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Education, Healthcare and Infrastructure: Development Tripod

Newton or some other genius when praised profusely for his discoveries and inventions is said to have humbly remarked that if I look so tall, it is because I stand on the shoulders of giants. If a nation aspires to become developed and wealthy, it first needs the tripod of education, healthcare and infrastructure to elevate itself to a higher plane. There are other elements like landmass, natural resources, innovators, which help but the former three are the primary colors. Singapore, Japan, Netherlands and Britain have a small landmass and few natural resources, Switzerland is landlocked, but they are all developed wealthy nations and the last one did not even have colonies to exploit. America, within a few decades of its birth made basic school education compulsory and free. An educated workforce is essential for manufacturing industries, a necessary intermediate stage for development from an agriculture based society.

Singapore, Malaysia and more recently China began their climbs with universal literacy. India, as I emphasized in my article on its path to stunted growth has failed miserably in that goal with literacy rates of 60+ % even after 60 years of independence. Lack of education dooms a large chunk of the population to menial jobs with pay so poor that 75% of the population has to survive on less than two dollars a day. Amartya Sen and other developmental economists have emphasized that female literacy leads to tremendous progress by better childcare and child survival with reduced birthrates and improved economic status of the family. Urbanites in India often make heavy personal sacrifices to provide private education to their children. Those in villages do not have incomes or functioning public schools and are compelled to use their children for economically productive labor. The failure of all Indian state and central governments to provide basic education to all its citizens shows the incompetence and shamelessness of its corrupt, power hungry, dishonest and self-serving leaders from all political parties.

The second leg of the tripod is healthcare. A nation needs educated healthy workers. This is why all major developed nations with the single exception of America (with the same caliber of leaders as India) has failed miserably in this. Most intelligent compassionate persons would consider basic healthcare a human right and not a privilege. The demented rants of Republicans from Reagan to Bush and McCain, the false propaganda of the insurance companies and the beholden status of Democrats from Clinton to Obama ensure that there will not be a national health plan for a decade, if at all. The gullible electorate, due to ignorance and lies has been made allergic to government health plans and addicted to the narcotic of free enterprise in healthcare, even while the Congress and presidents give themselves gold plated plans paid almost entirely by the government as do all seniors on Medicare and poor people on Medicaid.
These plans cost 6 to 7% for administration overheads (leaving over 90% for delivery of healthcare), while private plans consume nearly 30% for administration, humongous CEO salaries and perks. Corporate and hospital profits take their pounds of flesh leaving about half of the individual premiums for actual delivery of healthcare. If hospitals and insurance companies are converted to a non-profit status as is done in Germany and other developed countries or a single payer government insurance as in Britain, Canada and other developed countries, the US healthcare expenditure would fall from the current 15% of GDP to a more reasonable less than 10% with more uniform care as in most of Europe, Canada, Australia, Japan, Taiwan and other civilized countries.

The high cost of healthcare is why many automobile manufacturers, domestic and international, prefer to locate their plants in Canada (with a national health service) rather than America even though the Canadian operations are meant to provide products and services to the US. That way the companies are relieved of the heavy burden of paying their employees' health costs. This is why US companies and employers are dropping health coverage or increasing employee contributions and deductibles and making it difficult for workers to change jobs. The insurance companies desiring to skim the cream and avoid insuring the sick use the punishing threat of not covering pre-existing conditions, creating a nightmare for workers. Nearly 50 million Americans have no health insurance and over 20,000 unnecessary deaths occur every year because of people not seeing doctors due to lack of money.

The figures for India are probably hundred times higher. India provides free healthcare in government hospitals by using Parkinson's third law -Delay is the deadliest form of denial. These hospitals are understaffed, often with less competent doctors with many a times less compassion, honesty and willingness to work and are rarely monitored or suffer any disciplinary action for failure to do their duty. Their facilities, drugs and equipment are often dismal, substandard and non-functioning. Thus the poor spend inordinate time to obtain inadequate care with dismal outcomes. Indian public hospitals are even worse than the scandals of the American VA system and bureaucrats of both countries are oblivious to suffering of others. Indian politicians mouth high sounding slogans while American politicians blame the government and wish to reduce it to such a small size that it could then be strangled in a bathtub (words of Republican pundit Grover Norquist).

Infrastructure accounts for the recent growth and development of Hong Kong, Singapore and China. America had first class infrastructure. It first learned from the Nazi autobahns and developed the highway system beginning with Eisenhower. Now McCain and Clinton want to gut the system by removing federal gas taxes for the summer so that they can win elections. That will make more bridges fall down like in Minnesota, more sinkholes in Texas and make the Brooklyn Queens Expressway and the road to JFK airport just as safe and rocky as the road to the Baghdad airport. The present US administration wants to rule the world with space weapons and air-bombing, so no need to spend on roads and infrastructure. We can get our kicks out of bombing Afghanistan, Iraq, Somalia or Iran. We don't need to make anything to use by us or to sell abroad. We will just trade stocks, bonds, commodities and credit default swaps on our way to prosperity according to our Rubins and Paulsons. At a G8 meeting, the soft spoken German Chancellor Angela Merkel reminded our idiot president when he was offering gratuitous financial advice, 'We, in Germany still make things the world wants to buy'.

India's dictionary has yet to list a word called infrastructure. It still lives in past glories of the Silk Route. Road, rail and air transportation are slightly better in 60 years of independence but still marginal and primitive. Large swaths of the rural population are isolated in the monsoons and in the north in winter snows. Huge numbers have no paved roads, electricity, potable piped water or a sewage system. Even major urban areas receive a few hours of electricity daily (like American management of Baghdad) and piped water (often unsafe to drink) for four hours a day. Even a hole in the ground latrine is absent in many rural areas. In the meantime members of the Indian parliament and state legislatures just like the American Congress members make frequent expensive unnecessary trips abroad to improve their governance. Both governments practice socialism for the rich and jungle capitalism for the poor. Bandwidths, broadcast frequencies and licenses are given to friendly campaign contributors for a song or free. Billions are spent to bail out Lockheed, Chrysler, LTCM hedge fund, Bear Stearns, while homeowners, credit card holders (all common people) are legally cheated by fraudulent loans and usurious interest rates (18 to 30% on credit card balances; Hillary Clinton as a New York Senator voted for the new bankruptcy bill and bank charges).

None of these inequities promulgated by the crooked and corrupt leaders of India and America would persist if the electorates were not devoid of a thinking brain. Indians and Americans seek refuge in religion. Indians worry about being reborn in even worse conditions next time and Americans are bamboozled by their churches and politicians by inflaming their passions and hatred towards abortion, gay marriage and African Americans on public assistance, aid to dependent children or earned income assistance. The truth is there are more whites than blacks collecting on those aid programs, just as there are more whites than blacks attending elite colleges on affirmative action programs. The difference is that white affirmative action program is called alumni preference.

In India, the quotas for different castes in elite educational institutions will decrease the previous high standard of Indian professionals that is so noticeable even to Americans today. Affirmative action entraps us in a bush full of lice (forgive my spelling errors and oriental pronunciation) to the detriment of the nation and the world. If India and America want to genuinely redress past wrongs, let them grant free college and professional education to the previously oppressed castes or African Americans or free special education to mentally handicapped persons like Bush Jr., but they must be admitted to colleges and get academic promotion on merit only. By our mistake the genie has been let out of the bottle and does Cheney's bidding whenever he rubs his magic lamp and the price of Rice is in a bubble. India's tripod to ascend is yet to be built while America is dismantling its tripod to use as fuel to keep warm and drive SUVs.


More by :  Gaurang Bhatt, MD

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