Tagged: 12th Five year plan

Has the country’s central bank ( Reserve Bank of India – RBI ) collapsed ?


On 22nd March 2012, i had written that we have ‘Oversold the India story’ https://commonmansblog.com/2012/03/ ) , and what i had predicted for the economy in the April , May and June quarter,  happened ! 

Again , on 11th October 2012, i wrote on my blog ‘How India was fast turning from a ‘Emerging economy’ to a ‘Submerging Economy’ ( web link  :  https://commonmansblog.com/2012/10/11/india-from-emerging-to-a-submerging-economy/ . Now , read the fact about our Central Bank . As i said earlier , i am not worried on the 2014 for elections , but for the economic scene that will unfold in 2013 for the average Indian middle class , we are building a disaster  & fooling ourselves ! It is a call to action !

On November 5th ,2012 ,  The Economic Times carried the report that , the country’s central bank , Reserve Bank of India ( RBI ) would run into losses if asked to pay interest on mandatory percentage of deposits banks have to park with the centre bank , called the Cash Reserve Ratio ( CRR).  The RBI has stopped paying interest on such mandatory reserves since 2007.  Finance ministry had suggested the bank to pay 7 % interest on these deposits . 

 Does it mean that the country’s central bank has collapsed ?  If yes , why have we not discussed this in parliament, and are looking at FDI and other ways like stake sales in PSU’s and auctions of the sovereign assets to hide this news and infuse money in the system . 

 
Prime Minister and Finance Minister owe and explanation to this nation on this issue .
 
 

NEW DELHI: The finance ministry has decided to review the expenditure and reserves position of the Reserve Bank of India (RBI) after the central bank indicated that it is not in position to pay interest on the reserves banks maintain with it.

A government official downplayed it as a routine review of the reporting structure and disclosure requirements of the RBI, but it comes at a time when there is already obvious tension between the finance ministry and the central bank over the conduct of monetary policy.

“It is the government which tables the annual report of RBI in Parliament, so there is nothing wrong if it (government) wants to know how RBI prepares its balance sheet. We are not questioning them or raising objections,” a ministry official said.

However, another finance ministry official admitted that the review started after the RBI had indicated that it would run into losses if asked to pay interest on mandatory percentage of deposits banks have to park with the central bank, called the cash reserve ratio (CRR). The RBI had stopped paying interest on such mandatory reserves since 2007.

The finance ministry had suggested that the RBI should pay 7% interest on these deposits, pitching it as a measure that will help lower rates even if the central bank does not ease monetary policy. It had argued that all major central banks either do not mandate a reserve ratio or pay an interest on the mandatory reserves they ask banks to set aside.

“RBI had made certain arguments. Now, we want to understand their expenditure sub heads, format of disclosures so that we both are on the same page,” the official said.

The government is studying RBI’s expenditure, revenue, contingency reserves and investments, he added. On Tuesday, the RBI dashed hopes of a rate cut, but lowered the cash reserve ratio (CRR) by 25 basis points to 4.25%.

Please check more eye-opening statistics on Indian Economy on my blog .

From January , 2013, i will be working full-time to figure out the economic model for India , that will take the country out of the current crisis

Rajendra Pratap Gupta 
Healthcare I Retail I Rural Economy I Public Policy

Planning Commission’s approach paper on Healthcare


 Rajendra Pratap Gupta

President & Member

Board of Directors

August 21, 2012.

Dr.Manmohan Singh,

Prime Minister

Government of India

7, Race Course road , New Delhi -110001.

Shri. Ghulam Nabi Azad

Union Minister for Health & Family Welfare

Government of India.

Nirman Bhawan, New Delhi – 110108.

Reference: Faster, Sustainable & more inclusive Growth- An approach to the 12th Five year plan – Health

Dear Dr.Singh & Shri Azad ji,

Congratulations on pushing healthcare at the top of the agenda for the 12th five year plan . I am writing this note on behalf of the Disease Management Association of India – DMAI – The Population Health Improvement Alliance .

