Who wants to become a doctor?
Evidently, not too many people, as this ToI report notes.
It takes ten years of sustained, punishing, high-risk training of the finest minds to make a trained specialist (obstetrician, surgeon, pathologist); fourteen if you want a 'super' specialist (cardiologist, brain surgeon). The results these days, despite the risk, can be quite impressive.
The only known 'de-risker' we know? The calibre and training of the mind-hand holding the scalpel.
About 15 years ago, Maharashtra created a new 'super-risk': a line of mantris and babus of the command-and-control dispensation, for whom doctors were slave labour.
Clever policies and incentives ensued: mandatory rural postings, endless exams, shifting universities, disappearance of teaching seats, and, of course, increasing reservations.
The finest minds have voted with their feet. Should we be surprised?
Showing posts with label healthcare. Show all posts
Showing posts with label healthcare. Show all posts
Saturday, May 09, 2009
Tuesday, August 14, 2007
Prime Minister's Independence Day Address -- an agenda for reform Part 1
PRESS RELEASE
15 August 20xx
In a significant break from tradition, the Prime Minister delivered the Independence day Address to the Nation while standing outside Parliament, in contrast to the usual heavily barricaded Ref Fort ramparts.
Excerpts from his speech:
"My dear countrymen. This day marks the xxth anniversary of India's political independence from over 300 years of Imperial occupation.
Every Independence day is a time for reflection -- of past successes and failures and of future opportunities.
Too many independence days have been spent thinking of the past, and of missed opportunities.
I believe, starting this Independence Day, India and Indians should spend more time thinking about their future.
Keeping that in mind, I spent a significant period of my first 30 days in office meeting over a thousand Indians, from all walks of life, from all parts of India.
Despite their incredible diversity, what struck me was how similar their aspirations for India were: Virtually all aspired to see, in their lifetimes, an India that is safe, powerful, prosperous and dynamic; an India that guarantees the safety and security of all her peoples.
As your Prime Minister, that message is especially pertinent : my people are demanding actions from me and my Government that take concrete steps in setting India in this direction.
And we are required to deliver -- in five years.
On the occasion of this 15th August -- my government's first 15th August -- i will unveil our "first 100 day plan". Reflecting the urgency of expectations, this plan is time-bound -- a response to a clearly articulated expectation of tomorrow's India.
This 100-Day Plan is clearly focused on fundamental reforms and improvements in five core sectors that underlie people's aspirations for a safe, dynamic and wealthy and caring India.
These sectors are: Law and Order (internal and external), Healthcare, Education, Economic performance and Social reforms.
Even as we have focused on these five core sectors, my Cabinet colleagues have debated extensively what the role of Government in each of these areas should be. We believe that in any sector, the Government can play three separate roles: the role of a regulator (that sets and enforces laws), of a provider (an entity that renders a service) or of financer (pays for the service in question, but does not necessarily provide the service itself).
My government has established a clear point of view on the Government's role in each of these sectors.
The objective of the "100 day plan" is to set in motion fundamental reforms in each of these sectors. I shall outline my vision for reform in each of these sectors one by one, beginning with probably the most important: Law and Order.
Law and Order
Ensuring the security of peoples is the first and fundamental role of any Government. Unfortunately, over the past decades, this area has been systematically ignored.
This is an oversight that must be corrected; for, unlike in the other sectors, the role of the Government here is that of regulator financier and provider -- all in one. Failure in this sector is thus entirely ascribable to a Government failure.
Our first priority then in Law and Order will be to raise the funding of elements of our internal and external law and order mechanisms. Resources are needed to raise the service levels of our Courts (that have over 22 million cases pending), our understaffed Police services and our Armed Forces -- to minimise this risk of failure.
In addition to augmenting resources, structural reforms are also necessary to ensure that Lew and Order are always upheld. My government is working to create a reform blueprint to completely insulate Law Enforcement from political influence. This is necessary to ensure that the fundamental right of all citizens to a safe living environment is never held hostage to political and vested interests. It is my belief that with the implementation of these reforms, every perpetrator -- irrespective of class, religion, creed or nationality, will be brought to justice effectively and quickly. A crime punished is ten crimes averted.
Healthcare
Ensuring the mental and physical health of all 1.2 Billion Indians is the bedrock of a strong society.
Healthcare is a top priority for this government since in the next 5 years, this country will have over 300 million children below 15 and over 200 million people over 65 -- both of whom have significant healthcare needs.
The first reform my Government plans to make is to shift the burden of payment for healthcare from the user to the provider.
In our present healthcare system, the government funds hospitals and providers -- irrespective of the quality of care they provide or whether they provide care at all. In this system, citizens end up paying healthcare expenses from their own pockets -- a system that, in nation after nation, has proved to be inequitable and inefficient.
In contrast, the healthcare payment system being devised by my government will provide citizens with cash equivalents that they can redeem in exchange of healthcare services. Hospitals and doctors will be paid on the basis of healthcare cash equivalents they accumulate.
