Ethics dilemmas at Harvard Medical School

The Hindu recently carried an article on ethics issues involving faculty at Harvard Medical School.  The question of keeping clear distance from the pharmaceutical lobby is discussed.

Health insurance: Socialistic influences in US

Although international issues appeared to be paramount in the early phase of the US Presidential race, the collapse of the American financial greats has turned attention to bread and butter issues, including healthcare.

Paul Krugman’s concise and clear analysis of the positions taken by the nominees, Barack Obama and John McCain points to the enfeebling health effects of private sector health insurance. Read it here. It has now become clear that US Health Insurance companies will refuse cover to those with pre-existing illnesses, and the McCain camp wants to strengthen their hands by slashing protections available under employer-funded insurance. Obama is clearly on the side of a stronger state-supported system, and very importantly, against weakening the already weak system in America.

Predictably, the Wall Street Journal came out on the side of the insurance companies in this Op-Ed. A glance at the public discussion on the WSJ position (at the end of the same article), shows that the public is fiercely against McCain and his debilitating proposals. The sleight of hand of the Republican camp is exposed by the nominee’s proposal to provide tax credits (that won’t pay in full for a family’s private insurance, requiring out-of-pocket expense) but removing incentives for employer-funded health insurance. Even worse, it will shrink the scope of state-insured medical care which is available for emergencies and those over 65. When this is achieved, the insurance companies can set even stricter terms for individuals (who cannot get insurance from their employers) or simply refuse insurance! 

The message from all this should come through clearly for the myopic Indian middle classes, who are clamouring for corporatised healthcare and private health insurance, as if that will solve all the problems of our admittedly poor health care delivery system. It should also lead to a review of the working of the entire health insurance industry in India by the UPA, if it aspires for another term.  Of course, the supreme tragedy is that the UPA Government of Manmohan Singh has a Health Minister who is a votary of private health insurance and for-profit health care. 

/ga

Ilina Sen speech for Binayak Sen’s award highlights India’s food, nutrition inequities

“In India, nutrition surveys of the National Nutrition Monitoring Bureau have shown that over 33 % of the population have a Body Mass Index (BMI) of less than 18.5, considered to be the minimum level for less than starvation standards. Translated to demography, this means that over 400 million people are exposed to near starvation conditions. To add to this catastrophic situation, we are confronted now with a new set of crises. Between 1990 and 2005, the daily per capita availability of foodgrains has fallen from 510 grams to 438. World food prices have risen, and the concentration of land ownership in a few hands has intensified.”

– Acceptance Speech for Jonathan Mann Award: Ilina Sen, Awards Banquet of the Global Health Council,
Washington, DC, May 29, 2008.

US Healthcare: Evidence of a flawed model

Many middle class members have a simplistic, rosy view of US Healthcare. It is to this group, which also has significant purchasing power, that the private health insurance business is addressing its messages in India. The outcome is both negative and paradoxical in societal terms: the government is effectively withdrawing from expanding tertiary care for symptoms of chronic diseases, while for-profit institutions are fattening themselves on gullible citizens.

For all its perceived superiority among the middle classes, is the US system delivering the best results?

The most recent revelations point otherwise, as this excerpt from a story in the New York Times shows.

“It’s very troubling that there are parts of the wealthiest country in the world, with the highest health spending in the world, where health is getting worse,” said Majid Ezzati, the lead author and an associate professor of international health at Harvard. It is a phenomenon, he added, “unheard of in any other developed country.”

Read the full story here. The full paper published by the Public Library of Medicine is here.

Clearly, Professor Ezzati is making a comparison with the rest of the developed world that believes in state-supported, total healthcare, with demonstrably better results.

Will our policymakers take note?

ga

TAKE DR BINAYAK SEN’S MISSION FORWARD!

