The nation has been captivated by the crusade of the doctor-activist, Dr Govinda KC. After all, in the midst of all this anarchy one can't help but be moved by the sight of a doctor and a humanitarian drawing on 'Gandhian' principles to fight against the pervasive corruption in the system.
I, for one, gladly support him against the government, but that is as far as my reasoning will allow me to go on this particular struggle. Every issue can be seen with a different lens and mine just happens to be of a different kind. All the people involved with this campaign have been quick to throw the word 'mafia' around quite liberally which gives us the impression that these 'businessmen' are the kind of super villains whom the minions would be all too eager to serve. This story does have a hero, but does it really boast of any villains?
They are shady, opportunistic people – not very different from our 'tirpal scam' government officials and politicians – who want a slice from the lucrative pie that is modern medical training and services. It isn't a new or novel issue in commercialized sectors which show generous margins of profit leading to high rates of return. Like education, food, and many other fields, medicine has long since closed the door on ethics, switched off the lights and sold off its dignity to big business.
While people are busy displaying outrage at the 'mafia'and the commercialization they represent, they are oblivious to the fact that the medical profession has already evolved into an avaricious monster. These people being labelled the mafia are just a sad by product of this greedy system.
The rampant commercial manipulation of the patients at every turn, the inflated costs and unethical practices in healthcare are testament to this fact. Ask the patients who are fleeced day in and out by different hospitals and you will hear all sorts of stories that will make you question the status of health services in our country.
I know it because I've done the rounds of various hospitals. It costs an arm and a leg to get anything done and the all dubious profiteering practices in many of the hospitals would be enough to put the blushes on any 'mafia', never mind the medical one. A small problem warrants millions of completely unrelated tests, thus adding to institutional revenue. A lack of mutual recognition of one another's tests is also an example of exploitative administrative practices that require you to complete another array of expensive tests for a second opinion. All stakeholders, including doctors and administrators, turn a blind eye to it. After all, they in the end are the indirect beneficiaries of this commercialized system. How is this white collar crime any less than the 'mafia' threat? In a country with such a high rate of poverty isn't affordable healthcare worth a shout?
I have nothing against the good doctor and neither am I the cold blooded anti-nationalist that I am no doubt slowly shaping up to be in your mind's eye. While a lot of people and the media have touted the protest as a morality play between good and evil, there is always a different perspective to any issue. While you may think that their intentions are noble and my thinking perverse, I, as a common citizen, have every reason to be more concerned about the affordability of healthcare rather than how many doctors this country produces.
Yes, we need more doctors in rural areas, but how many of these doctors will actually work in places where they are needed instead of cramming into urban centres and taking the fast track to prosperity? How many of these 'under Rs 3.5 million' doctors will be conscience bound to uphold the virtues of this noble profession because of the fee limit? The common consensus is that substandard doctors may proliferate if this 'mafia' were given free rein. It's not like we don't have enough of those already, both home-grown and imported, and we have done nothing about it so far.
The Placebo Effect
I don't wish to detract from Dr KC's protest because as a doctor and philanthropist he has earned that credibility and respect for his work. But while I stand together with the nation and wish him the best, I don't see much hope for his cause as yet. All his team have are assurances from the government and the promise to form a commission to initiate reforms. Haven't we all heard that before?
Any novice will tell you that the first sign of government reluctance to do anything is when you hear the words committee, commission, and panel being thrown around. It's the oldest trick in the government handbook – the politician's equivalent of the placebo effect. In short, bide your time it all blows over whilst placating them in the meantime with commissions, reports, panels, committees and recommendations and promises of reform.
The optimism on display when the government committed to time bound obligations in the deal with Dr KC's team was rather naive. When has time or obligations ever pressurized the government to do anything? The only thing they will do is sign lots of 'something point' agreements with every Tom, Dick and Harry. A 16 point agreement, a 30 point agreement, or in the case of Dr KC, an 11 point deal.
If we had a rupee for every 'point' deal that the government did, we probably wouldn't even need any foreign aid. There is still a long way to go for Dr KC and his team. His opponents are still as formidable and they are entrenched in the political establishment and administration. As if all of these facts didn't stack the odds high enough, we haven't even begun to consider the new constitution and the changes it might bring if medical education policies are brought under the purview of provincial governments. This battle is not over by a long shot.
An individual act, while well intentioned, is not enough to solve the problems. If he enjoys broad based support like a lot of people profess, then a concerted effort is required by all within the medical fraternity. I would have liked to offer my apologies for all the doom and gloom of my views but I thought the better of it. Maybe it's the lens I'm wearing or maybe it's because I fully expect the government to prove me right. And unlike with Dr KC, they may actually live up to my pessimistic expectations.
gunjan.u@gmail.com
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