The Sharm Al-Sheikh Scare

The Indian and Pakistani Prime Ministers met at the Egyptian town of Sharm Al-sheikh on the sidelines of the NAM summit, a meet which was billed as an occasion where India would read the riot act to Pakistan following the latter’s failure to prosecute terror perpetrators and take any action on the executioners of the 26/11 attacks. Prime Minister Manmohan Singh had set himself high standards by talking tough to Pakistani President Asif Ali Zardari over a month ago, when they last met in Russia as part of the SCO summit delegates. The outcome of the Egyptian round of talks, however, have been disappointing. Much to the dismay of many Indians, the prime minister bargained too much and got precious little in return. India has recognized, right from the Havana round of talks in 2006, that Pakistan suffers equally from the specter of terror as much as India. This contentious recognition is lop-sided given that India suffers directly from terror perpetrated, planned and executed by elements on Pakistani soil. Pakistan has vacillated from this assertion by terming terrorists alternately as “freedom fighters”, “non-state actors” amongst other terms to deny India the right to see these criminals being brought to justice. Additionally, while the prime minister’s spin doctors are quick to point out that Kashmir has been taken out of the declaration, a quick read of the document shows it to be very much present with the statement talking about India’s readiness to “discuss all issues with Pakistan, including all outstanding issues”. Then again, India has “de-linked” talks with terror; amazingly, the exact opposite has been India’s assertion for years, no talks till terror stops. The statement goes further to include Balochistan in the dimension of bilateral talks, a clear red-herring like the previous Joint Anti-Terror Mechanism that shifts focus from Pakistan to India as an equal perpetrator of terror and mischief in its neighbors affair. The effect of this inclusion will be profound and work against Indian interest, for we have now, on record, recognized Balochistan to be an issue that requires bilateral diplomacy rather than terming it as an internal matter of Pakistan.

Diplomacy and foreign policy is driven by the twin principles of pragmatism and national interest. A third variable may be trust based on bedrock of evidence. At the moment India’s policy towards Pakistan seems to fly in the face of all three principles. The Havana round of talks of 2006 were preceded by the train bombings of 7/11 in Mumbai, when the prime minister talked tough, albeit on Indian soil or on board his aircraft, only to capitulate in Havana and setting up the contentious Joint Terror Mechanism, which was given a decent burial after Pakistan used it as a bargaining chip against India. We initiated numerous ‘people to people’ contacts through rail and bus links only to be betrayed by Pakistan last year with the most devastating and daring 26/11 terror attacks in Mumbai. The prime minister then solemnly held that talks with Pakistan will not resume till the terror infrastructure is removed from Pakistan and that the Pakistani establishment ends support, covert and overt, to Pakistani terror groups. Months have elapsed since a dossier indicting suspects in Pakistan have been handed over to our neighbor, only to see it indulge in double speak and indulge in the most vile sleight of hand. The question that arises to most minds is why after repeated betrayals by Pakistan, does our prime minister offer a hand of friendship to Pakistan? What material benefit has India got from this unnecessary kids glove approach to our neighbor? And more importantly, where does the prime minister see Indo-Pak relations in the coming five years, given the Pakistani track record of the past five?

No Charisma? Don\'t Worry, You Can Still Be a Leader

No Charisma? Don\'t Worry, You Can Still Be a Leader

Railways: Financial Surpluses' and Political Deficits

The furore over the real status of surplus' at the Railways Ministry has become a mudslinging match between the current incumbent and her predecessor. The Congress-led UPA government has maintained a stoic silence with the Prime Minister not willing to comment on the issue of what is the truth about the Railways financial health. Railways Minister Mamta Bannerjee has raised doubts over the claims made by her predecessor over the surplus achieved under his reign and has pegged the actual surplus at a much lower number. This confirms the doubts raised throughout Laloo Yadav's reign that his actual achievement was clever accounting practices and good public relations rather than a year on year growth unseen since the inception of the railways in post independence India.

