In response to an article by Arvind Panagriha in Economic Times discussed on another blog.
I would like to throw out a different way of thinking about this. My point is that this issue has nothing to do with “socialized medicine”. Let me elaborate.
Panagriha’s main contention is:
…it is time to accept the fact that the government has at best limited capability to deliver health services and that a radical shift in strategy that gives the poor greater opportunity to choose between private and public providers is needed.
(i) Number of doctors:
He further makes a point:
With a population of 1.1 billion, this implies approximately 1,700 people per doctor. In comparison, there are just 400 people per doctor in the United States and 220 in Israel.
Why compare to US and Israel? Considering they are one of the richest in the world.
Why not compare to Cuba, a much poorer country? And a much more “socialist” country to boot. Cuba has higher proportion than both US and Israel (in fact one of the highest in the world).
(ii) India actually has one of the lowest spending on health in the world (proportional to total govt. spending) (3% of total expenditure). Compare this with 19% for US, 12% for Israel, 11% for Cuba and 5% for Vietnam. The private spending (of an individual) on health is 5 times the govt. expenditure. In this sense, India has one of the most privatized health care system in the world.
If you compare apples with oranges, you’ll get absurd results.
4 comments:
Nice discussion between you and Mr. Vaswani, though if the axioms and world-view (i.e. foundations) are vastly different, the structure built on them is bound to be different too.
I think you're right, but still there's a lot of ground in common. At least he was arguing rationally and there lies some hope.
I believe the brand of market economics championed by him is inconsistent even with his own axioms. I'm much more of a "conservative" than he is, since I think that the doctrine of "freedom" should extend to corporations as well as to the state.
I have some other discussions with him which explore this.
I agree re: some common ground. I don't think that State is all that benevolent as it's made out to be - but then, capitalists tend to ignore the same/worse faults in a corporation.
I actually spent some time yesterday going through all your past posts and the comments between you two. :)
I also left a comment on another post from 2007.
The centre of right is spreading half truths on development. welfare implemented through the market is not an axiom.
let us look at the cuban healthcare system, where they continued their high GDP spend on healthcare even at the expense of defence during the 1990s crisis.
one can’t produce a full account of the cuban healthcare here. but some salient points.
its founding principle is public health. a glance at WHO indicators of health give us clear idea. Infant mortality, under 5 mortality, and life expectancy in cuba matches that of us (and is even lesser when it comes to infant mortality, which in 2006 was 7 vs 5.3).
in 2005 healthcare spending in cuba was $260/capita (uk $3065 US $6543). they have a three tier system — consultorios (here each doctor serves about 150-180 families), polyclinics, hospitals. all easily accessible. consultorios are in the immediate vicinity of the communities.
Cuba has the lowest HIV prevalence in the world. it beats the idea that ‘generating wealth is the fundamental precondition for improving health’. the cuban system roots are in provision rather than purchase of health care. its system is vertically integrated, with each consultorio (the immediately local family doctor) linked to a specific polyclinic in the neighbourhood. nhs is also discussing implementing polyclinics and is now copying their approach to prevention.
the Finlay institute is amongst the world’s best when it comes to vaccine research and production. the biotech r&d is similarly amongst the world’s best. for example, the institute was the first to manufacture and produce the meningitis b vaccine.
cuban healthcare system is just not part of the english debate, largely due to the complex socio-political and economic framework within which the former healthcare system is provided.
Lancet has come out in support of the Cuban health care system. And there are other independent voices from the west who are now stepping out to do research and validate what is already known.
- Global health-worker crisis: the UK could learn from Cuba
The Lancet, Volume 371, Issue 9622, 26 April 2008-2 May 2008, Pages 1397-1399
- Going where no doctor has gone before: The role of Cuba’s Latin American School of Medicine in meeting the needs of some of the world’s most vulnerable populations,
Public Health, Volume 122, Issue 6, June 2008, Pages 552-557
Robert Huish (Department of Geography, Simon Fraser University, Burnaby, British Columbia, Canada V5A 1S6)
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