This will significantly increase the efficiency of the system by ensuring that costs are incurred only for services rendered, while also providing users -- especially the poor -- with a real choice in healthcare. A special ring-fenced fund will be established for administering this service to the poor.
The second major reform in health care is around quality management: its important for the Government to ensure that only those health facilities that meet stringent quality, service, hygiene and competence criteria are allowed to operate.
To that end, strong professionally run regulator institutions will be established in the next 5 years to monitor healthcare education, hospitals and patient safety.
[to be continued]
15 August 20xx
In a significant break from tradition, the Prime Minister delivered the Independence day Address to the Nation while standing outside Parliament, in contrast to the usual heavily barricaded Ref Fort ramparts.
Excerpts from his speech:
"My dear countrymen. This day marks the xxth anniversary of India's political independence from over 300 years of Imperial occupation.
Every Independence day is a time for reflection -- of past successes and failures and of future opportunities.
Too many independence days have been spent thinking of the past, and of missed opportunities.
I believe, starting this Independence Day, India and Indians should spend more time thinking about their future.
Keeping that in mind, I spent a significant period of my first 30 days in office meeting over a thousand Indians, from all walks of life, from all parts of India.
Despite their incredible diversity, what struck me was how similar their aspirations for India were: Virtually all aspired to see, in their lifetimes, an India that is safe, powerful, prosperous and dynamic; an India that guarantees the safety and security of all her peoples.
As your Prime Minister, that message is especially pertinent : my people are demanding actions from me and my Government that take concrete steps in setting India in this direction.
And we are required to deliver -- in five years.
On the occasion of this 15th August -- my government's first 15th August -- i will unveil our "first 100 day plan". Reflecting the urgency of expectations, this plan is time-bound -- a response to a clearly articulated expectation of tomorrow's India.
This 100-Day Plan is clearly focused on fundamental reforms and improvements in five core sectors that underlie people's aspirations for a safe, dynamic and wealthy and caring India.
These sectors are: Law and Order (internal and external), Healthcare, Education, Economic performance and Social reforms.
Even as we have focused on these five core sectors, my Cabinet colleagues have debated extensively what the role of Government in each of these areas should be. We believe that in any sector, the Government can play three separate roles: the role of a regulator (that sets and enforces laws), of a provider (an entity that renders a service) or of financer (pays for the service in question, but does not necessarily provide the service itself).
My government has established a clear point of view on the Government's role in each of these sectors.
The objective of the "100 day plan" is to set in motion fundamental reforms in each of these sectors. I shall outline my vision for reform in each of these sectors one by one, beginning with probably the most important: Law and Order.
Law and Order
Ensuring the security of peoples is the first and fundamental role of any Government. Unfortunately, over the past decades, this area has been systematically ignored.
This is an oversight that must be corrected; for, unlike in the other sectors, the role of the Government here is that of regulator financier and provider -- all in one. Failure in this sector is thus entirely ascribable to a Government failure.
Our first priority then in Law and Order will be to raise the funding of elements of our internal and external law and order mechanisms. Resources are needed to raise the service levels of our Courts (that have over 22 million cases pending), our understaffed Police services and our Armed Forces -- to minimise this risk of failure.
In addition to augmenting resources, structural reforms are also necessary to ensure that Lew and Order are always upheld. My government is working to create a reform blueprint to completely insulate Law Enforcement from political influence. This is necessary to ensure that the fundamental right of all citizens to a safe living environment is never held hostage to political and vested interests. It is my belief that with the implementation of these reforms, every perpetrator -- irrespective of class, religion, creed or nationality, will be brought to justice effectively and quickly. A crime punished is ten crimes averted.
Healthcare
Ensuring the mental and physical health of all 1.2 Billion Indians is the bedrock of a strong society.
Healthcare is a top priority for this government since in the next 5 years, this country will have over 300 million children below 15 and over 200 million people over 65 -- both of whom have significant healthcare needs.
The first reform my Government plans to make is to shift the burden of payment for healthcare from the user to the provider.
In our present healthcare system, the government funds hospitals and providers -- irrespective of the quality of care they provide or whether they provide care at all. In this system, citizens end up paying healthcare expenses from their own pockets -- a system that, in nation after nation, has proved to be inequitable and inefficient.
In contrast, the healthcare payment system being devised by my government will provide citizens with cash equivalents that they can redeem in exchange of healthcare services. Hospitals and doctors will be paid on the basis of healthcare cash equivalents they accumulate.
This will significantly increase the efficiency of the system by ensuring that costs are incurred only for services rendered, while also providing users -- especially the poor -- with a real choice in healthcare. A special ring-fenced fund will be established for administering this service to the poor.
The second major reform in health care is around quality management: its important for the Government to ensure that only those health facilities that meet stringent quality, service, hygiene and competence criteria are allowed to operate.
To that end, strong professionally run regulator institutions will be established in the next 5 years to monitor healthcare education, hospitals and patient safety.
[to be continued]
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