On Thursday 07 Jul 2011 10:27:59 pm you wrote: > Are > there no points at which this "foreign model" will suit us? > Deepa I would like to put my reply on silk as well and will do that.
No No Deepa. The foreign model is extremely good in a lot of ways. But we need to be honest and pragmatic - which we are not. A significant proprtion of the Indian "system" (scholars, doctor, bureaucrats, leaders) are not honest enough to actually study Indian requirements and apply the best solution - western or Indian. We just apply western solutions after quoting western studies and gradually dilute and water down those solutions to create an Indian parody. Time and again I see statistics in American journals regarding some American issue. A few months later those statistics are quoted by someone in India as if they apply here - which is clearly untrue. India seems to have developed neither the ability to generate its own data a credibly, not do we have a system that is able to discard inappropriate western data when it is copy pasted into an Indian situation. Examples abound: 1.The American says (hypothetical figures) "Disposable surgical staplers save time and money". A stapler costs US$ 500 and saves 30 minutes of operating time and amount to a saving of US$ 2000 overall. These are the statistics that are good in America and for American bean counters and insurance companies who would rather pay 500 for a stapler than 2000 for an extra 30 minutes. In India the same (imported of course) stapler costs Rs 20,000 but the extra 30 minutes in the opreating theater costs only Rs 2000 more. The solution is nonsense for India. 2. The American says: "Medical mistakes are a leading cause of death". The truth is that medical mistakes become a leading cause of death when you have eliminated most of the other treatable causes of death and are saving people quickly, efficiently and accountably. This does happen in the west. If you have a lethargic and decrepit system where people are still dying from diarrhea, accidents and tuberculosis - the "medical mistake" is in not recognizing that and imagining that the American situation is true for India. Maybe in America medical errors kill 10 % of patients (I don't know the actual figure) . In India the figure would be less than 1% because people are busy dying from diseases that Indian medical systems have failed to control as efficiently as has been done in the west. I have mentioned disposable staplers deliberately. They are a typical example of Indian medical fraud and self delusion at the highest levels. A "stapler" comes in 2 parts. The staples cost about Rs 5000 but the stapling gun costs 15,000. You can use one gun on one patient and as many staples as you need. You may need more than one, but everything must be disposed of at the end. So in India, if I am honest, the patent will spend 20,000 for just one line of intestinal staples. But we are not honest. The stapling gun company rep will tell the surgeon "Sir - here is a gun. You can resterilize it and re use it so the patient pays only Rs 5000 for the staples and nothing for the gun." Those guns are not meant to be resterilized. Thay are meant to be disposable - but in India they are re used. Otherwise they would be too expensive for use. No one will admit this because it is lucrative for both manufacturer, the dealer, the doctor and the hospital. And the idiotic insurance company pays. No wonder everyone is having a ball. shiv