On 14th May 2007 when the Chattisgarh police arrested reputed public
health and civil rights activist Dr Binayak Sen they threw into prison
along with him all of Indian Democracy itself.
Detained under the draconian ‘Unlawful Activities Prevention Act’ on
false charges of being a ‘Naxal’, slandered in the media, denied bail
by the Supreme Court, Dr Sen’s case stands as a challenge to every
Indian who aspires for a humane, democratic and civilized India. If
this is the treatment meted out to the Vice-President of a national
civil rights organization and a doctor of international reputation,
who has dedicated three decades of his life to work among the rural
poor and tribals, it can very well be imagined what more ordinary
citizens are undergoing all over the country.
Right now as we write Dr Sen continues to be in jail and hearings of
the case against him in the Chattisgarh High Court have commenced.
While the future course of the trial cannot be fully predicted, going
by past experience, it could be several years before even a judgment
of sorts will be delivered. In the meanwhile Dr Sen, who has already
lost 15 kilos in just ten months of imprisonment and is in poor
health, will continue to languish in jail- robbed of his freedom for
the sole crime of working with the poor and defending democratic
rights.
However, given the vague provisions of the law under which Dr Sen has
been arrested as also the deliberate delays in the legal process it is
difficult to envisage how his release can be achieved without a
national level social and political movement.
There is an urgent need now to carry forward the mission that Dr Sen
has dedicated his life to – namely public health work among the poor
and civil liberties activism on behalf of the powerless. The message
that we, the people of India, need to send to those who are willfully
throttling Indian democracy must be – ‘if you arrest one Dr Sen we
will make sure there are many more like him to take his mission
forward’.
It is with this objective it is proposed to hold regular medical camps
and public health campaigns across India, starting modestly with one
camp in the last week of every month in six or seven cities and towns.
The camps will be organized by groups working with urban poor
communities in various parts of India together with concerned medical
professionals who are interested in both Dr Sen’s release as well as
the cause of public health in general.
These camps and campaigns will over course of time highlight the work
done by Dr Sen, particularly in the area of nutrition and the link
between socio-economic rights and health.
We appeal to all who wish to work for a more democratic, just and
healthier India to come forward and contribute to these campaigns in
whatever way they can.

Cop-doc nexus in kidney racket?

The mega racket unearthed in Gurgaon last week of kidney theft from poor working class youth by a cabal of doctors and agents bringing in foreign clients is a gruesome metaphor for what the Indian elites in general have been doing to the country’s poor for several decades now. This report below confirms the fact that the Indian State, represented in this case by the Gurgaon police, wears its uniforms and wields its guns to protect the perpetrators of such crime and not the victims.

Gurgaon, IBNLive.com: Life has come full circle for the Gurgaon police. On Friday, the city police commissioner in a press conference, claimed credit for unearthing the biggest kidney racket.

On Saturday, the Gurgaon police are under the scanner. Moradabad police, who first registered the case, claim that information of the raid was leaked leading to the escape of the main accused.

“Looks like there’s some kind of nexus. Otherwise what explains the leak of information,” says ASP, Moradabad, Manjeet Saini.

The ASP is not the only one complaining. Residents of Gurgaon’s Sector-23 are now alleging they had suspected foul play for long but despite their repeated complaints the police chose to ignore the warning.

We told the police that this house and whatever goes on inside needs to be investigated. That’s what we told them,” says a resident, Satbeer Singh.

Agrees Gautambheer Das, another resident, “There has to be some nexus between police and doctors or the police are totally blind.”

Meanwhile the Gurgaon police continue to raid several places in the city and also in Delhi looking for clues on the whereabouts of the main accused Dr Amit.

That the clinic where the racket was unearthed was D-5 is not the only similarity between the gruesome Nithari killings and this kidney racket. In this case too, the police conveniently ignored all complaints made by the residents of the locality and with the mastermind still on the run, they have not much to boast of.

Nandigram victims recount tales of horror

 

Tomluk (West Bengal), (IANS) Cowering in fear, victims of violence in West Bengal’s Nandigram region Wednesday recounted tales of torture at the hands of Communist Party of India-Marxist (CPI-M) cadres.

‘My wife was beaten up by CPI-M attackers when I was not at home. They broke her legs with a rifle butt and dragged her to a paddy field at gunpoint and raped her till she lost consciousness,’ Mir Akbar Ali told IANS at a government hospital in Tomluk, about 130 km from Kolkata.

 

‘Both my daughters, 16-year-old Ansura Khatun and 14-year-old Mansura Khatun, were abducted by CPI-M cadres and are missing,’ he said.

 

Ali said the CPI-M cadres started their operation of recapturing Nandigram in East Midnapore district Nov 5 and worked gradually through the area.

 

‘If you go to Nandigram you will find red flags fluttering on top of every house. The entire district has turned into a ghost town,’ he said, recounting how people were killed when CPI-M men fired upon a rally taken out by the Bhumi Uchched Pratirodh Committee (BUPC) activists Nov 10.

 

The rally was moving from Maheshpur to Sonachura within the Nandigram area when CPI-M supporters surrounded the procession and started firing, Ali said.