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The Government has no idea how many doctors India has!

This is a pretty sad state of affairs. It appears that the government of India does not have the correct data – they don’t know how many doctors India has.

And policy decisions as well as governance decisions are made using the wrong data.

And  when they don’t know how many doctors exist, how will they know how many of them actually practice? Many doctors don’t.

It is very difficult to believe that in this day and age when it can be safely assumed that all these doctors have Aadhar numbers, they can’t be tied into a national database which requires them to confirm their presence once a year.

It looks like our data on how many cars and trucks we have on the roads is better than our data on the number of practicing doctors.

Any ideas for our government on how to solve this problem?









Unintended pregnancies and abortion law

An amazing statistic from Dr Malhotra in this article –

48 percent of all pregnancies in India are “unintended” pregnancies.

I also find the use of the word “unintended” fascinating. Is it the same as “unplanned”? I think not. Is it the same as “unwanted”? Again I think not.

There is published information elsewhere that  half of the children in India are victims of sexual abuse.

If I correlate these two statistics, I assume it follows that a significant percentage of the unintended pregnancies are a result of sexual abuse outside of wedlock. And a very large number of the mothers are children/teenagers.

This lends a lot of gravity to Dr Jaideep Malhotra’s views. The abortion law must be changed as she says.

20 weeks is too short a time and does not deliver justice to these young victims who should not be and do not want to be mothers. This is not just an issue of justice or gender justice. This is also about child rights.

Referenced articles –

One in two children in india are victims of sexual abuse

A Law Past Its Sell-by Date








Healthcare Insurance for 500 million people?

I am all for universal healthcare insurance and I really hope that the Ayushman Bharat scheme delivers on its promise to adequately insure the healthcare for 500 million people.

But I have serious concerns and questions that nobody seems to have answers to.

Public sector healthcare facilities in India are in very poor shape and grossly inadequate. The private sector delivers over 70% of healthcare in India. In any case, the insurance scheme is meaningless when applied to  public sector healthcare because it is available free of cost anyway.

So then, here is a first principles approach to asking some questions –

1. Adequately insured communities are an incentive for doctors and businesses to invest in medical care facilities for those communities. This means that these facilities must have profitable income from insured patients.

2. It therefore follows that premium incomes earned by the insurance companies must be higher than the cost of healthcare delivered.

Even if we discount the cost of universal healthcare in countries like Canada and UK by 90 percent, we still need something like 50 billion dollars a year to cover healthcare costs for 500 million people, which is what Ayushman Bharat aims to cover.

I can’t see the budgets. Where is the government going to get this much insurance premium from?

Some would argue that the budgets are sufficient by pointing to the insurance schemes that already exist in states like Tamil Nadu. But that only strengthens my argument. Most good private sector medical facilities do not accept the mandated rates of those schemes. The  adequate availability of good quality healthcare for the people covered by those schemes has not happened.

Where is the money?

Kanti Bajpai’s post in TOI raises a different set of questions. But those are not the points I raise –


Is your (South Asian) baby at risk of heart disease later in life?

Here is a very interesting thing I read in this article I refer to in this post – “The body’s metabolism adapts to low nutrition in early life, and later, a high carbohydrate diet gives rise to higher fat deposition especially in the abdomen”

I am inclined to agree.

I do not believe that the South Asian male is genetically predisposed to abdominal fat accumulation or that he is genetically predisposed to heart disease or that he is predisposed to it’s key risk factors.

The poor nutritional status of mothers in South Asia, the poor nutritional status of children under the age of five, the carbohydrate heavy and protein poor adult diets, the widespread micronutrient deficiencies. Each of these and more are the major contributors to high rates of abdominal obesity, visceral fat, heart disease and diabetes in India.

Let’s not blame poor genetics. Let’s also not start hunting for a “new normal” and use the existing poor health indicators to establish a lower “South Asian” baseline.

Our children will grow to be just as healthy, fit, strong, tall and athletic as their Caucasian counterparts. If their mothers were healthy and so they had good birth weight, if they had adequate and diverse nutrition in early childhood and ate a nutrient rich and balanced diet as teenagers and adults.

Here is the link to the article. Some of which I agree with and much that I do not –