About Disease Management Association of India ( DMAI ) Disease Management Association of India (DMAI – The Population Health Improvement Alliance), was formed by Executives from the Global Healthcare industry to bring all the stake holders of healthcare on one platform. DMAI has been successful in establishing an intellectual pool of top healthcare executives to become an enabler in building a robust healthcare system in India. India is on the verge of building its healthcare system, and it has a long way to go. DMAI is building the knowledge pool to contribute & convert ‘Ideas’ into ‘Reality’ for healthcare in India. DMAI is the only not-for-profit organization focused on population health improvement in India

Through this note, we wish to draw your attention to the 12th Five Year Plan approach paper dated October’2011, on the Health chapter ( chapter 9, page 87-95) and put forth some suggestions for your kind consideration and action

The approach paper correctly highlights the areas of concern and seven measurable targets like;  IMR- Infant Mortality Rate, MMR- Maternal Mortality Rate, TFR- Total Fertility Rate, Under-nutrition among children, anaemia among women and girls

( According to this plan paper , 55.3 % of the girls are anaemic ) , provision of clean drinking water for all & improving child sex ratio for age group 0-6 years .

Given the formidable challenge that the Indian healthcare system faces, of having 830 million rural population & 6,40,000 villages, we need to be innovative to find solutions that leads to better health outcomes at standards comparable to the best and with least price points that are sustainable in the medium and long term. Also, the role of technology ( Telemedicine and mobile Health) for rural health and chronic disease management, is missing from the plan paper. Without Telemedicine , the goal of ‘Inclusive healthcare’ will remain a distant dream.

Let me take the most critical issue for which India has invested billions of dollars , and still has been facing the flak of all the international bodies and i.e. the issue of Infant mortality and maternal mortality .

We have about 18 million births every year (about 34 per minute), with highest number of still births, according to a study by Lancet . So clearly, there has to be an action plan for 18 million mothers; right from the time of conception which includes awareness , education , sensitization , nutritional & medical support as an Integrated ‘Healthy Baby Mission’ for India . This will cost about Rs. 5000.00 per new born ( not including delivery charges and post natal care ). If we include all , this could reach around Rs.10000.00 to a maximum of Rs. 15000.00 per baby. So , a total budget of Rs. 18000 crores would be needed to fix the problem if we invest Rs.10,000 per new born baby every year . But assuming the number of rural births to be 12.6 million ( 70% of all births i.e 70 % of 18 million per year), of which 80 % i.e. 10.08 million only need financing ; and the number of births in urban India to be 5.4 million ( which is 30 % of all births i.e. 30 % of 18 million), of which 50 % i.e. 2.7 million need financing, the net investment comes to not more than Rs.12,780 crore per year taking an investment of Rs 10,000 per baby per year. To make this happen, a radical change in approach is needed. Also, hoping that population stabilization efforts will contain the cost of financing in the medium and long term.

Without innovating with radical changes, this program or any program that we are building for IMR –MMR, is not going to yield any results ! ICDS has spent thousands of crores for the past 35 years and we are still trying to figure out a new model for ICDS with an inter-ministerial group ! Hoping that the new program will deliver ! Despite the fact that the ICDS has a budget of Rs. 10,000 crore for 2011 / 12, and for the entire 11th five year plan had a budget of Rs. 38980 crore, still our IMR – MMR is amongst the highest in the world.

On page 90, point 9.18, the plan paper states that, “One of the major reasons for the poor quality of health services is the lack of capital investment in health for a prolonged period of time.

The National Rural Health Mission had sought to strengthen the necessary infrastructure in terms of Sub-centres, Primary Health Centres and Community Health Centres. While some of the gaps have been filled, much remains to be done. According to the Rural Health Statistics (RHS), 2010, there is a shortage of 19,590 Sub-centres; 4,252 PHCs and 2,115 CHCs in the country”.

According to point 9.19, “It is essential to complete the basic infrastructure needed for good health services delivery in rural areas by the end of the Twelfth Plan”.

The plan paper rightly talks about lack of human resources and the accountability of people recruited. Given the complexities of the challenges faced and the keenness of the Government to save the Indian healthcare system from the pain & irreversible damage being faced by the healthcare systems in USA, U.K. & Europe , it is imperative to focus on the plan papers note on point 9.34 on ‘Publicly Financed Healthcare’ . This is a very good move and will yield significant positive outcomes

According to the point 9.34, “Public financing of healthcare does not necessarily mean provision of the service by public providers. It is possible to have public financing , while the service itself is provided by private sector players, subject to appropriate regulations and oversight. This type of partnership is common in many areas, but its scope has not been fully explored in the health sector. However, a number of experiments are now in operation, which allow for private sector participation. At the Central level, the Rashtriya Swasthya Bima Yojana (RSBY), is a health insurance scheme available to the poor and other identified target groups where the Central Government and the State Governments share the premium in 75:25 ratio. RSBY covers more than 700 in-patient procedures with a cost of up to Rs. 30,000/-per annum for a nominal registration fee of Rs. 30/-. Cashless coverage, absence of any bar based on pre-existing conditions and age limit are other unique features of this scheme. A total of 2.4 crore families have been covered under RSBY and over 8,600 health care providers are enrolled in the selected districts across 29 States and Union Territories. In several Central Government hospitals, pathology and radiology services are outsourced to private providers”.

