ( Please correct me for my lack of knowledge ) What can you get in Rs. 20 per day per person ( Tea one cup Rs. 2 , Lunch Rs 10 , Tea evening Rs. 2 Dinner Rs. 10 ) This is the cheapest meal option ( Though ,i still have to find a stall that can serve you such cheap meals ).

Also , with this , i must highlight the following daily requirements:

1. Breakfast – 5 Rs.

2. Lunch – 10 Rs.

3. Evening tea and something to eat – 5 Rs.

4. Dinner – 10 Rs.

5. Clean water to drink , and taking care of the basic hygienic – 2 Rs.

6. Clothes to wear with washing Rs. 5 Per day ( atleast 1500 per year – two sets of an upper garment and an under garment and daily washing will need a minimum earning of Rs. 5 day )

7. Healthcare & Savings for unforeseen contingencies ( Rs. 5 per day )

8. Travel for going to take meals or get to work for earning the daily subsistence is not accounted for

9. Shelter to sleep, with bed sheet and seasonal clothing for winter and rain – 5 Rs / day

So, one needs atleast Rs. 37-50 per day to stay alive on the basics necessities of life On what basis the government calculates the PBL .

I think what C.K. Prahalad mentioned as the ‘Fortune at the bottom of pyramid ‘ , i will phrase it as ‘Unfortunate at the bottom of Pyramid’. The government’s basic responsibility is to create ‘Fortunate at the bottom of the pyramid, and than think of Fortunate and the fortune at the bottom of the Pyramid ‘

Our current Prime Minister is a typical case of good brand and poor performance !!

Time to think practically, and work more Dr.Singh  !!

Rajendra Pratap Gupta

Email: office@rajendragupta.in

from CSR to ISR


Thanks  Paritosh,

Keep up your good work. I hope that the article is as per your request on the issue of Naxalites . Though , i have covered other issues as well.

Here is what i want to do next . Your newsletter reaches out to 2 lac people . Let’s bounce this to them and build upon this

For a prosperous India – Fixing accountability is the biggest challenge and how we can address it

All the money that we pay as taxes is frolicked by these politicians without any questioning or accountability

Consider  these examples :

  1. Air India & Indian airlines ( NACIL ) will lose this year Rs. 4500 crore . Does the public realise that we will pay for these loses from our pocket as increased taxes on our fuel , service tax , property tax etc ? The parliamentary committee has asked the Ministry to pay for these loses as they have resulted from a wrong decision to merge these two incompatible airlines . Should we not sell it off to avoid thousands of Crores as loses ?
  2. BSNL will lose a lot of money this year . While all private telecom players are making money and some are even open to acquiring foreign telecom companies . Why is BSNL losing money ? What has the government done to make it profitable ?
  3. Dr. Manmohan Singh , Our ‘honest but inefficient’ PM & his team delayed the auction of the 3G spectrum by almost two years which would fetch our nation some Rs.30,000.00 crore. This delay caused our nation a loss of atleast Rs.6000.00 Crores . Now imagine that it was just an action of air waves with no hard infrastructure to be built in ? This year 8 new services were added in the budget to raise another Rs.3000 crore . We as citizens will pay newer and more taxes for the inefficiency of these leaders ? Who is responsible for this loss to the citizens ?
  4. 7 out of 11 major projects announced by Mamta Banerjee have been given to West Bengal . This is when it will take another five years to connect the nation by railways ? No one asked her to justify the reasoning behind such an allocation !!
  5. Last year , in the budget ,  the health minister announced National Urban Health Mission and allocated money for the same . This year , the project was shelved . Why was this announced in the first place ?  No one has questioned why it was shelved
  6. Austerity drive for the bureaucrats & political leaders is over . Now they can travel business class.  On what basis has this decision been taken when we are falling short of budgeted revenue by thousands of Crores ? Public does not realise that it is our hard earned money that is being wasted. Domestic travel is on an average an 2 hours flight . Why should business class be offered at all. Infact, it should only be Economy class
  7. Mayawati is installing statues from the money that people like you and me pay as taxes.
  8. All ministers spend the largesse in their home constituency , while they represent the nation . They are biased .  Why are they not questioned and removed ?

Now the question is , do these politicians realise that it is not their personal money ?

Most importantly , do the people know that directly or indirectly we are paying for all this  from our hard earned money ? It is the money we pay as taxes that goes in such spending .

Every minute a politicians remains in office and every inch he or she moves , is funded by our money . Why do we not hold them accountable ?

I think , we need to form a tax payers association and ask these reckless spenders on everything they do that is a loss to us ?

We are paying more for food , fuels and more taxes with every year passing by, but there is no improvement in our lives . Nation is plagued by ‘Powerful announcement and powerless execution’

We cannot take all this with our eyes open and mouths closed.

Let us initiate the ‘Tax Payers Association’ and create education , awareness about all these and fix the accountability . Let’s fix this inefficient and corrupt national leadership  . it is time to change ‘CSR – Corporate social responsibility ‘ into ISR – ‘Individual’s social responsibility’

It is our people, our money and our nation . Let’s not sleep anymore

I had discussions with Praveen Khandelwal, Secretary , CAIT – largest traders body with 5000 Supporting organizations and he is keen to take this idea further.

