July 30th, 2009 
Admin 
SOCIAL JUSTICE THROUGH HEALTH CARE
We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These mismatching result in defective and inefficient health care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.
Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.
Name : Dr. Pardeep Kumar Sharma
Email-ID : omfspardeep@yahoo.com.
(M) : 0988456296
Date of Birth : 12.02.1962
Education Qualifications : BDS (Bachelor of Dental Surgery)
MDS (Master of Dental Surgery in Oral and Maxillofacial Surgery)
Educational Institutes Attended
Govt. High School Bargari : Matriculation (1969-1977)
Distt. Faridkot, Punjab, India
DAV College Chandigarh : Pre-University (1973-79)
(Punjab University)
Barjindra College Faridkot : Pre-Medical (1980)
Dental Wing, Medical College : BDS (1981-1986)
Patiala
Dental College and Hospital : MDS (2003-2006)
Amritsar
Professional Experience
House Officer, Christian : 1987-1988
Medical College & Hospital,
Ludhiana
Research Officer, All India : Jan. 1989 to June 1989
Institute of Medical Science
AIIIMS, New Delhi
Dental Officer, Indian Armed : July 1989 to August 1994.
Forces in the Rank of Capt.
3
Medical Officer (Dental) : w.e.f. Nov. 1995 till date
in Punjab Civil Medical Service
(PCMS)
Research papers Published
“Role of Programmed cell death in dental anomalies associated with cleft lip and Palate”. “Medical Hypotheses” Churchil Living Stone Publishers London-1991
Post traumatic polatoglossal adhesion, a case report stomatologica India (1990).
Research Project Undertakes
“Malocclusion and associated Factors among Delhi Children” a study sponsored by Indian Council of Medical Research (ICMR).
Areas of Interest : Environment, Health, Defence, International Affairs and Rationalism
Watch the video related to health care
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Help answer the question about health care
How would health care reform effect doctors and patients in america?What are the pro's and cons for both doctors and patients…
I like the quality of care that i receive now but the price of medical care is sickening & unaffordable to pretty much everyone. How would this effect health care? If you get to pick your own doctor how would this effect your treatment? How can our country realistically afford to pay for health care? Are taxes going to go up to pay for this which in the end is that even saving americans money?
Give me some facts about this health care plan
About Author
author is an oral and maxillofacial surgeon working as programme officer with civil surgeon ludhiana,punjab ,india
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People like Seldon are scary…. he would give up his liberty and freedoms because he's been told to be mad at the insurance companies. Really pitiful.
I know this is not addressed to me. I just want to say that I think you are very wise to look at other countries. If my husband and I were younger, and if I were healthier, we would be doing the same. We love this country but we are about to see her change for the worse and forever. Maybe our children will be as wise as you are.
BTW, Costa Rica is absolutely spectacular! We have been (surfing) a few times over the years. It is an amazing place. You will find much happiness there. Love it!
You cant just walk into any dentistry and expect they will treat you right off the bat. You half to book an appointment. Its not like they have an emergency system in dentistry.
Just remember that Congress was quick to exempt themselves from having to use the same option as the Joe Public whould have to use. I think government employees to include career military would still have the opportunity for the same plans that would be available to Congressmen. What is good for the goose (government workers) is not always considered by the government to be good for the gander (public or private citizens).
He cant keep his foot out of his mouth long enough to say anything worth listening to.
Demand socialized prostitution Now ! How long would we have to wait?
The situation with the baby happened to me. I was rushed out of the hospital with no real diagnosis and had to go to another hospital to get a real diagnosis for something that was potentially life threatening. That was about 8 years ago. Recently, I was in the hospital with a high fever that had sustained for over a week and I had to wait 8 hours to be seen. The idea of putting a negative spin on this in the video is ridiculous.
I am studying nursing and I know for me it is the right choice, not because it is a 'woman's thing' (there are several men in my classes), but just because it is what's right for me.
I know here in Canada nurses are taken very seriously. We aren't ordered around by doctors, we are autonomous.
You need to decide what is best for you. You, and no one else,
The quality of health care in our country is also a great deal better. With universal health care we will still have MRIs. We will still have family doctors. The problem with Canada is they do not have enough doctors in the country with the education that is provided at United States universities that we do here.
GULAG was the government agency that administered the penal labour camps of the Soviet Union.
They call them hockey rinks in Canada.
I agree with you. Democrat Rep. John Conyers backed down from his pledge to investigate ACORN fraud:
http://spectator.org/archives/2009/05/07/conyers-kills-acorn-probe/print
What happened in a mere two weeks to change Conyers’ mind? Did he get a call from friends of ACORN in high places? Did he get something else? Why drop the call for a congressional probe in the very same week that ACORN criminal charges have been filed in Nevada and Pennsylvania?
http://www.foxnews.com/story/0,2933,519155,00.html
http://www.thepittsburghchannel.com/politics/19395414/detail.html
What gives? Or who gives? Now why would Conyers want to go after the goose that laid the golden acorn.
I get a kick out of all these people who vehemently support and protect Obama and his policies – they act as if his decisions will not effect them – only other people. They act as if they are immune to the coming Socialism and the devastating effect it will have on our country.
What does it mean when they say that they “want Obama to succeed?” Does that mean that his supporters just want him to “personally” succeed at passing through all of his programs? This is the sense I get. His supporters seem to be only focused on this man and his own “personal” success RATHER than focusing on the outcome and ramifications of his decisions.