“State Governments are also experimenting with various types of PPP arrangements which at times also

include actual provision of healthcare by private practitioners. Public Private Partnership (PPP) as a mode to finance healthcare services, if properly regulated, can be of use to the intended beneficiaries. However, care needs to be taken to ensure proper oversight and regulation including public scrutiny of PPP contracts in the social sector to ensure freedom from potential conflicts of interest and effective accountability”.

Taking into account the recommendations of this plan document, contributions , achievements and learning from other sectors , I would like to highlight the following :

Private sector has clearly made commendable difference to oil exploration , road building , ports , airlines , news and media , education & telecom, besides other sectors. Not only have the services increased & improved drastically, but India has also attained global standards in many fields where private sector participated, bringing in more and better options to the public at affordable price points. In addition, this has created more employment than the public sector. According to the report by the Planning Commission and Directorate General of Employment and Training (DGET ) , Ministry of Labour and Employment, between 1994-2008, the employment has de-grown by -0.65 % in the public sector ,while it has grown by 1.75 % in private sector .

We have achieved a lot by actively engaging the private sector in various segments of the economy. We have also learned a lot during this journey . Now is the time to translate the learning and involve the private sector in government programs for healthcare, and make sure that we have a healthier nation, with investment in healthcare leading to positive outcomes . Not only that PPP’s in health will lead to better health outcomes with accountability but also lead to increased investments and employment generation.

Need of the hour is to implement the recommendations of the Planning Commission . We need to chart out the road map for private sector engagement , and also the guidelines to balance profits with outcomes and not trade one for another !  We lack an economic model for healthcare. If we madly rush for Universal Healthcare in the name of social mandate without a proper implementation roadmap and with checks and balances , we would have embarked on a road of irreversible financial losses to the exchequer with little or no impact on the healthcare outcomes.  Past experience with various government run programs shows us that we have been running ICDS in the health sector for about four decades ,and we still are rated amongst the worst when it comes to Infant mortality and maternal mortality ! Time to immediately introspect and correct as in the approach paper of the 12th five year plan.

Recently, I have been approached by two international organizations ; MAMA Alliance and the MDG Alliance

The MAMA Alliance ( Mobile Alliance for Maternal Action) is a Private Public Partnership launched in May 2011 by the founding partners- United States Agency for International Development , Johnson & Johnson with supporting partners – the United Nations foundation , mHealth Alliance , and  BabyCenter.

MDG Alliance is working with the support of UN Foundation , World Bank, UNICEF, PMNCH , and the Global Compact .

I have accepted to support them by joining them as the advisory board member / partner . Such organizations will do what is easily doable by the PPP models within India !

It is the time to seriously re-consider our approach for each program, and sit & discuss with the sector that brings phenomenal execution capability ( the private sector ) and work together to come out with an economic and health outcomes model for the Indian healthcare system

Without the private sector engagement healthcare will remain a ‘bottomless pit’ for the exchequer and accountability issue will never get addressed . But for sure , with the right PPP models , we will have a faster , sustainable and more inclusive growth in the 12th five year plan ; The goal of the government .

With best regards

Rajendra Pratap Gupta

Member, World Economic Forum’s Global Agenda Council.

Board Member, Care Continuum Alliance , Washington DC.

President & Board Member, DMAI – The Population Health Improvement Alliance

further details http://www.dmai.org.in

Contract workers in NRHM & Exclusion of Wine under FSSAI


 Rajendra Pratap Gupta

President & Member

Board of Directors

March 11, 2012.

Shri Ghulam Nabi Azad

Union Minister for Health & Family Welfare

Government of India.

Nirman Bhawan, New Delhi – 110108.

Reference : Contract Employees under NRHM & Exclusion of Wine from FSSAI

Dear Shri Azad ji,

In the above quoted reference , I wish to draw your attention to the above mentioned two important issues .

Firstly, the status of contract employees under the NRHM: Over the last few months, I have got thousands of emails on my blog about the future of employees working under NRHM.  People have been asking me about their future after putting in 10-15 years under NRHM? The people fear that if their services are terminated after March 2017 (when the 12th five year plan ends), people would have become over aged for the government jobs and their careers would be ruined!

