What’s up, Doc?
One of the biggest issues Sen saw looming in India’s near future was health care. India spends only 1.2 percent of its GDP on public health. Sen remembered that when Jamshedji Tata set up Jamshedpur he provided free healthcare to everyone not just the employees of the company. While the US for a long time was the one outlier among developed countries when it came to public health care, even it was making baby steps in that direction with the so-called Obama care.
But “India is the only country that is trying to have a health transition on the basis of a private health care that does not exist,” warned Sen. “We have an out-of-pocket system supplemented by government hospitals.” That was bucking the trend in the rest of the world.
“Privatisation is doing an extraordinary amount of harm in health care,” cautioned Sen. In 1946 a committee said India’s economy was affected by terrible health care. While he admitted India has achieved “much economic growth” he lamented that as a country we have “an extremely foggy idea” about what economic growth is. India’s per capita income has gone up but its position in living standards has gone down. It was the second best in South Asia after Sri Lanka, said Sen. Now “we are the second worst, ahead only of Pakistan.”
“It is isn’t about whether opposing the US-India nuclear deal was right or wrong, that’s a minor thing compared with what you are providing for the people. And I don’t expect that to come from a Hindutva-oriented party. I expect it somewhat more from the Congress but also much more from the Left.”
But Sen said he was dismayed that even the Left parties were “going after cooking gas, electricity prices and aam aadmi issues rather than the larger picture.”
Virtuous circles (and Tagore)
All, however is not lost. Sen looked at the corruption protests and said mindsets can change if there is “a virtuous circle.” When we recognise that something “may be common but it’s not standard and it’s bad” that is the first step towards creating a “groundswell.” It happened with footbinding in China and is happening with female genital mutilation in Senegal. And he saw it happen in Italy when he advised its anti-Mafia commission. Until then the Mafia had just been regarded as unavoidable because everyone did it and you would be at a competitive disadvantage not to do it.
That change in mindset could happen here as well if we are open to looking outside for some answers instead of hiding behind lack of “political will” which he dismissed as “a non-answer”. India can learn about introducing universal health care from Mexico. It can learn democracy and public unions from Brazil. And women’s agency from Bangladesh.
“Rabindranath Tagore was telling us to break out of the limited universe,” Sen reminded his audience. (Yes, of course Tagore came up. Sharmila was on stage. Sen had gone to Shantiniketan. And this was Kolkata). “That breaking is not complete yet.”
“The most terrible thing that happened in the world were because of ignorance,” said Sen. “The moral obligation to be informed is very important. The cupidity and villainy of human beings is over emphasised. Ignorance is under emphasised.”
And the opposite of ignorance is sometimes also the wisdom to know what you don’t know. When a questioner asked him a complicated question about changes in university admission procedures in Kolkata, the Nobel winning economist grinned and said “I am always flattered when people think I know more than I do. I have absolutely no idea what you are talking about.”