Focusing on the sickest saves money for the health system

I am reading Atul Gawande's piece on how focusing on the sickest segement of the population and basically setting up "ambulatory intensive care" eventually ends up saving health care costs for all. The argument is compelling.

http://www.newyorker.com/reporting/2011/01/24/110124fa_fact_gawande?currentPa...

One wonders the extent to which these ideas can be applied to other countries as well, specifically developing countries.

A nice tribute to Pt Bhimsen Joshi

http://www.telegraphindia.com/1110126/jsp/opinion/story_13494474.jsp

I could at least relate to what RJ writes about the music of Pt Bhimsen Joshi.
What an extraordinary musician.

The End Of Internal Medicine As We Know It

Interesting article to review

http://healthaffairs.org/blog/2011/01/14/the-end-of-internal-medicine-as-we-k...

Lancet special issue about health care in India

Here is the link to a series of articles on Indian health care in a recent issue of Lancet. 

Got to write and discuss more on this series later

http://www.thelancet.com/series/india-towards-universal-health-coverage

An interesting article about economic growth as a national objective

Prabhat Pattanaki wrote a very interesting article in today’s TT linking the Indian PM’s statement about putting economic growth of 10% as a national objective and recent spate of events in India that undermined democratic processes and punishment of dissent to the state policy. The article was quite a chiller of a reading, positing that it explicit use of growth as national objective means that the state loses control to corporates or business which in turn dictate terms, but also, any resistance to such an idea of vested national interest renders them “anti-national”.

Economic growth does not necessarily mean national prosperity for all. The statistics cited in the article suggest that the poverty rate worsened over a ten year period (1993-94 versus 2003-2004 even with revised definition of poverty, (see a blog on Tendulkar report here) as inability to provide for 2400 cals/day for rural folks and 2100 cals/day for urban folks) despite “economic development”. Economic growth does not necessarily mean poverty alleviation; in fact, the poverty and marginalisation of certain section of the population can worsen.

The article talks about Indian prime minister’s recent speech to a section of police officers that a growth of 10% be set as a national goal, and states that this has far reaching consequences and connotations in the direction of governance, specifically in how dissent and democratic processes be tackled.

The argument stems from the fact that growth does not necessarily mean less marginalization or elimination of poverty; further emphasis of “economic growth” as national objective in place of issues such as poverty elimination, emphasizes a very limited view of people; the article argues that placing national economic growth as achievable objectives legitimizes and virtually endorses low levels of state controls on industry and high levels of submission to industry interests which itself have their own issues around social responsibility to deal with. In the context of Central India, it means more mining, more marginalization of Adivasis and tribals, and endorsement of a specific ideological position against the Naxalites because in these areas Naxals are super-active. Thus, and any resistance that may be perceived as inimical to economic growth is deemed as anti to national interests and therefore legitimizes police actions.

Scary, isn’t it? Given the fact that economic growth does not necessarily lead to poverty reduction, if not outright increase in the number of poor and marginalized people; that, corporates have very poor records of social accountability and social responsiveness in India (think of Bhopal Tragedy and recently Kodaikanal Mercury Poisoning), and endorsement of police actions against resistance aims to stifle dissent.

http://idathupaksham.wordpress.com/2010/01/05/the-tendulkar-committee-report-...

Our Trip to the Glentui Falls

Weekend trip to Glentui Falls

The weekend trip to the Glentui Falls were magical. In Primal Blueprint, Mark Sisson writes about getting out of the city and spend walking tramping trail running for a few hours every week (he of course writes about a lot of other things too, :-), but living in Christchurch, we are really spoilt for choices). This weekend we left for the magical deep forests near Oxford township looking for the Glentui Falls. Have to say that the NZ Department of Conservation does a great job in maintaining the tracks, signposting them, and so on. There are occassional minor glitches, for instance on this track, if you took the long route you would not see which track leads to the waterfall.

You access the road to Glentui Falls from the Ashley Gorge (another beautiful scenic getaway) and drive on a gravel road to a picnic area and start your journey from there. We took the slightly longer walk through a beech forest. We walked for about an hour and then came to a point where three tracks pointed to three different directions. Which way would the waterfall be? Not sure. One could go up a track signposted with an orange triangle mark, but that would lead to a very long loop. One could go all the way back, or one could walk down to a small stream, cross a bridge and continue for another good twenty minutes before coming to a viewpoint from where one can see the magical tranquil waterfall cascading down. We did not know how we could reach the base of the waterfall, something that we'd like to do some day.

Forest Walk

Kulturträger: Beware False Idles | Alternatives Journal - Environmental Ideas + Action

But you know what? Cars and culture haven’t really changed that much. The old SUV ads and the new green-car ones have something in common. In both cases, the car is the hero of the narrative. Conqueror or saviour, it doesn’t matter as long as the viewer believes the product will win the day.

And that’s a problem because cars will not save us or polar bears or the rainforest. Even if we could make cars from branches and grasses (as one Prius ad demonstrated) and power them with the sun, we’d still need roads and parking lots. And those bring habitat loss and the colonization of wildish places.

Just as I like to dream about cars, I get a kick from the ads. They are indeed a barometer of culture, and they signal at least a small shift in values. But let’s not deceive ourselves into believing that we can save the world at the car dealership. What you drive matters, but not driving matters much more.

via alternativesjournal.ca

The happiness-income paradox revisited [Economic Sciences]

Interesting read about income happiness connection pardox.

The happiness-income paradox revisited [Economic Sciences]

Proceedings of the National Academy of Sciences current issue

The striking thing about the happiness–income paradox is that over the long-term —usually a period of 10 y or more—happiness does not increase as a country's income rises. Heretofore the evidence for this was limited to developed countries. This article presents evidence that the long term nil relationship between happiness and income holds also for a number of developing countries, the eastern European countries transitioning from socialism to capitalism, and an even wider sample of developed countries than previously studied. It also finds that in the short-term in all three groups of countries, happiness and income go together, i.e., happiness tends to fall in economic contractions and rise in expansions. Recent critiques of the paradox, claiming the time series relationship between happiness and income is positive, are the result either of a statistical artifact or a confusion of the short-term relationship with the long-term one.

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