Let’s do it

Best regards

Rajendra

Growth, Recession & Realities


Dear Blog Readers,
Thanks for your continuous feedback .
I am attempting to address the issues that you have talked about .
Over the last few months, i have been reading a lot about inflation , double digit growth and so on………………..
We need to understand the real issues a little deeper and better if we wish to do something worthwhile for this nation
Consider the following :

A few decades back , government thought that nationalization was in the best interest of this nation and it nationalised the airlines , banks etc…….Now after a few decades , privatization is considered in the best interest of the nation !!!
The government was cursing the huge population in 80”s and termed it as  ‘Population Explosion’ . Now the government is talking of the demographic dividend , because everyone across the world is  talking about the same ! We are having the government that does not have original ideas but have copy cat versions or China inspired & induced growth !
What is the government doing to convert ‘No productivity jobs into low productivity jobs and finally into high productivity jobs’ Every district should focus on productivity  . People do not reason the government and never questions the actions and government even does not know if it is doing the right things .
Look at these facts

Between 2010 and 2020, India will add 120 million people in the ‘working age population’ . It will also add 43 Million senior citizens to its population . Does the  government have a concrete plan to address this ?
If we do not plan for 120 million people that we are adding to the working age population , we will be provoking between 10-30 % of them into naxalites or anti-social elements . Imagine , 12-36 million gun wielding naxalites !!
If there is no growth , it does not lead to poverty . It either leads to ill health  & evil minds . Which is more disastrous than poverty   In the next 10 years , some parts of India will become more developed than they are today. We will become a more materialistic nation in places like Mumbai , Goregaon , Bangalore , Pune etc…………….. Media would have exposed this ‘Have not’s’ to this material world .This will lead to aspirations in youth for a better life style, and with no means to make it to this elite league with legitimate means , the criminal route to making money will lead to more extortion , more drug lords and criminals in politics – GDP growth can be 8.5 % or 10 % but criminal activity will growth much faster under such conditions . There is no doubt on this . India will become a naxalite factory and will surpass Pakistan in producing anti-social elements
GDP attributable to agriculture is de-growing , GDP attributable to services and industry is growing . Agriculture not only supports 57 % of the work force & has low productivity per capita but has to feed the 1.2 Billion population else , we know the triple digit inflation that will strike India by 2050.
Agricultural productivity can go up if we bring down the cost of logistics from the current of 16 %. Worldwide , it is around 9  % …………. Government must plan in detail how to boost the agricultural productivity
We are treading a difficult path and the “demographic dividend will become a ‘demographic disaster’ or the ‘Demographic bomb’.

People with many educational degrees ( Indian experts from USA  recruited by the government as advisors ) are working for people with no degrees (poor population ) . So they do not identify the real problem leave alone addressing the issues . Recently , i have heard about the food coupons being distributed to the BPL families . What a joke ? BPL people do not know how to read and write & also this is bound to be misused ( 10 paisa of every 10 rupees will reach the BPL families )
Few fundamentals have to change .

India has not to change , Indians have to change .

Made in India has to become made in ‘rural India’

We are talking of CSR ( Corporate Social Responsibility ) but what we need is ISR –(Individual’s Social Responsibility )

We are all talking of divestment . The government is looking to raise Rs.40,000.00 crore through divestment but  why is government not looking at investing back 10 % of the divestment money to build another PSU that can yield returns disproportionate on its investments ? How about setting up the Solar Energy Corporation of India or the Hydro Power corporation of India ?  Build them now . Don’t just sell
Governments tax collection targets have been missed by around Rs. 40000 crore, i am sure that divestment target is also going to be missed !! Where will be the GDP deficit be in 2011-12 ?
Indian government has not just to create jobs ( employment ) but also create entrepreneurs . It has to think inside the box only ( forget out of box ). Imagine , if different cities with tourism potential start training tourist guides , taxi drivers and listing  them on a central website . People travelling to these towns can avail the services of the government approved guides at the pre-decided rates & can pay in advance through the website . The money can be transferred electronically directly to the service provider after a referral cut ( government can retail 20 % &  transfer 80 % money). Safety & savings for tourists and income for self employed people .
Back to my favourite recession & India :

Why did recession in the USA / Europe not affect India so much  Or you all believed that government was able to protect India from recession effectively ? Think about this report
Times of India , 17th March 2010. According to the WHO – UNICEF report ,58 % of all the people in the world who defecate in the open are in India . 638 Million people in India have no access to toilets . Will India, with such living conditions ever get effected by recession ? The same government could not control inflation . Imagine how they can control affects of recession – they faked the efforts and impacts and we all believed it like fools !
In 62 years after Independence , we have more than 60 % population having no access to ( toilets ) hygiene , 2/3rd of the population living in absolute poverty , 1/6th of the nation living in naxalites controlled areas . And we are already a “recession proof” India . Entire India has still not felt the impact of growth except a few urban towns , so recession hitting us is a joke ?
By the way , next few days will show India conquering the world as ‘ BHARTI is acquiring an African Telecom Giant’. Read all the headlines …………………………..
While you read these headlines , more than 50 % of India will go to sleep without a meal ………………………..
And also, according to the government , the austerity drive for Indian government  is over & our babu’s and politico’s can fly business class, so finally , India is out of recession & on a high growth phase
Rajendra Pratap Gupta
Email : Office@rajendragupta.org

Vscan – Please do not launch in India


Mr.V Raja,

President -South Asia – GE

Dear Mr. Raja,

Trust this finds you doing good.

This mail is regarding the Vscan product that GE is planning to launch in the Indian market .

I have been always appreciative of the latest technology that GE has brought to the Indian market and helped millions across the nation . GE , under your excellent leadership has also set up the PPP models that are a good start for our healthcare system

I have some serious reservations about this product Vscan & that i must share the concerns with your good selves . In fact , i believe that Vscan is an absolutely fantastic product for the rural masses and for physicians in general, if we are able to prevent the misuse of this wonderful piece of portable technology !!

I might be wrong in my assumption, but this is what i wish to share and humbly submit to your company – GE If Vscan can be used for Sex determination in a handy manner by unscrupulous doctors etc. It will adversely impact the use of this technology and go against the interest of the society .

I might be wrong in my assumptions on the capability of this beautiful device, but this is what i fear will happen and since the device is portable , it can be disastrous for the nation and the female births .

