Sustainable Health Care for all?

Over the last decade a number of governments of developed economies have questioned their health care model.  In the US, President Obama has gone out on a limb to set up a much needed Medicare service to ensure access to health care services for those that most need it.  In many European countries as well as Japan, the generous health care benefits that were a universal right where being questioned in the face of growing economic uncertainties.  On the one hand, the American system championing a free economy and private medical insurance that has left many of the poorer members of  its society without access to basic health service, while on the other the European model, which although long praised for its compassionate stance, turns out to be wholly unsustainable.

Can we evolve towards a more humane and sustainable health care model?  I believe a small experiment started off by an enterprising eye surgeon in Madurai (South India) which has grown into a world wide success may shed some light on the question.

I recall some 25 years back, Arvind eye hospital was already renown in the country for its service as my mother used to drag me all the way to Madurai for her annual check up on Glaucoma. Since, the hospital started by Dr. G. Venkataswamy, has grown into a network of several hospitals within India but also expanded its business model through out the world.  It is today recognised as the largest eye care hospital in the world!

If you have never heard of Aravind eye hospital, watch this video, it's well worth it!

The Aravind health care model

So what is so sustainable about this model?  Well it's very simple, if you can afford to, you pay for the service.  If you can't afford it, it's free!  The model started off in South India to save needless blindness which is rampant in the form of cataracts and such.  The hospital even had to set up free bus trips to surrounding villages as the poorer of the poor could not even afford to go to the service centres.

Aravind eye-care hospital is a for-profit business.  2/3rd of all its operations are done for free.  They have eye camps in villages that sort out patients, ferry them to the hospital for the operation, accommodate them and feed them during their time there and eventually bring them back to their village.  Everything is free.

People come from abroad to get treated in these hospitals.  The Aravind business model is now a case study in a large number of business schools and universities.

The McDonald of Eye-care

Dr. V kept talking about the need to organise a system that could reproduce the success of McDonald worldwide: enable the same quality of product and service irrespective of location.  He set off with his vision to enable his eye-care success to be reproduced anywhere in the world.  How does one enable such a vision with a such a complicated product and service as eye surgery?  This is what a recent study by Ninad knowledge architects set out to do.   Ninad is a research and consulting network that ideates Knowledge Management strategies to help entrepreneurs and organizations to become nimble and dynamic.   The case study has highlighted issues such as how to translate and communicate online teachings from Indian doctors to students from totally different cultural background such as in African countries? Through this work, the spirit and success of the Aravind will spread beyond India.

Sustainable Care?

Can the Aravind model serve as an inspiration for a more general approach to the problem of health care for everyone?  It is of course a long shot, Aravind has been successful because of the compassionate spirit that permeated the entire project.  A sustainable health care model based on a similar approach requires vision from both the decision makers as well as the corporates that supply the medical world.  Still, a roadmap exists and has proven to work!

The Farm Mela @ Chennai

The Farm is a multi-acre farm located among the new office jungle of the Chennai IT corridor.  It set off to offer family-fun experiences based on farm activities.  They do a brunch on w.e. and this coming w.e. (18th and 19th August) they are promoting a Mela for local artisans to promote their wares.  Do come and visit, the Farm is counting on this kind of activity to promote its offer and allow it to sustain its existence.  There is tremendous pressure from land developers to sell the farm and make way for more office buildings.

Poor roads cause fuel overconsumption, a report.

Various sources report (here and here) report on an interesting study by the IIM university of Calcutta on the rise in fuel consumption contributed from our poor road conditions.  The report estimates a whopping 87,500 crore INR (about 15 billion USD) is lost annually in fuel bills and at toll gate queues.

Estimating the various average speeds on our countries highways and the number of times vehicles have to stop at plazas, compared to an ideal road without stops, the study reveals a dire picture.

In view of recent price hikes on petrol throughout India, this news is not good for the current government.  The report argues that the fuel subsidies cost to the government is 60,000 crore INR, which would be largely compensated by having quality roads.

Another article throws further light on the recent increase in petrol prices, demonstrating that the government isn't actually loosing money on the subsidies.  In fact Indian has one of largest taxes on fuel in the world, on par with European nations and thus the government's increase in fuel price is yet another way to increase their revenues.  Probably to fuel yet more loss making projects or should I say scams?

The need for creative design!

A couple of weeks ago I came across an interesting article that was talking about the rise in popularity of a Creative Design course at MIT in the US.  There is a good need for this right here in Chennai.  A few months back the Souther Railways set up new automated vending machines to sell tickets to commuters.  The city's station is scene to long queues of commuters at ticket counters as there are much demand and few open counters.  Apparently the new vending machine required a smart card to operate, which means one has to buy the card in the first place.  One assumes this was meant to solve the issue to machines issuing change and thus not having to empty them of cash each day.  However, given our propensity to neglect schemes for deposit credit, the new venture is a big flop.  Regular, pass carrying commuters are buying their monthly or quarterly tickets as before, while daily commuters do not want to part with the deposit money required to obtain a smart card.  The result is that queues are still forming and the Railways have spent bad money on machines that are going idle.

To remedy this, they are now proposing to have the machines manned with retired railway personnel who will have their own smart card and accept change from the commuters ???? Clearly a problem that has not been well understood and a solution that lacks creative design.