Carting Off Medical Institute to Corporate Predators
No one can be perfectly free till all are free; no one can be perfectly moral till all are moral; no one can be perfectly happy till all are happy."
To that talisman you could add another: no one can be perfectly healthy till all are healthy.
At a time, however, when Obama, the welfarist democrat, battles the American Congress, sundry red-necks, and powerful Pharma lobbyists and private medical insurers to bring to beleaguered Americans a guaranteed public health dispensation, his strategic partner, Manmohan Singh, may be about to cart off the All India Institute of Medical Sciences, an iconic symbol of Nehru's welfarist national vision, "recognized for providing low-cost medical care to large numbers of patients" (Wikipedia) to sundry business interests.
A committee (Valiathan) now recommends that the institute "should form consortia to develop and transfer for commercialization a range of products and processes."
It suggests that "consultancy for Indian industry should be encouraged among faculty," and faculty "should be given leave to join industry." Further that research papers should be monetarily rewarded as well, such as may be "of great interest to industry."
Inorder that these predatory objectives are nicely fulfilled, it recommends that "industrialists. . . be nominated by the central government" to the controlling Board "in consultation with CII, NASSCOM, and FICCII"—godlike conglomerates of India's private capital.
Lest you think that these recommendations have anything to do with enhancing the primary health care obligations of the Institute, please note that for the 12 years that the prestigious India Today magazine has conducted surveys, AIIMS has been ranked number ONE for 11 years!
Just as surveys conducted by the Week and Outlook magazines have named it the best hospital in India overall, as well as best in several individual fields, such as Cardiology, Nuerology, Gasteroenterology, Gynocology, and Opthalmology, ahead of several specialized institutions (Wikipedia).
Thus, even as Obama pays compliment to Castro's Cuba for the care it takes of Cuban's health, Manmohan Singh rushes to emulate the American Republicans who believe passionately (read rabidly) that the least penny spent on public health by the state violates the overriding sanctity of the Market.
As you would imagine, there is great and honourable resistance to the Valiathan recommendations within the AIIMS faculty, even as many also see in them an opportunity to make a private killing.
A Statement issued by no less than a 100 faculty members have underlined all the obvious and right things:
--that even in the US, UK, EU, Japan, there is no practice of encouraging research papers with monetary incentivization—a move sure to lead to fudged research to cater to private wealth; and repeatedly;
--that the best research is always that which has the approval not of industry but of peers;
--that good research should be approved by the Institute and certificates of honour issued to the researchers.
More explicitly, the Progressive Medicos and Scientists Forum has in a letter to the AIIMS' President pointed out that the whole Valiathan exercise is calculated to transform the Institute "from a people Institute to an Institute serving Corporate interests."
The Valiathan recommendation that "members of pharma industry and business bodies be empanelled on the research council and decision-making bodies of AIIMS. . .in consultation with bodies like FICCI, CII, ASOCHAM" can have no other earthly purpose than to subvert the very Act of Parliament establishing AIIMS which had intended to make of it a premier act of faith to the people of India that the best health care would be made accessible to the aam aadmi (common man, a phrase that formed the bedrock of the Congress Party's election manifesto) at low cost.
As shown above, no argument can be made that this intent has over the years brought the professional standards of the Institute low.
On the contrary, the effort now on to gobble up the institute is but another shameful and grisly part of the tenets of the Washington Consensus of 1990 which enjoined that as far as possible public assets must be transferred to private wealth owners worldwide—tenets that the Manmohan government in India seems still devotedly wedded to even after the Lehmans and the General Electrics, and the Goldman Sachs and the AISes and you-name-it giants of private wealth have gone down the drain, breathing now if at all due to the munificence of the State at public expense.
But the abiding lesson of Capitalism remains that cannibals will be cannibals until the proposed victims clench collective fists and put the fear of mass uprisings into them.
If you didn't know, India already has the world's sixth most privatized health care system.
And you may well wonder why that should be so in a country which in absolute terms has the largest numbers of children dying from preventable diseases, largest numbers of the world's malnutritioned and undernutritioned populations, largest numbers of anaemic mothers, and some 77% citizens who afford an expenditure of only half a dollar or less per day.
You may well wonder at the obscenity that those national indices should go hand in hand with dreams of superpower glory.