If the Vscan can identify the sex as in the case of the sonography machines , please do not launch the product in India

I hope that you will take this email in the right perspective and do the needful in the larger interest of the society as a responsible corporation

With best regards

Rajendra

Rajendra Pratap Gupta

President & Director

Disease Management Association of India

Mobile: India + 91 9223344542

Budget , Governance & Political leadership


Budget , Governance & Political leadership

Few important points :

Paridhi : Here is the answer on how budget could have been better: Besides ,there are many other points that i have covered based on queries from other Blog subscribers

1. If the budget was not just a statement of account or an announcement . All the investments should be related to quantifiable outcomes

2. What will 37 % investment in infrastructure lead to ? How many jobs ? How much time will it take ? Were there any other opportunities that can have a better ROD ( Return on decision ?? )
3. If the PSU will get divested , what is the return on Divestment (ROD ). When you divest, you are giving away profits to the investor forever . How much profit will we give away because of divestment ? one is the ROD ( Return on divestment ) or the cost of divestment ( COD ) over the next 10 years & the last is the Return on Opportunity loss ( ROOL ) .
4. Every year 3 % of the population ( 30 million ) go below the poverty line due to healthcare costs . Last year due to recession , at least 3 % more would have gone down below the poverty line + 1.55 % annual population growth rate adds another 15.5 million people to India every year . Where does the budget put in place these numbers and the plan to address the needs of additional 75.5 Million people ? . Can we call the current budget without such considerations & provisions an all-inclusive budget ?
5. Budget should also give an account of the last year’s budget versus achievement and also state how many plans have been shelved and what is the amount that has been unused by the various departments . So that we can ensure the sanctity of the budget and the accountability of the people at the helm of affairs
6. On one side we are talking of revenue / budget deficit , on the other side , we have given a 30 year tax holiday to SEZ ? What is the logic ?
7. Over Rs.6 Lac crore worth of Black money is lying in the banks . Government should promise the people that the money will be brought back to the country in the next few years . This should actually cover the revenue deficit
8. The current budget is provoking budget for Naxalites . Naxalites strives on poverty and poverty thrives on poor governance
9. If the government wants to increase spending for employment generation , it must pass a rule that from 2015, any company bidding for government tenders should have a manufacturing base in India to cater to 50 % of the delivery of products and services
from its Indian company . This will fuel large-scale investments and generate phenomenal employment opportunities .
10. The budget must have allocated money for solar energy in Rajasthan and for villages that still do not have electricity
11. Pentakota in Orissa has one school for 40,000. We need one university and 15 -30 schools in that town. Such things should be considered if we talk about all-inclusive growth .
12. It will take 320 years to clear the judicial back log, Every Indian judge has a load of about 2147 cases. This must be addressed or else i might consider becoming a hard core criminal than writing such emails expecting a change . Simply because my case would beyond 2147 and it will never get settled in my lifetime at least !!

India has the biggest problem with the average age of the political leadership that is a big disadvantage seeing the average age of Indians . The ratio’s are out of sync . Age of political leadership should match the national age group . I am totally against reservation that divides the society and the nation. The best thing would be to provide financial and institutional support to those who need and may be get 50 % of the youth in government ( without any reservation )to lead this nation’s political agenda

. RESERVATION PROVES THAT PEOPLE AT THE HELM OF AFFIARS ARE NOT WILLFULLY WANTING TO CHANGE AND NEED LAWS TO ENSURE THAT CHANGE HAPPENS BY FORCE !

WHY RESERVATION FOR WOMEN ? GIVE THEM 50 % TICKETS TO FIGHT ELECTIONS ON YOUR WILL

See the case of 3G spectrum : few questions .

Why are we launching 3G. Can we not move directly to 4G ? Smaller countries like Sri Lanka started 3 G five years ago. Why are we so late ? It could be a better decision to move directly to 4G . Government wants to collect more than Rs.30,000.00 crore. But it has not stated what is the benefit of 3G for the investor over the next 5 years . What is the life cycle (Span )of 3G,  when the 4 G comes , what will the players do then ? This could prove to be very costly and killer for some of the telecom players. India is still a voice driven cell phone market .

2. Why India should have 16 circles . Why not one India . USA has single geography for its mobile user
3. I personally believe that 3 G will hit the telecom companies mercilessly . It might lead to losses and mergers & finally consolidation amongst telecom companies in India

In India , i believe that the basic problem is ‘powerful announcements and powerless execution’

Corruption & leakage is leading to a black money economy : Why it is that giving bribe is a crime ? No one gives bribe willingly . It is only a choice-less option when you are pushed against the wall . We need to encourage people to report bribing . But seems that the current law is to protect and patronizing bribe takers. The law must be amended with a clause that giving bribe is not a crime as long as it is reported with the vigilance authorities after the bribe has met its purpose. This will help ensure that the work will get done and the person taking bribe can be brought to the book. We must encourage people to come out and report without the fear of getting caught and that their genuine work does not stop !

China – India : Politicians in India are trying to ape china . The fact is that, a few decades from now China will be a big economy and an old nation. India is not a big economy now but is a young nation today and we will lose our Future demographic advantage (FAD ), if our politicians do not act with right policies now .

We are a victim of a good government , but poor governance .

2010- The start of the India Decade


Happy New Year

I wish all my friends a very happy new year and a great decade ahead. I truly wish that this decade becomes the ‘India Decade’ for the World, and we emerge as a great nation by 2020.

 Best regards

Rajendra Pratap Gupta

India Decade Foundation

Email: office@rajendragupta.org

Mobile : +91 9223344542

India needs massive healthcare reforms – Rajendra Pratap Gupta


Dated: November 23rd, 2009 Rajendra Pratap Gupta
President
Dr. Manmohan Singh
Hon’ble Prime Minister
Government of India
7, Race Course, New Delhi

Shri.Ghulam Nabi Azad
Hon’ble Health Minister
Government of India
Nirman Bhavan, New Delhi -110011


Reference: Healthcare reforms – A detailed agenda for Population Health Improvement

Dear Dr.Singh & Shri Azad ji,

This needs your esteem, kind and personal attention. I am sending a detailed note on what India needs to do to build an effective healthcare system. Over the last 62 years , we have increased the life expectancy by 26 years , reduced the infant mortality and morbidity significantly, eradicated Small pox and Guinea worm and almost eradicated polio and Leprosy.