It is expected that the government will either regularize these workers in the 12th five-year plan or work out the proportionate payments as pensions for the number of years put in service of 15 years and above. Also, it would be great if the services of these contract workers are regularized with deliverables fixed for each worker / cadre

FSSAI (Food Safety & Standards Authority of India). It is learned from the FSSAI workshops that, ‘Wine’ has been included under FSSAI. It is an unexpected and an unfortunate step for India. We are not sure what kind of ‘message’ is the government giving to 100’s of million youths of this country by putting ‘Wine’ under Food Safety & Standards Authority of India (FSSAI )? Does it imply that consumption of wine is now being considered safe and recommended for consumption by the Indian population ? or is it the handiwork of some foreign lobby groups? Hoping that the corrective steps would be taken immediately.

Appropriate actions should be initiated post the discussion with the stake holders

Yours truly,

Rajendra Pratap Gupta

CC:

Dr.Manmohan Singh, Prime Minister, GOI

Mr.Pranab Mukherjee, Finance Minister, GOI

Mr.P.Chidambaram, Home Minister, GOI

Mr.Sharad Pawar, Union Minister for Agriculture, GOI.

Shri Ajay Maken, Union Minister of State for Youth Affairs & Sports, GOI

Chairperson, UPA

Shri Nitin Gadkari, President, BJP

Mr. Sitaram Yechury, CPI.

Dr.Syeda Hameed , Member , Planning Commission , GOI

Dr.Murli Manohar Joshi, Chairman , Parliamentary Accounts Committee , GOI.

12th Five Year Plan – DMAI


Image

Rajendra Pratap Gupta

President & Member

Board of Directors

March 09, 2012

Via e-mail / Speed-Post

Dr. Manmohan Singh,

Prime Minister

Government of India

Shri Ghulam Nabi Azad,

Union Minister for Health & Family Welfare

Government of India.

Subject: Strategic Considerations for Healthcare in the 12th five year plan

 

Dear Dr. Singh & Shri Ghulam Nabi Azad ji,

I am writing this note on behalf of DMAI – Disease Management Association of India.

Disease Management Association of India (DMAI – The Population Health Improvement Alliance) is formed by leaders from the Global Healthcare fraternity, to bring all the stake- holders of healthcare on one platform (Both the public & the Private sector). DMAI has been successful in establishing an intellectual pool of top healthcare leaders to become an enabler in building a robust healthcare system in India. India is on the verge of building its healthcare system, and it has a long way to go. DMAI is building the resource – knowledge pool to contribute & convert ‘Ideas’ into ‘Reality’ for healthcare in India. DMAI is the only not-for-profit organization focused on population health improvement in India.

Earlier in 2009, I have authored the comprehensive healthcare reforms agenda for India, and this has been appreciated by political and policy-making leadership at the highest level. Further, the healthcare reforms agenda  (detailed agenda is available at the DMAI website http://www.dmai.org.in/Healthcare_Reforms_Agenda.pdf) has been incorporated in the healthcare planning in the state of Chhattisgarh.

Further, DMAI has given inputs to various government bodies, as sought from time to time on:

Re-structuring of ICDS

NCD Policy

Re-structuring the 12th Five year plan for healthcare

Formation of NCHRH

Inputs in the high level UN summit for NCD’s (DMAI was an official invitee to the UN)

DMAI has raised important issues w.r.t. The Mental Health Act 2010, banning of Junk food in schools, reservations in airlines and railways for critically ill and in times of medical emergencies, radical changes in Jan Aushadhi scheme, healthcare reforms in J & K, Protocols and treatment guidelines for all major acute and chronic illnesses; besides other issues. Details available on www.dmai.org.in

12th five year plan is being talked of as the ‘Plan for Health’, and through this note, DMAI wishes to bring a few important issues before the policy makers for debate and appropriate action:

Quality of Healthcare: Last year, I was nominated to the five member Healthcare committee of the Quality Council of India. Since then, I have been discussing with all the stakeholders in healthcare, including the patient groups, about how to improve the quality of healthcare in India.