I pose that question not as a rhetorical flourish but to register a deeply embedded truth of India's Brahminical culture, one that bears intimately on the svarna (twice born) view of whose life has meaning and whose rights to life are admissible—a theoretical legacy of inequity tailor-made to fit the inequities of the Capitalist social order.
And this sordid story is nowhere more thoroughly and trenchantly laid out than in that magnificent piece of research and analysis by one of the world's foremost social thinkers and philosophers, the late D.P. Chattopadhyay, titled "Science and Philosophy in Ancient India," (in Marxism and Ideology, K.P.Bagchi and Co., Calcutta and New Delhi, 1981).
And at the heart of that exploration we are taught about the greatest tragedy that Indian social and intellectual life ever underwent some 2500 years ago, namely, the systematic decimation of the beginnings of science in India at the hands of priestly law-makers.
With the first emergence of surplus as ancient India evolved to its agricultural stage, two deadly theoretical pincers were floated by the dominant, Sanskrit-using Brahminical class to ensure its appropriation:
One was to say that our endowments or denials have nothing to do with any material principles of social organization but with our karma; and, second, that whereas till as late as the IXth canto of the Rig Ved the object of prayer had remained the procuring of food, all that changed to the attainment not of food but of moksha (emancipation from the cycle of birth and rebirth), something which again could not be hoped for without involving the exertions of the priest class.
Imagine that into such a conjuncture should have stepped in India's first materialist school of thought, the Carvak Samhita, which argued that "everything about purusa or man is established in the body." And to say "pranah pranbhutam annam"—"life is just food transformed into the living."
From those stipulations issued the science of the Ayurveda, an empirical science that proposed that the body of man comprises pancha bhuta, five elements (much like the western theory of cholers), and that good or bad health had reference merely either to the sound or unsound proportion in which the elements inhabited the body. And, following from that, the praxis that cure could not be caused by priestly rituals but by the administration of elements procured from the physical/natural world.
Is it difficult then to understand the mortal threat that the new science posed to the dominant social groups, or to understand why they should have set about, in unabashedly obscurantist and cruel ways to ensure that the Ayurved was rendered the shudra among the Vedas, and that the new physicians were shunned, ostracized, and ejected from social approval?
As Chattopadhyay writes:
"while the scientists are interested in the theory and practice by which man acquires mastery over nature, the law-makers are interested in the theory and practice by which man may acquire mastery over man,i.e. to keep the large masses of men under control or as law-abiding people which in the ancient Indian context, concretely means people submitting to the model of Varnasrama society (loosely, the caste hierarchy, where the word Varn means, interestingly, colour—the first enunciation of a racial principle). Understandably, therefore, the ancient Indian law-makers find their basic purpose totally incompatible with the promise of positive science."
Thus, just to give you a taste of what is meant:
--"the law-codes of Apastamba declare that food given by a physician is too filthy to be accepted by members of the higher castes";
--"Gautama's law-codes assert that a Brahmin may accept food from a ‘trader who is not an artisan,' but he must not accept food from an artisan or a surgeon who belongs to the group of the intrinsically impure persons";
--"the law-codes of Vasistha fully concur food offered by the physician is as impure as that offered by the harlot etc.,"
Note that the Gita stipulates that "one's own duty (sva-dharma) is relative to one's social status" (see Shri Krishna Saksena, "The Story of Indian Philosophy," A History of Philosophical Systems, ed. Virgineus Fern, New York, The Philosophical Library, 1950.)
Thus it is that these legacies continue to inform the policy preferences of India's current Brahminical major domos, preferences that gel nicely into the preferences of private Capital.
Those preferences conjointly hold that not all human lives have equal worth or equal claim, and that being so, institutes like the AIIMS have but been squandering expertise and resource on those whose claims to health and happiness are denied by the best principles both of India's Brahminical philosophy and of the diktats of private Capital.
In recommending what he has recommended for the reconstitution of the institute, Valiathan is but only being faithful to those converging principles.
And, yet, now that we understand more than we did in the years gone by, it is about time that somebody stood up and showed him the door.
"We the People" of our times are no longer the dumb-driven lower orders of times past, and there are physicians among us, like the 100 signatories, who now possess both the theoretical and social clout to defeat social and economic Brahminism.
All power to them and to all the others who are on their way to join with them.