The government of India has taken up a smart fight against HIV, T.B. , Tobacco. The launch of massive programmes like NRHM & NUHM by the government & the ban on smoking in public places is a proof of the fact that, Indian government is committed to the healthcare of its population. I believe that the healthy population is a prerequisite for an economically vibrant & a healthy nation .

At this juncture, with such a proactive government, I must bring to your kind notice a detailed note on how to transform the healthcare system of the nation. To start with, healthcare has to become the priority sector for the government of India. The Indian healthcare system must have a broader scope and a bigger purpose!

Firstly, let me apprise you of the fact that, higher spending does not mean better healthcare. We have the case of America where 17 % of the GDP goes on healthcare. Still 77 % of Americans have at least one chronic disease, 1 out of 2 Americans have a chronic disease and 7/10 people die of chronic diseases. Despite such a high spending, according to WHO, US Healthcare system ranks 37th amongst nations, at par with Serbia; 31st in life expectancy and 40th in child mortality, worse than Cuba and Croatia . So we must not pursue wrong goal of just doubling the healthcare spends as a percentage of GDP. We need a system that is outcome driven and not that is expense driven !!

Even the French Healthcare system which was ranked as the best by WHO in 2000 is losing USD 28124 every minute and is expected to go bankrupt by 2019.

Taking into consideration the global examples in healthcare , where most of the healthcare systems have failed , India is fortunately better placed. As developed regions like USA & Europe are struggling to correct their system backwards, India is just starting to build its healthcare system. We must embed strong fundamentals in our healthcare system. Though India is better placed not by design but by default and faulty policies over the last six decades, we must use this opportunity to build in our indigenous healthcare system and not import failures by copying anything from abroad .

Let me draw your attention to a few important observations of mine regarding the healthcare system:

Payer model: India has the right payer model , where the user pays. This makes the user as the ‘gatekeeper’ in the healthcare system. The global experience shows that, whenever there is a blanket cover for free healthcare, it is likely to be misused, over used and prone to fraud. Global examples have proven that, whenever healthcare is free, systems collapse. So I must request the policy makers never to change this basic fundamental of the healthcare system, though you must provide free healthcare to BPL families.

Preventive care & Recession: My belief is that healthcare was also one of the main reasons why America faced recession. In 2008, U.S. employers paid an average of USD 9144 per employee for healthcare insurance. Over the last few years, increasing healthcare costs have forced American companies to ship jobs overseas as this presented significant cost savings. Imagine that a computer sold in U.S. was produced in China. So the entire process of building a computer created job and income for Chinese but it was sold in the U.S? So while U.S. kept spending on buying products, U.S. lost its earning & income creation opportunities to China. For each product U.S. citizens purchased, salaries and income moved to China for producing such products. No wonder, China became the biggest lender to America!! American recession was in the making for the last couple of years because of the healthcare costs going up.

Why healthcare costs went up in America? In 1970 preventive medicine specialists represented 2.3 % of the physician work force and by 2002, the preventive medicine specialists were down to 0.8 %. America did not take care of prevention, and today it is home to a population that is more ill than healthy and so is the economy. American economy is a mirror image of its healthcare system. U.S. spent USD 700 billion on the troubled assets relief program (TARP) & USD 568.4 billion on fighting chronic diseases in Medicare and Medicaid. India must learn from USA on the management of chronic diseases early on. We need to build a strong preventive care in the Indian healthcare system.

India is a young nation with more than 60 % of its population below 40 years in age but, in the next thirty years; we will become an aged nation. We will grow ‘Older’ before we grow ‘Wealthier’. Moreover, with the rising incidence of chronic diseases, we are heading towards a problem where even after spending 25 % of our GDP on healthcare, we will never be able to salvage our healthcare system.

It is high time we converted our slogan from Food, Clothing and Shelter to: Food, Clothing and Healthcare. Health care needs to become the fundamental right of every Indian

Disease burden in India: India has to first asses the health burden in India. The figures released by the top consulting firms are not reliable given the wide disparities. Let me give you a glimpse of the ‘potential’ disease burden in India.

A. According to WHO, India has 14 % of its population suffering from Arthritis. This takes the Arthritis patients to approximately 140 million
B. According to WHO, India has 10 % of its population suffering from Hypertension. This takes the Hypertension patients to 100 million
C. According to the International Diabetes Federation , approximately 5 % of the Indian population suffers from Diabetes i.e. 50 million
D. India has at least 40 million CVD patients
E. Cancer patients in India are about 2.5 million
F. Elderly people in India are about 150 million

So, by any conservative estimates, we have about more than 400 million patients suffering from one or more chronic disease.

ABCDE of Indian healthcare system . I coined this Acronym , where A stands for Arthritis , B – Blood Pressure , C- Cardiac diseases & Cancer, D- Diabetes , E – Epilepsy or Elderly. My belief is that the prevalence of chronic diseases is such that today every family if India has one or more members of either of ABCDE .

Due to out of pocket spending on health, about 40 million people go below the poverty line every year.