Action:  It must be made mandatory for all healthcare providers (Care Givers), to submit the Patient / treatment outcomes data e.g. for hospitals (including admissions, no. Of night stays, re-admissions, infection rates, deaths, referrals, etc.) to the government every year without fail. Also, getting similar data for doctors, clinicians etc. should also be looked at. This data could be maintained under the Quality Council of India (QCI) or an entity under QCI, funded jointly by the government and private players or, as an independent organization. This organization must analyze the data and post it on the website, so as to enable the patients to make an informed choice when it comes to choosing the doctors / hospitals or the caregivers. This will be the first step in bringing transparency in healthcare and a major boost to improving quality in healthcare. A hospital stay costs an average of $236 per day in India, $655 per day in France and an average of $3,949 per day in the US, according to a report — 2011 Comparative Price Report Medical and Hospital Fees by Country – released by the International Federation of Health Plans.  After paying USD 236 (Approximately Rs. 11328.00 / day (USD 1= INR 48), what does the patient get in return?  . We believe that by implementing this reporting by caregivers, the caregivers would work harder to improve their performance in terms of outcomes for treatment and, in a way, it will lead to ‘Pay for Performance’.  Patient would be able to make choices based on whosoever provides the best care!

Also, all the hospitals / care givers must ensure appropriate patient follow-up and feed back mechanism, and the government must devise an institutional mechanism to collect the data on success rate of treatments and examine the reasons for failure so that the quality of healthcare delivered can be improved.

This must be done by setting up the National Institute for Research in Healthcare Quality Improvement.

This institute must focus on coming out with annual reports on improving the quality of healthcare in all the states, as the healthcare issues vary from state to state. We have seen that recently, West Bengal has been home to dozens of child deaths in major government hospitals.

But as of now, there is no investigating body for healthcare to look into these issues, and the crime investigating agencies (Police) lack the necessary qualifications & skills to carry out any meaningful investigation and suggest remedial steps for such incidents. It is the time to correct this by setting a dedicated national body for such incidents.

USA has moved towards ACO’s (Accountable Care Organizations); and it is high time that India sets up the guidelines for all healthcare delivery organizations to become self-regulated ACO’s

Recently, DMAI was actively involved in doing the biggest Healthcare camp in Ajmer (the constituency of Shri Sachin Pilot), and examined over 50,000 (according to some media estimates, approximately 71,000 people). The people were given free diagnostic tests & medicines only due to active participation & support from the private sector. It is high time that the government acknowledges that the private sector has a pivotal role to play if the ‘Healthcare for all- Universal Healthcare’, has to move beyond ‘mike & paper’! Private sector has always shown commitment by providing resources for ‘pilots’ and ‘Free camps’, but we must not forget that, ‘Charity is as deep as the pocket’! It would be a win-win, if the government starts with launching the mass screening program with the private sector, re-launching the ‘Jan Aushadhi’ scheme with the private sector & implementing mass scale telemedicine / mHealth projects with the private sector

I was an invitee to the meeting called by the Hon’ble Health Minister /WHO on 23/ 24th August 2011 at Delhi, and was also involved in the writing of the document called ‘Delhi call to action’.  I recall, that the Hon’ble Minister made an announcement to screen 200 million people for diabetes and hypertension by March 2012. I have learned through reliable sources that this mass screening plan, that was to start with 100 districts was reduced to 10 districts and finally to slums of two districts, and the results were not encouraging! In a way, even 10 % of the target of 200 million (2 crores) has not been achieved. This reminds me of the Sir Joseph Bhore Committee report in 1946, which talked about Universal Healthcare.

Also of the National Health Policy (NHP) 1983, which talked about ‘Health for All’ by 2000 AD’.

Both these committees failed to deliver Universal Healthcare. So, essentially, even after 65 years, ‘Healthcare for all’ has just remained a ‘concept’ & a mere ‘talking point’.

In the current plan – 2012, we are again talking about the same thing ‘Healthcare for all’. This time, we have a high level committee and the wordings have changed to ‘Universal Healthcare’. Doubling of budgets for healthcare will not be able to address the healthcare problems facing the nation, till we ‘double our understanding’ of the real issues and the solutions and give up the parochial approach to remedy the ills in our system!

It is clear that the government lacks an execution plan, and also that; ‘execution’ has never been the forte of the government. It is high time that government puts “PPPr”- Private Public Performance based rewards partnership in place like the NHAI and then only releases the budget for the 12th five-year plan.

It is time to learn from what you did in UID! A person from the private sector has already issued 30 million Aadhaar cards, and this has already become the biggest biometric program in the world. Can we not learn from UID and implement in MOHFW ?

We need a ‘Professional’ CIIO (Chief Innovation & Information Officer) in the Ministry of Health, who will bring the necessary capabilities in the ministry to make a difference in the ‘Health for All’.