The Congress Party has approached the issue by adopting a political perspective. Laloo does not seems to have become a liability rather than an asset given his poor showing in the Lok Sabha elections and given the Congress' intent to revive the party in Bihar. Also, Mamta is the current flavour of the month in the corridors of power given her potential to upstage the Left in West Bengal in 2011. What is regrettable is that this is a good example of how the Congress mixes politics with governance. The UPA cannot suddenly disown the performance and figures of its previous minister in favour of its current incumbent based on political expediency. If the former ministers figures are incorrect an audit and White Paper must be considered and facts must surface as to how the government backed numbers that were clearly fudged. And if Laloo's figures are indeed true, the present Minister must own up and apologize. Ministers come and go, but institutions remain, they cannot be subject to political whims by the ruling party of the day. The truth must come out.

The Railways Budget Rebuttal

An excellent rebuttal by Arun Jaitley, the Leader of the Opposition in the Rajya Sabha to the Railways Budget of 2009-2010. Read it here, will the main stream media please highlight some very pertinent facts raised in this rebuttal?

Walk The Talk with Brajesh Mishra

Random Musings: Indian Healthcare

Apropos to the piece by Dr. Devi Shetty titled, Healthcare's grand reformation (Indian Express, June 16th), the eminent author has done well to highlight some of the issues that need the urgent attention of reformers and policymakers. However, Dr. Shetty has tended to focus on the financing aspect of the healthcare quandary and has referred to the US system, which sadly is not only the world's most expensive and inefficient, it is also the least equitable. The US has more than 44 million uninsured or underinsured people and spends over a trillion dollars to take care of its people. The litany of problems of that system are legendary and we would be better off not going down the American way.

It would be better if our policymakers look at the Bismarckian model of healthcare in practice in Europe. The social insurance network that the government has mandated allows both public and private hospitals to exist as providers, while allowing people in networks to buy insurance to pay for it. Dr. Shetty makes a reference to it through his successful Yeshawini scheme. Since health is a state subject, this social insurance can allow states to define what network people get into, be it at the district level or at a block or panchayat level. This scheme allows for multiple payers while at the same time allowing private competition both in insurance and in hospitals.

Secondly, Dr. Shetty has not pointed out the dismal spending on health by the Government of India. India spends a paltry 1% of its GDP, when more developed countries spend anywhere between 7-9% of their GDP. The World Health Organization recommends as 6% to be spent on health, clearly we have a long way to go before we achieve those levels.

Thirdly, there is a genuine need for the insurance network/market to gain ground for it can then allow the government to remove itself from the more capital intensive tertiary level hospitals and look at an extensive network of primary and secondary health care which provides preventative and accident and emergency care amongst other things. Today, the government is in a pointless competition with private players for the tertiary care "market" often at the cost of primary health care. The WHO had called for a strengthening of the primary health network in its 2008 annual report and it needs to be the focus of the current government.

Lastly, the explosion of the "mom and pop" clinics and nursing homes needs to be curbed. These are often manned by under-trained personnel with profiteering as their sole motive. A strong lobby ensures their continuity at all levels of the health care pyramid. A strong primary and secondary care network can help alleviate some of the problems that have manifested themselves as a result of this booming 'sector'.

Private healthcare needs encouragement but so does affordable healthcare. The mythical 'ideal' health system which has the triad of - affordability, quality and access does not exist anywhere in the world. All three of those attributes cannot exist at the same time. But the current malaise in the health sector needs to be addressed urgently and Dr. Shetty's prescription is a welcome step in the right direction.

Annals of Medicine: The Cost Conundrum: newyorker.com

Dt. Atul Gawande's experience from McAllen, Texas on why the cost of healthcare is soaring in the US. Makes for grim reading.

Annals of Medicine: The Cost Conundrum: newyorker.com

Shared via AddThis