If we see the population dynamics & demographics , it calls for a serious planning and implementation on healthcare reforms so that we don’t face what America is passing through today! We need to build low cost, user friendly & accessible healthcare system so that people enter the healthcare system earlier and leave it earlier and it does not cost more!! I have changed the centuries old saying ‘Prevention is better than cure’ to ‘Prevention is better than death ™’ Since chronic diseases, if not controlled, lead to disability and finally , death

Problem of distribution: India has a serious problem with the focus & allocation of health resources ; we are quite urban centric. A survey by the Indian Medical Society had found that 75 % of the qualified consulting doctors practice in urban centers, 23 % in semi-urban areas and only 2 % in rural areas, where about 65 % of the population lives

Acute model of care: Though over the past 60 years the disease patterns have shifted from acute and infectious diseases to chronic or life style diseases, still Indian healthcare system emphasizes on acute care and medical care model. This needs an immediate correction. The problem of not adopting preventive care is that aging population requires more healthcare treatments with a lower earning and paying capacity. Earnings reduce with age but healthcare problems increase. This will put our ‘Young’ nation of today into a serious economic, social and development crises in the next 25 years. The ‘baby boomers’ of today will become ‘Patient boomers’ of tomorrow.

A study done by Kaiser Family Foundation revealed that, the healthiest 50 % of Americans account for just 3 % of the annual spending; the sickest 15 % represent nearly 75 %. This should help India understand the importance of preventive measure to keep our population healthy.

I believe that we have already been late for this generation, but we must build a robust healthcare model for the coming generation. We need to bring a change in government policies, medical curriculum, medical practice and channels of delivery of care across the healthcare spectrum. Without an integrated care system, we cannot have results, and without preventive care we cannot have an integrated healthcare system.

We must seriously consider that it might be cheaper to provide free preventive care than to absorb the high cost of chronic care. Preventive care must become the minimum standard of healthcare.

New paradigm of care: We must work towards building a strong support system for our healthcare infrastructure to build an effective healthcare system. This calls for a strong:

• Self control & Self care : Individuals must take to self care and self control and become health conscious individuals. This is where the government can play an important part and sensitize the population on health issues , so that the healthcare becomes effective
• Education system: The Prevention must move from the ‘Medical school’ to ‘Primary school’. It should be ingrained in our school text books and Preventive care is more important than the sex education for which too many efforts are being made too fast! Yoga & Meditation should be taught for at least 30 minutes / day from class 1 onwards
• Occupational health: Work place wellness is not established in India. I would expect that the proactive private sector gets active on providing preventive care to its employees at the work site

Why should a person approach the doctor directly for every small / routine issue?

For Preventive care , we must have two goals :

A. Preventive care has to be the mainstay of the stable healthcare system
B. Preventive care becomes the minimum standard of care

Government: Action points:

• The government must set up an inter-ministerial task force under the Prime Minister’s office or mandate the National Knowledge Commission to make recommendations every five years on healthcare reforms needed , based on the fast changing dynamics and demographics of the Indian population. The ministries to be included are Ministry of health & family welfare, Ministry of labour , Ministry of sports, Ministry of finance , Ministry of defense , Ministry of rural development , Ministry of child & social development ,and

Ministry of tourism .We must look at Brazil’s healthcare system where the health provisions are under the state & municipalities , but the Federal government continues to be responsible for the quality of care
• Health should be a federal subject
• Department of pharmaceuticals ( currently under the Ministry of Chemicals and Fertilizers) must be brought under the Ministry of Health & Family Welfare
• Central Health Authority : We need a central health authority along with similar state health authorities in every state to focus on Health Risk Assessment , Healthcare forecasting, Health Awareness , Immunization , Mother & Child care , Geriatric care , Primary prevention , Occupational health , Disease management , Organ transplants , Emergency care & Palliative care
• Government must take the sole responsibility for awareness creation about wellness and diseases separately, and both should be handled by different heads with proper coordination
• India immediately needs an epidemiological survey. As of now, there is neither an epidemiological survey nor a health risk assessment index to find the actual disease burden. Without that, anything we are doing amounts to Adhocism. We need to be more scientific in whatever we do to have an outcome. The data given for various disease states are thrown by various organizations and the data is hard to believe! Health Census must be done along with the population census.
• Government must take the responsibility for mass screening and mandate the employers to do mass screenings for their employees based on the guidelines for each sector
• Government must issue industry & sector specific recommendatory daily allowance (RDA) for food intake or calorie intake , health & wellness guidelines for employers and employees. If need be, government must appoint a employee health regulator to enforce the guidelines
• All the admissions after high school should have a basic health check as a prerequisite
• People above the age group of 21 should go for a yearly basic health check up
• Marriage certificate should only be issued after a comprehensive risk assessment
• Those with BMI above 23 should be put on annual preventive check
• Those with a family history of any chronic ailment should be kept on OPC – Observatory preventive checks at an early age ( 16 years )
• Government must come out with a health status report on its national leaders and set up a separate health department for political leaders both at national & state level
• Government must focus more on Geriatric care
• Government must address the issue of mental health deficiencies & encourage TeleHealth in Psychiatry seeing the ratio between Psychiatrist and population being 1:1 Million
• Government must start ‘Day Care’ centers for minor surgeries across the nation
• There are thousands of lives lost every year in road accidents. Government must work out organ transplant centers and frame guidelines for cadaver implants.
• The government must start a 24 hour health channel.
• Local governments must start a IVR – Toll free health helpline for the local population with Frequently asked questions on health put in IVR format

Special guidelines to treat chronic diseases:

• The government must immediately start a Central Disease Registry (CDR). All the
chronic disease patients must be registered under the same by the path labs itself
• Once the person is diagnosed with a chronic disease, the entire family must undergo a health risk assessment covering basic checks like BMI, B.P., Sugar, Cholesterol etc. This will be an effective way to monitor and control the chronic disease incidence. Such families should be advised to undergo a yearly basic check to avoid chronic diseases
• Chronic diseases cannot be controlled by prescription alone. It involves a behavioral change. This calls for counseling. Counseling should be made mandatory for chronic diseases. Doctors , Pharmacists and Nurses should be trained in the management of chronic diseases
• Patient’s family must be involved in the management of chronic diseases. Chronic diseases cannot be managed alone; it needs proactive support from the family members. Guidelines should be issued for the same
• Based on the disease state , the patients must be put on the appropriate disease
management program
• The doctors practicing in the field of chronic diseases should not be allowed to practice without a counselor , dietician , Phlebotomist and a fitness trainer
• The local municipality must encourage the formation of patient groups at a local level to help in the self management through ‘role model’ approach and via experience sharing amongst patients. This can be quite effective in the management of chronic diseases
• Nurses & Pharmacists have not been effectively utilized in the management of chronic diseases. These health professionals should be effectively used. In fact, the pharmacists should become the first local touch point for health information dissemination
• Pharmacies must be mandated to provide instant checking like BMI, Sugar, and B.P., Cholesterol etc.
• Pharmacists must be mandated to counsel all chronic patients
• Government must encourage generic prescription in all government hospitals and allow patients to seek generic substitution at the pharmacies.
• All doctors must seek patients nod before prescribing products other than generics
• The government must implement Disease management in the PSU’s immediately to
study the amount of money & lives that can be saved. Also that this can lead to better
outcomes and increased productivity
• Religious leaders must be used to tackle health issues as they can prove really very
effective
• The government must ban Junk foods in schools
• Special emphasis needs to be on Geriatric care and a separate set of guidelines needs to be worked out on the same
• Government must mandate the insurance companies to pay for routine health checks and
preventive care. Home based self diagnostics should be re-imbursed under insurance
• Gram Panchayats must be starting points for information dissemination for rural India.

Primary Healthcare centers should add Telehealth to its faculties to take the health to the rural population. Building and maintaining healthcare faculties in rural India is not viable. But Telehealth is an option worth trying to provide boost to rural health

Standards & protocols in Medical Practice : Due to absence of medical establishment standards , lack of treatment guidelines and protocols ; substandard facilities are mushrooming and malpractices are leading to ‘Over Diagnosis’ and ‘Over Treatment’ The government must play an effective role for the formulation of guidelines and enforce the same effectively . Also , despite having the best of brains and facilities , we are still
using the JCI / Australian accreditation . The government must recognize only the NABH / NABL accreditation for its healthcare facilities and take it international through support and incentives .

The detailed guidelines are expected on:

• Guidelines for screening.
• Guidelines for diagnostics
• Guidelines for treatment of various disease and the line of treatment along with the diagnostic requirements
• Government must come out with grading norms for facilities based on the treatment outcomes, number of beds , clinical staff, facilities , accreditations offered , town class and treatments offered
• Government must decide the price / rate for various treatments & procedures in facilities based on the infrastructure , town class , outcomes data for treating patients & grade of the facility
• Referral protocols for higher diagnosis and treatment
• Rural health guidelines should be formulated

Financial Incentives for the health sector:

• Rapid or instant diagnostic kits should be entitled for lower taxes & duties. Ideally, it should be duty free. But we must also encourage local production
• Telemedicine or Telehealth hold a promise when it comes to healthcare delivery in more than 6.20 lac villages. Such companies should be given a tax holiday for the next 10 years
• Medical imports under PPP must be tax free
• Clinics & Hospitals in rural areas must be given a tax holiday for 10 & 20 years
• Government must give a tax holiday for 3, 5, 7 & 10 years for healthcare facilities in tier 1.2. 3.& 4 class towns
• Preventive checks should be made tax free
• Currently government gives rebate in income tax for medical insurance. The same should be given for preventive check and the amount for such checks should be Rs. 2500 per family member per year. For senior citizens, it should be Rs. 3000 per member per year. Gyms & Yoga club memberships should be included in the preventive check category

• Health professionals working in designated rural areas should be given 50 or 100 % tax free income based on the regional disparities
• Companies that do preventive checkups for employees must be entitled to a tax rebate on such expenses to an extent of 100 %
• Pharmaceutical & other companies that sponsor health checks in communities should be given 50 or 100 % tax rebate for the amount spent.

Health Minister’s Fund – (HMF). The government must create a health minister’s fund to encourage donations from individuals and corporates with 100 % tax exemptions on donations. This fund must be used for providing healthcare to BPL families

Compulsory Health Savings Account(CHSA) & Health Cess: We need to look at innovative ways to fund healthcare. Levying 1 % health cess on taxes would collect Rs.4000 crore.

The government can draft a CHSA under three classifications and people can opt under the scheme as per their entitlement. The people enroll in CHSA at an age of 25-30 years and contribute a monthly amount for 30 years. Say, for example, a category A person pays Rs. 1250 per month per family for the first 10 years, Rs. 1500 per month for the next 10 years and Rs. 2000 per month for the last 10 years. So in 30 years the family saves USD 31000 and can get free healthcare for the rest of his life. Also, if we assume that the dollar is at an exchange rate of Rs. 45 & an annual interest rate of 7 % is accrued on this ; the middle class which is assumed to be 150 million now, grows to 200 million in the next 20 years and 250 million in the next 30 years. The government will stand to collect USD 1 trillion after 10 years, USD 2 Trillion after 20 years and USD 6 Trillion after thirty years. . The money thus collected can be used to make the best of healthcare facilities.

Indigenous research: We have sent Chandrayaan to the moon and made our own sub marine. But we have not done great research in medical technology and pharmaceuticals. Technology and equipment import constitute a major cost in a healthcare facility set up cost. These costs are passed on to the patients. This can only come down if we can have our own technology. Irony is that, we export our brains and then import technology at an exorbitant cost!! We have the best institutes & best brains to train them but we are not able to retain them! The government must frame strict deterrents to avoid brain drain. Healthcare will only become affordable if the cost of set up comes down. This can happen if we have indigenous technology. Going forward, healthcare will be totally technology driven.

AYUSH Professionals: The government must integrate and effectively utilize AYUSH professionals in mainstream healthcare & rural health. This could be the best way to make use of the resources at hand.