Free insurance & Free medicines: This scheme is a ‘Killer Combination’.  ‘Social healthcare’ has failed miserably in the western world, and we seem to have not picked up the lessons but are hell bent on ‘Importing failures’ of the west into the Indian healthcare system. As I mentioned in the 2009- ‘Healthcare reforms agenda’, I will re-iterate that we need a ‘Co-pay’ model for healthcare delivery.  Except the BPL families, all others must have’Co-Pay’ component in the healthcare services even if it is a token of 5-10 % of the total healthcare cost borne by the government. Co-Pay must go up with the income slabs!

Rajiv Aarogyashree scheme (highly publicized scheme of Andhra Pradesh), is now widely talked of as a ‘failure’, and the government is not in a position to pay the empanelled facilities for the ‘free treatment’ that has been a part of the popular scheme

It is time to re-look at ‘Free universal healthcare schemes’. If the government examines the free healthcare schemes currently offered all over the world, it would think twice about free healthcare!.

Free medicines scheme: During my visits to Rajasthan (medicines are given free in Rajasthan government hospitals), I was made to re-think about this scheme

This scheme has created a peculiar situation for doctors.  Doctors are told that the family member is suffering from cold, cough or backache, and s/he is asked to give the medicine!

When the doctors request to examine the patient as to check if it is dry cough, TB induced cough etc., the response that the family members give is, ‘ When the medicines are provided free by the government, then why do you ask so many questions?

If the doctor refuses to give medicines, political pressure is applied and the doctors are harassed! Doctors have been reduced to ‘compounders’, and are just dispensing medicines rather than treating patients, because of the ‘free medicine scheme’!  Even in the USA, we have seen scams where ‘dummy patients’ were created under Medicaid, and reimbursements taken from the government in the name of ‘diabetic patients’. India will witness large-scale organized frauds if such a scheme is rolled out without adequate checks and controls.

When it comes to medicines, I must request the government to monitor the pharma industry closely, as the customer is not getting the benefit of ‘low prices’ (read as- schemes that are offered by the industry to the distributors).  Just for the sake of information, I am quoting two examples:

Panegra is available at an MRP of Rs. 124.00 and the scheme offered by the manufacturing company is- seven strips free on purchase of one strip! Still the end consumer buys the medicine on MRP!  The manufacturer distributor – retailer nexus swallows the entire margin.

Another example is that of Cifran, priced at Rs.58.80 and the scheme offered by the manufacturing company is – one strip free on buying two strips. But, such benefits are never passed on to the ignorant end customer- patient. Similarly, 1000’s of products are available with such ‘deals’ but the patient does not get the benefit.

Government must take decisive action against such pharma companies. The two companies quoted here are just for reference and most of the companies are indulging in these practices

Also, the government must give a big push for mobile healthcare (mHealth & Telemedicine). CDAC Mohali (a government body) has developed a great application for telemedicine, and DMAI used that service during the mega healthcare camp at Ajmer, in collaboration with PGI, Chandigarh. It is time to promote such institutes and organizations.

May be, it would be worth having a joint working group between the ‘Ministry of Communications & IT’ and ‘Ministry of Health & Family Welfare’, to explore the commercially deployable models of telemedicine & mHealth

It is the right time to train all our nurses & pharmacists in healthcare counseling through online training modules and create a special cadre of healthcare counselors for chronic diseases.

It is the right time to set the Patient Charter for Healthcare, which includes the patient’s rights and responsibilities. DMAI is driving an initiative to come out with a ‘Patient Charter’ under the leadership of Dr.Aniruddha Malpani.

These changes are required if we wish to make an impact on the healthcare delivery system.

Currently, there is a big gap between ground realities, policy formulation & execution framework. We need radical changes in our thinking to create an ‘Inclusive Healthcare Ecosystem’. It is better that immediate steps are taken to correct the loopholes so that Healthcare for all can become a reality without compromising on the quality of care.

DMAI would be willing to volunteer with its knowledge pool and resources should the policy makers need the same

Yours in good health

 Rajendra Pratap Gupta

CC:

Mrs.Sonia Gandhi

Shri Nitin Gadkari

Dr.Manmohan Singh,

Dr.Murli Manohar Joshi, Chairman, Parliamentary Accounts Committee

Minister for Communication & IT, GOI

Montek Singh Ahluwalia

Dr.Syeda Hameed.

Shri L.K.Advani

Smt. Sushma Swaraj

Shri Sudip Bandyopadhyay

Sam Pitroda

Rahul Gandhi

Sitaram Yechury

Secy, Health & Family Welfare, GOI

DGHS, MOHFW,GOI.

