WELFARE STATE – WHOSE WELFARE DUDE ?

Over the past several years I have been trying to make some sense out of world’s two most confusing concepts – Democracy and Socialism. And I have reached a conclusion that although individually each of these systems may provide some answer to worlds need for a stable governance model, but when combined together they result in full scale mediocrity and wastage of resources. To underscore the point lets look at the state of Government Hospitals in India.

The subsidized ( or rather free) medical facilities made available by the state out of its socialist inclinations of the past meant that Government hospitals never earned enough money to upgrade their facilities, premises, equipments, staff etc. Which over the years resulted in service quality and service levels getting degraded to such low levels that the mere suggestion of being taken to a Government run hospital was enough to scare the guts out of any patient.

Socialistic ideologies meant that Governments had to charge a uniform nominal fee from all individuals independent of their ‘capacity to pay’. Which in turn meant that in addition to catering to the welfare of the poor and down trodden of the country, these hospitals also bettered the welfare of the fairly well off population. Additional burden of servicing economically well off population created severe capacity problems in such hospitals which exists till this day. One has a higher probability of dying on the footpath outside AIIMS (All India Institute of Medical Sciences) waiting for their turn to get the OPD Card than getting treatment from AIIMS.

Since its handicapped children (the hospitals) were not in a position to fund their operations or pay their staff salaries for that matter, the responsibility fell on their father, the Government, to bear the burden. However, as any working family man would know, the welfare of a family is directly influenced by the “Income” of the bread earner and the size of the family (which determines the expenditure levels). Government could only keep on siring delinquent children (public enterprises/utilities) only up to a certain point i.e. the point till which its income supported such largesse (well actually it didn’t at all, Governments borrowed heavily to meet their expenses and result was even higher taxes) . Moreover, a large percentage of Government’s income from other sources was already diverted towards meeting the growing operating expenditures of the created hospitals rendering it incapable of infusing much needed fresh funds for capacity building and improvement of service quality.

So far we have discussed socialism, what about democracy? Well democracy ensured that Government couldn’t increase the ‘nominal fee’ fixed ages ago to bring it to a more realistic level. I call it the vote bank effect (you may call it whatever you want) in operation. In a democracy, populist measures suffer from a degree of ‘stickiness’ and all efforts to roll them back or lessen their impact is met with rock solid resistance.

Today Government sponsored healthcare sector in India is in shambles, covered with dirt, filth and unbearable stench (anyone having been to a Government hospital for treatment will agree). Frequent strikes by medical staff for raise/promotions and the inability of the Government in meeting their demands have taken innumerable lives. Even more lives are claimed by the hospitals themselves due to the unclean environment which results in patients getting frequently infected. The Government today is in a fix, “damned if we do…damned if we don’t” is their position now.

I think, now that the Governments honeymoon with socialism seems to be officially over its apt time to ask – So Dude, Whose welfare was it anyways?.

YF - IThink