Medical Curriculum: Far reaching changes are required in medical curriculum

•
•

• The government must not allow M.B.B.S. to do Post graduation till they spend 3 months each into rural health, telemedicine, pharmacies and Panchayat health centers.
• Private medical college students should also undergo the same internship as is for students of government medical colleges.
• Those health professionals ( doctors , nurses and pharmacists ) working in rural areas for three & five years must be given special quota / guaranteed admission in P.G. courses or given fast track promotion in government jobs
• Government must provide higher pay and perks ( including tax free income ) and more paid leaves to doctors working in rural areas
• Doctors who working in rural areas should be given loans at a cheaper rates from the ‘Central Health Fund’ to set up medical clinic / facilities

In Mexico, absence of proper planning during the 70’s lead to oversupply of physicians in the 80’s. India should avoid the same and plan carefully.

Rural health needs a special consideration. In rural India, whenever a patient is taken to the nearest urban center for treatment, at least two family members accompany him. That’s the reason why even the 20 % beds mandated free for BPL families remain unused. Government must provide for free accommodation to these two attendants of the rural population who travel to urban areas for treatment including free train & bus travel. Telemedicine should be the core to rural health model in India

New Models : The government must ideate and try new low costs model where the primary preventive care can be availed at Rs.2 per day. Imagine, if we get 5000 people to pay Rs. 2 a day , we can have Rs.3 Lac per month per facility .This can be used to have two full time doctors , two nurses , two counselors to provide basic care to the population of 5000 people round the clock. I believe these are the models to be tried and implemented

The government’s role must logically move from a provider of care to payer and a regulator. Though government must be responsible for primary care,disaster management & sudden outbreaks but it must also focus on

• Awareness and education about health & wellness for the common man
• Primary care and prevention
• Rural health
• Regulation and standardization

The government must follow the chart mentioned below when approving secondary & tertiary care facilities in any place based on the population size as the standard for population health improvement. Government must not approve the higher end facilities for a geography till the facilities are existing for the levels below ,for which the approvals are sought. The government must also encourage private players by incentivizing them for providing primary care before approving them for secondary and tertiary care

Level of care Population Size Facilities Services provided
1 1000 Telemedicine, Panchayat level dissemination of info. Basic health services must be provided
2 10,000+ PHC – Panchayat Health Center Trained Nurse Practitioner
3 50,000+ Primary Hospital with 25 beds Primary Care
4 100,000 + Secondary Care Hospital 100 beds Secondary Care
5 500,000+ Multi Specialty Care hospital 250 beds Tertiary Care
6 10,000,00+ Institute of Medical Sciences Centers of Excellence

Private Public Partnerships (PPP): I have been actively involved from the very beginning in the PPP document authored by CII. I have already written in detail about the success factors for PPP in healthcare. The government must enter into PPP only for secondary and tertiary care. There is a lack of trust, transparency, speed and continuity in the government policies. Government does not trust the private players and Vice Versa. All PPP’s must pass the test on the four parameters

• Scientific credibility
• Operational stability & scalability
• Financial feasibility
• Political viability

Medical Tourism: Medical tourism can be a big revenue earner for the Indian healthcare system. But there should be a segregation of DHSP – Domestic healthcare service providers and IHSP – International Healthcare Service providers

Government must provide land at highly subsidized rates or free, at or near the airports, for hospitals and facilities catering to medical tourism ,and take the profits as a sleeping partner

For private players entering into IHSP, for each IHSP facility they set up, they should set up three DHSP.

Government must come up with an insurance scheme for international medical tourists coming to India for medical treatments to encourage and promote medical tourism

We have the best of tertiary care in India but what we lack is the basic primary & preventive care in the country .If we don’t start healthcare with preventive care and continue with chronic care management; one day, the entire healthcare system will become over burdened, under- funded and outdated – no matter what we do !

We have to move from being a ‘Disease focused’ and a ‘Doctor centric’ system to a system that revolves around younger populations, and where nurse and a pharmacist play the role of a health coach

The government has to be careful in our healthcare capacity building. One side, we need to increase the healthcare service providers, on the other hand, we have to work to reduce the burden of ‘Killer’ diseases. A very strong primary and preventive care model needs to be embedded in the system.

Healthcare is the largest service industry in terms of revenue and the 2nd largest after education in terms of employment

‘World Class’ standards in India is not the goal, ‘India Class’ standards for the world should be our goal. We can teach the world how to run an effective healthcare system

I am quite convinced that committed leadership will take cognizance of this note and take measures to implement the suggestions after a debate with all the stake holders in the continuum of care . Should you need any assistance at my end , feel free to connect.

With best regards

Rajendra Pratap Gupta

CC.
Sonia Gandhi
Rahul Gandhi
Dr.Murli Mahohar Joshi
Montek Singh Ahluwalia
Shri L.K.Advani
Smt. Sushma Swaraj
Shri Dinesh Trivedi
Sitaram Yechury
Members of Parliament
Sam Pitroda
Secy , Health & Family Welfare , GOI
Dr.K.Srinath Reddy
Chief Minister’s of States
Dr.Salim Hebayeb, WHO
Gerard M La Forgia , World Bank

India’s growth questionable – Rajendra Pratap Gupta


India’s questionable growth story :

While the government’s overall inflation figures remained at record lows of 0 to 1.5 %. The average wholesale price of food items had increased by a whopping 17.5 % in past one year as per the government announcement yesterday

Despite the good growth , the country’s fiscal deficit at the end of the first half of the current year ( April – September 2009 ) stood at 7.9 % of the nominal GDP compared to 4.4 % in the corresponding period last year . It is very difficult to contain the increasing deficit at budget targets . Pranab Mukherjee has estimated the full year fiscal deficit in the budget 2009 presented in July at 6.8% . A sharp pick up in the economic activity will not help bridge the gap as the tax collections remain depressed.