Dr. K. Srinath Reddy

Dr.Girdhar Gyani, QCI.

Dr.V.K. Singh, QCI

Board of Directors – DMAI


Potato Politics and Commercial Airport in Rae Barielly !


Dear Rahul,

Last week you made a statement that , ‘ 50 grams of potato chip are sold for Rs. 10 , and that this is made from just half potato’ ! Correct ! But again , Rahul don’t forget that the foreign companies no lesser than Wal-Mart ( likes of Pepsico ) are selling these expensive potato chips made from half a potato . So, does it not make more sense to check the growth of MNC retail chains / companies in India, who are buying cheap potato but ‘profiteering’ by selling chips at Rs. 10 per packet and the poor farmer is losing his produce at a throw away price  ?

Also, I wish to draw your attention towards the fact that currently the farmers are paid Rs. 1 per KG. I cannot understand why will ‘Profit & balance sheet obsessed’ Retail chains pay more to these poor farmers !

Simply stating that the middlemen would be removed and so farmers will get more, is a fallacious statement and conveys a lack of your ignorance about the realities. I think your party and Maya ji are fighting in the ‘aerial warfare’ with no touch of realities on the ground

I can clearly see the trick in getting the farmer leader Ajit Singh into Congress. Clearly , he will help you pitch farmers in favor of FDI and also convert a few of them as voters . But these tactics might not work in the long run , hopefully there are millions like myself who know the reality of these old tricks of congress for vote bank politics  !

I read another news that Rae Bareilly will get a commercial airport

Let me enlighten you about the Awadh region where your dad , mom & yourself have fought & won elections for decades

The Awadh region once ruled by nawabs and taluqdars and known as granary of India because of its fertile Gangetic plain. The area has given prime ministers to the country – Indira Gandhi, Rajiv Gandhi, and Atal Bihari Vajpayee. But most districts are still backward.

Population | 3.654 Cr

Per Capita Income | Rs 13,150.81

Faizabad division | Faizabad, Ambedkar Nagar, Sultanpur, Chhatrapati Shahuji Maharaj Nagar, Barabanki

Devipatan division | Gonda, Balrampur, Shravasti, Bahraich

Kanpur division | Kanpur, Ramabai Nagar, Auraiya, Farrukkhabad, Kannauj, Etawah

Lucknow division | Lakhimpur, Lucknow, Sitapur, Hardoi, Unnao, Rae Bareli

Now here is an interesting fact : Purulia is better off than Rae Bareli and Amethi and this was quoted in this article of Business Standard & Mid-Day. http://www.mid-day.com/poll2009/2009/apr/270409-Purulia-is-better-than-Amethi-Left-tells-Rahul.htm 

Let me walk you through a planning commission report on the per capita domestic product , and the NDP per capita in your family’s constituency.

Net domestic product (total and per capita) 2006-7 as per planning commission, Government of India

 

  At Current Prices At Constant Prices 1999-2000
  Domestic Product (Total) Rs. in CR. Per Capita Domestic Product (Rs.) Domestic Product (Total) (Rs. in Cr.) Per Capita

Domestic Product (Rs.)

Rae Barielly 3288 10361 2489 7844
Sultanpur 3955 11168 3077 8687
         

Source:http://planning.up.nic.in/Annual%20Plan%202010-11%20for%20website/Volume%20-%20I%20(%20Part-II)/Chapter-6.prn.pdf

 So clearly, getting an airport in Rae Barielly is a stupidity of the highest order, and that too, when it is clear that the region is back ward and people can barely survive a year without good rains leave alone travelling by air ! Please read the per capita income and check out if the poor people of that district can even afford the air port taxes leave along the airfare !

 I have visited Amethi and met up with dozens of self-help groups that you have formed in Amethi, and let me tell you that, you are just ‘Using’ the emotions of these poor people for becoming a member of Lok Sabha from Amethi

 While I was travelling to Amethi, none else than your own people (close associates) have informed me that the worst road in India is between Rae Bareilly and Sultanpur. Do I write more!

 Learn from Mr. Vajpayee , who started the Golden Quadrilateral project for the Aam Aaadmi and your government is more interested in airports, so that you can fly directly to Amethi rather than taking the 2 hour road drive to Amethi via Lucknow . You are wasting the hard earned money of common men like myself , who earn by hard work and pay 1/3rd of our income as taxes to the government , and people like you go and throw it for things like building an airport at Rae Barielly !