This arrogance, insanity and idiocy MUST stop! You hear the media and others say that Obama is so smart, but what kind of “smart” man would arrogantly and obviously spend massive amounts of money that he simply doesn’t have — where is the intelligence there? What kind of “smart” man would create trillions in debt for future generations while at the same time complain about “the huge government debt and waste” Obama does have a “smart” – a certain kind of conniving “smart” – a manipulative “smart” – after all – since Obama lies EVERYDAY – he must be somewhat smart – but only in the sense that he has to remember all of his lies!
Bhil, aboriginals or natives of India are the first to own the land in India. Though could not go through your full narration however I included in watch list and would read at leisure.
However I agree that we so called urban Indian or so called Aryan have deprived Bhils of their legitimate rights and in greed of so called growth have encroached their habitat. Now they are forced to come out in our world and adapt to get integrated with so called main stream.
Max what we can do is now adopt then in our society and give them their due respect.
Another bleeding hearts story with no substance.
No one forced the adults here illegally. No one forced them to have 3 children here. No one forced them to remain here when the father returned to MX.
I was reading an article this morning about the MX call center in AZ. A immigrant worker in CA was looking for a family member who had come to the US illegally. He called the center and they found his family member withing 24 hours.
This tells me our government can find the illegals and deport them. We don't need an easier system to get them here, we need an easier system to get them out and keep them out.
Tell me sublimeade. Is there any truth to this statement that has been floating around?
“Not all Republicans are racists, but all racists are most definitely Republicans.” I
Well done. At least you've researched it. Many of the items you list are the reasons I do support Obama – so we'll agree to differ.
However, I will question your assumptions in point 11 and 12.
There's so much info here on this link – you'll have a field day – but it's quite interesting ( for example it has the national debt and inflation recorded year by year by President since 1780 ish on the spreadsheet at the bottom under sources – you need to select the worksheet).
You'll figure it out – but look at Fig 1 which shows the climb in National Debt. And look at Fig 3 together with the narrative underneath which shows the "change" by President for the last 50 years.
You will see that Democrat policies have been more successful (Clinton, Carter and Johnson) and that tax decreases have not had the anticipated effect.
http://www.cedarcomm.com/~stevelm1/usdebt.htm
.EDIT: Point 13 – The minimum wage is arguable. First should there be a minm wage? And then what level is it set.
It's a matter of judgement. I have a view that says it should be set in areas wider than one state.
Generally – I have to say it's difficult to compare the pre war period with the post war period – because so much has changed. The lessons are different – the balance is different.
I'll come back and give you a counter argument for Point 12 shortly. I have to attend to something briefly.
OK POINT 12 – I say increasing tax on rich does not affect jobs. The higher the income the more their money is spent outside their domicile country – holidays, overseas property. Taxation takes the money into "federal" control. That is then spent within the US – on infrastructure, on defence – or even as lower tax for low earners who spend on local goods and services. So taxing the rich helps the economy more than not taxing them.
A counter argument to this is that the rich move out – but thats a matter of balance again when compared to other countries. But bear in m ind – most choose to remain in the US and enjoy the benefits it offers . Lower tax countries are low for a reason – they don't offer the same environment or other benefits.
EDIT: Just read your updates. Regarding business tax. Businesses are in the the US because thats where their market is. It' not just about tax rates. Businesses also consider the benefits of a legislative framework – what redress they have on unpaid debts for example. One of the central planks of Obamas policy is to tax the many US companies who continiue to do business in the US but have chosen to register their business outside US to avoid paying US taxes. For example, over 12000 US companies are now registered in the Cayman Islands yet 99% of their market is in US. They are simply re-registering their office, tax advisors told them to. They still do the same business in the US -but pay their tax to Cayman Is not US. Obama is going to close that loophole. The money will be taxed from where it is earned – not where it is accounted. All these companies are doing is aviding the tax they should legally pay. That puts them back on equal status with their competitors – often smaller companies – who have been unfairly put at a disadvantage. It doesn't mean jobs are lost. It actually encourages more investment – because only profits are taxed. If they re-invest – they avoid tax. .
I've got to go out soon. I'll check this page later.
EDIT: Yes – a "paper office " as you call it. Thats whats been happening. You can keep lowering taxes – but if they find a country with a lower tax – they move – or re-register. They can hop from the Bahamas to somehwere else for a 1% difference. Obama plans to change the tax point. If they've done the business in the US they'll pay US taxes. They can keep their paper office – but there will be no point. It's been done in Europe where they had the same problem. Some of the finace companies still amnage to get round it – because they can "earn" moeny in the paper office. But manufacturing industries, service industries, distributive industries, retail businesses will no longer be able to avoid paying their legal tax contribution.
BTW I also have been in business, corporate and private for 33 years – and points 29 and 30 we could never agree.
Must go. Thanks..
Its True, I’m trying to get into medicine. I’m a canadian but i do want to go to an American Med School preferably. The problem in Canada is also the Canadian Medical Association – it doesn’t want too many doctors – b/c that would reduce pay – & to all those ppl who think docs in Canada don’t get paid enough – my doc bought a million $ house last year & those who think the gov. comes btw me & ma doc – i’m even goin to his sons wedding this Saturday. The prob is doc & nurse shortage.
Another prob. is that our system in Canada is not being co-ordinated too well – we need to modernize in the sense that we need to move towards Medical Databases that docs have easy access to & better communication btw a patients various docs again through electronic means – these kinda reforms r what Canadian health care probably needs for sure