If we strip the government consumption , then the real growth for the rest of the economy was 4.9 % in the September quarter, at 1999-2000 constant prices. That’s lower than the 5.5. % year-on-year growth notched up during the preceeding quarter. The last instalment of the pay commission arrears has already been paid , so no further boost to government consumption is expected. What will happen to growth realising that the rain God were not approving the plight of farmers under the current government and thought it wise to boycott India !!

How will the government fund ambitious schemes ?

What is the plan to bridge the deficit ?

Is selling off or divesting PSU’s a short sighted goal ? After a few years , when the deficit grows . We will be left with nothing to sell except this nation !!

Rajendra Pratap Gupta

Email : office@rajendragupta.org

Lessons to learn- Rajendra Pratap Gupta


Price rise & Inflation: ‘Elecflation’ –i coined this term for ‘election induced inflation’. This is a recurring phenomenon

I see a lot of hue and cry on the inflation and price rise of vegetables and pulses. While the public is worried, government seems to be doing nothing on it. Why???
Answer: Whenever there are elections, the business houses are forced to contribute to election funding or false cases built up to make money to fund the party. So how will the business houses recover the money they have spent for the elections? So very naturally, the politicians are also obliged to allow these business houses to hoard and sell at higher prices till they recover in multiples of the money paid for fighting elections. It is a simple election driven price inflation. Remember , same politicians and business houses will meet again for the next elections

I was recently addressing a gathering and i told the people that we don’t have any political parties in India. The people were quite anxious to know what made me conclude this? To which, i explained that what we have today are ‘election parties’ & not ‘Political parties’. Election parties come up with a manifesto during elections and then forget everything for another five years and spring into action again gearing for the next mandate. If we had political parties or politicians then we would have a long term vision for this great nation. Unfortunately, we don’t have politicians. A politician or a political party cannot run a nation of 1.2 billion population without an agenda for 10, 20 & 30 years. Adhocism has not taken this nation anywhere in the last 60+ years

Also, no politician or party can take credit for India’s growing middle class. What we are today is not by design but by default and fault of failed policies and politicians. Fortunately, it puts India in the right spot at the right time. But we should not brag about it but we must have a long term vision and policies and actions to shape the destiny for the nation

Just think, 1/6th of India is under naxalites, 4/6th of India is poor. So whatever you read or see as India opportunity is just representing 1/6th of India. I.e. 200 million Indians are in a position to afford what you have. This blog will only reach may be 40-50 million people. Isn’t that an irony of a nation with 1.2 billion brains? We are exporting brains and then importing technology. We are not a democracy but a pseudo-democracy for just 200 million Indians

There are clearly three segments of Indian population.
People who vote (majority are paid or coerced to vote – these are the people who fall into 800 million people living @less than 2 $ a day)

People who make others to vote (town class or semi urban middle class or Political workers.)

People who are voted – run into a few million as elected or rejected candidates who have the best of all available and are above the law of the land)

It is a time to change …………………………..The democracy that is India is for 1/6th of the population. Remaining 5/6th is either under the slavery of naxalites or poverty.

On 25th /11 there was a function organised at the Mumbai police Gymkhana. As a trustee of the United Force of India i was asked to share my views on the Mumbai security after 26/11. I only asked one question to the journalists. If after one year of attacks our elected representatives can be manhandled in the Vidhan Sabha and our journalists can be beaten and their office vandalised. Where are we? What security are we speaking about? We are just waiting for another attack to happen and it will!!

Now coming to Dubai crises: For long, i have believed that we are chasing wrong goals as an economy. In fact, on 19th January, i wrote a letter to our Hon’ble P.M. that we should not build our economy on dollars but it should be built on agriculture and SME’s. Free dollar flow is a sign of future pain!! . See the case of India’s stock markets . The FII’s invest in it raise the index , exit and book profits . Poor Indian retail investors lose when such FII’s exit . But you cannot do anything . The big fish make money . My perception is that , this is happening with the concurrence of the people who are a party to such ‘short money making tactics’. Every politician starts as a humble farmer or a worker and then becomes a ‘uncrowned king’ with schools , charitable institutions , real estate , business ventures unheard and unimagined by people like you and me . We have seen the case of YSR’s son, Reddy brothers , Madhu Koda and the list is end less …………

Take the case of Dubai. Now people have started calling it ‘Doob Gayee’ . Dubai built their economy on dollars and we know their fate. If India does not focus on Agriculture and SME’s. We will cry with pain. I recently read Dr. Manmohan Singh statements that with strong FDI inflows, our economy is slated to grow 9 %. I sometimes, don’t understand why are we still dependent on the foreign money? This FII / FDI are like a refined and sophisticated terms for EIC – East India Company. They will take profits abroad. These instruments have only one goal – Feast on the growing middle class. Do we allow them? The day we make our ’Farmers , the father of the nation , the nation will turn into a vibrant economy’. I wish Dr.Singh to say some day that our farmers contribute to the growing GDP and SME contribute to a majority of dollar inflow .
Lastly, i must quote our Environment Minister, Mr. Jairam Ramesh – ‘If there was a noble prize for filth, India would get it hands down as there would be no competitors’. I expected our M.P. friends to seek his resignation for officially calling India a land of filth. He is a union minister and he should have abstained from making such a degrading comment on this great nation. Anything he says impacts India’s image negatively. What will people think about India when they read about this ‘noble prize’ eligibility for India? Do we expect more tourism with such statements or do we get more sanitation funds from WB / WHO etc with such irresponsible comments? Is the entire nation full of filth? Mr. Minister, please apologise for your senile statements and resign . You are getting your perks from this nation of filth .
Does it not prick your conscience to bring about a change in the nation than to complain??

Each one of you can bring about a small change in the scheme of things . Think small , aim big and act fast .

Rajendra Pratap Gupta
President
Country FirstEmail: President@countryfirst.org / mail@rajendragupta.org