By the way i could not understand that in the same week you talked about potato being sold at Rs.1 per KG and the other side an Airport in Rae Barielly ?

 Gandhi Dynasty has taken India back ward by at least 30 years , and we need to stop it soon.

 I also don’t understand what is your intent for the so-called ‘Food Security Bill’ and ‘Job Guarantee Bill’. You will give fixed income to people so that they do not have to work and then you guarantee them food ? So it means that people will not have to work and earn the food , and will get it free ? Where will the Rs. 5 lac crore come from for these schemes ?  Will these things take India forward or your party men who will get the ration shops to distribute ( read divert ) grains and sell them to the open market, and finally , the poor Aam Aadmi will be left stranded on the road !

 Wake up Rahul ! Time will never forgive your people, and the elections will decide your fate not this ‘aerial warfare’  .

Rajendra Pratap Gupta 

Healthcare I Retail I Rural Economy I Public Policy

www.commonmansblog.com

Right to Primary & Preventive Care


August 10th , 2011

Dr.Manmohan Singh

Prime Minister

Government of India

7, Race Course , New Delhi 110001

Subject: Right to Primary & Preventive Care

Dear Dr.Singh,

 

Greetings from the Disease Management Association of India – DMAI, The Population Health Improvement Alliance .

 

DMAI – The Population Health Improvement Alliance is a not-for-profit organization formed by global healthcare leaders. It is the only civil society organization in India dedicated to chronic disease management in the country, with an objective of overall population health improvement .In the past three years , DMAI has worked at both International level and within India to address the issue of India’s healthcare challenges,  with the support of  patient groups , Industry & policy makers , and wishes to put on record the continuous support DMAI has received from policy makers and the industry .

 

Your government has been behind some key initiatives like

 

Right to information Act

Right to Education

Right to Work / Employment

Right to Food

 

I wish to draw your kind attention to consider enacting, the ‘Right to Primary & Preventive care’ for all citizens of this country, before it gets too late !

 

The nation is burdened by ‘a catastrophic disaster in slow motion’, moving towards it in the form of a huge population suffering from Life threatening diseases / disorders ( LTD’s ) or Debilitating Chronic Disorders- ( DCD’s ); what is today called the NCD’s ( Non communicable diseases ) .

 

We are already facing an acute shortage of both, hard infrastructure and soft infrastructure in healthcare delivery , and with our current ‘Baby Boomers’ becoming ‘Patient Boomers’ in the next 15-25 years , we could lose our competitiveness & productivity by over 50 % . India  in 2025 , with over 1.40 Billion population and with over 600 million LTD / DCD patients

would be a burden for the human race if we fail to adopt the Right to Primary & Preventive care, as the basic right for all citizens .

 

I must also state an electoral reason to accomplish this very important act . It is not just the US that fought the last elections on issue of Healthcare reform , but back home,  Andhra Pradesh and Assam are examples of how healthcare schemes can be a deciding factor for the public to choose who will run their government and so, lets get this ‘Right to Primary & Preventive care’ implemented at the earliest possible.  My detailed note on healthcare reforms agenda available at the DMAI website ( www.dmai.org.in ) , has the details of what could be potentially done in this area . It has to be multi-sectoral and inter ministerial effort & I am sure that this act with vast social & economic implications will be the best thing to do in healthcare !

 

Also, to keep you posted , I am working on the Chronic Care Bill & the Child Health bill . If all goes as per plan , the draft of these documents will be submitted to the policy makers by end of September 2011

 

Hoping for a positive response from a responsible government on the ‘Right to Primary & Preventive care !

 

We remain at your disposal for any help / assistance that you might need on this matter of great national interest

 

Yours Sincerely

Rajendra Pratap Gupta

president@dmai.org.in

 

H.E. Ban Ki Moon, Secretary General , United Nations

H.E. Joseph Diess , President of the UN General Assembly

Hon’ble Deputy Secretary General of the UN General Assembly

Ms. Margaret Chan, Director General, WHO

Shri Ghulam Nabi Azad , Hon’ble Ministry of Health & Family Welfare, GOI

Dr.K. Srinath Reddy , President , PHFI

Dr.Syeda Hameed, Planning Commission , GOI

Sri Sudip Bandopadhyay, MOS- H&FW

Shri K.Chandramouli, Secretary , H&FW , GOI.

K.Desiraju, Additional Secretary , Government of India.

Dr.Sudhir Gupta , CMO, NCD’s. MOHFW.

Board Of Directors , Disease Management Association of India – DMAI , The Population Health Improvement Alliance .