Universal healthcare – Modi’s biggest gamble

In less than a month’s time India embarks on its most significant social experiment since independence with the introduction of a universal healthcare scheme, the largest in the world.

Covering around 500 million of the giant nation’s poorest citizens, the scheme is officially named the National Health Protection Mission, but has been instantly dubbed Modicare, after Prime Minister Narendra Modi.

With a General Election due in less than a year, that close association carries both benefits and risks for Modi and his ruling Bharatiya Janata Party (BJP).

The scheme has long been a dream of the Prime Minister, who has said that India can reach its true potential only with a healthy population.

“It is essential to ensure that we free the poor of India from the clutches of poverty due to which they cannot afford healthcare,” he said recently.

Brave words, but in India ambitious undertakings have a habit of falling victim to the country’s stifling bureaucracy.

Modi’s promise that every Indian village would have electricity in the first 1000 days of his administration foundered when that date passed with thousands still in the dark.

Public Servants covered over the failure by redefining ‘electrification’ as when power cables from the grid reached a transformer in the village, not when individual homes were connected.

Similarly, efforts to clean up the sacred River Ganges, in many places little more than an open sewer, have been shambolic, with officials saying this year’s deadline was always impossible.

Progress has been bogged down in endless negotiations over where to build sewage treatment plants, while complicated tendering processes have deterred private companies from seeking the projects.

Progress has been made, perhaps more than by any other Government in the country’s history, but Modi’s over-promising and his failure to fulfil the ambitions on which he was elected, could well backfire on him.

So the Prime Minister badly needs a win — and if the implementation of universal health care can be managed successfully it would overshadow the failures.

A study done almost a decade ago named medical costs as one of the primary causes of poverty in India, forcing around 63 million people below the poverty line due to their private healthcare bills.

Modi is relying on the country’s booming economy, the reform of the tax system with the introduction of a Goods and Services Tax last year, and increased foreign investment to fund the plan.

However, many commentators believe that in the short term at least, the major problem will not be money, but the ability of the country’s creaking health infrastructure and lack of qualified medical personnel to cope with what is expected to be a massive increase in demand.

Modicare is a huge political gamble for the Prime Minister, and the fortunes of the BJP in next year’s polls may depend on it.

Mahathir’s charm wins Beijing concessions

Malaysian Prime Minister Mahathir Mohamad successfully walked a fine line during his visit to China this week.

He had the delicate task of delivering some bad news to his hosts — essentially his country’s renegotiation, or even withdrawal from China’s much heralded Belt and Road initiative negotiated by his predecessor, Najib Razak, which he rightly believes was a terrible deal.

However, he did not wish to overly antagonise his powerful northern neighbour especially as the chaotic foreign policies of the world’s other superpower, the United States, could no longer be relied upon.

His Government simply cannot afford the $A30 billion infrastructure deals already under way in Malaysia — projects funded by loans from China that his country will eventually have to repay.

It would appear from the outcome of his visit that he got most of what he wanted.

The costly projects will not go ahead — for the moment. The countries “agreed to let the details be considered by officials and the companies concerned”, essentially a shorthand for putting them on the backburner at least for the foreseeable future.

Mahathir was able to sweeten the situation with a series of minor agreements involving currency swaps, e-commerce and agricultural products.

The new Malaysian Prime Minister quite frankly told his hosts that any pressure on him to continue with the Belt and Road initiatives would eventually send his country into bankruptcy.

From Beijing’s perspective that would be a worse blow for the image of the Belt and Road and could easily scare off other possible clients.

Foreign Ministry Spokesperson Lu Kang stressed that the problem would be solved through “friendly negotiations”.

“I can tell you that this is an important consensus reached during this visit,” Lu said.

For all the charm and soothing words during his Beijing visit, Mahathir has almost certainly not changed his belief, spelled out during the election campaign, that Najib’s relationship with China was risking “a new colonialism”.

At 93, he is old enough to remember the old colonialism and his country’s struggle to free itself from British rule.

Mahathir is also passionate about lifting his country’s living standards to the point where it can follow its neighbour, Singapore, in proclaiming itself a first world nation — but he wants it done on his terms.

There can be no ‘pause’ in aid programs

A recent report to the United Kingdom Parliament has revealed the horrifying extent of child rape and sexual abuse among aid workers in some of the world’s worst trouble spots.

The report, by the International Development Committee, rejected any suggestions that the abuse was a series of isolated incidents involving a few ‘bad apples’, stating that the problem was ‘endemic’ throughout the aid sector.

Commenting on the report, a former worker for the United Nations and the Red Cross, Andrew MacLeod cited an “institutional failure to crackdown on paedophilia” as one of the reasons he quit the sector.

He recommends people should be jailed, not just for taking part in the crimes, but for failing to report them.

This must happen — and happen quickly.

However, I draw the line when MacLeod calls for the “celebrity ambassadors” of international aid to suspend their roles until the situation is resolved. Why does he single out these people, mostly high-profile actors and other personalities? Or is he suggesting a general pause in the work of aid agencies until a resolution is found?

We are faced with an appalling choice here. Emasculate aid work while this endemic problem is stamped out — and allow more people to die of starvation or unattended injuries than the thousands who are already dying every day.

Allow aid work to continue at maximum effort — and risk serial abusers being let loose on vulnerable people.

A choice has to be made, and I choose the latter as the lesser of two terrible evils.

Never in recorded history have so many of the world’s people been in such dire need of relief; never has so much of that need been created, not by famine and other natural disasters, but by deliberate acts of inhumanity — by the persecution and slaughter wreaked by the strong against the powerless.

Every day Yemini civilians are pounded by a Saudi Arabian coalition. Innocent men women and children are dying in industrial numbers.

Every day, Syrian men, women and children are terrorised by the overwhelming might of Russian and Syrian Government forces; ditto Myanmar; ditto Afghanistan and the countless smaller but by no means less deadly conflicts that plague the African continent.

In addition, aid workers face unprecedented dangers in the field. No longer is the Red Cross on ambulances a guarantee of safe passage.

Rather, hospitals and their staff are deliberately targeted so injured opposition fighters can’t be patched up and put back in the field; aid convoys are attacked and the supplies they carry looted to feed and treat the combatants rather than their victims.

The globalised and often chaotic nature of aid work caused by this decline into barbarism is a challenge when it comes to aid agencies screening their workers. Often it has been a case of taking anyone who is willing and foolhardy (and devious) enough to put their hand up.

As CARE International UK stated: “The push to get lifesaving assistance… into the field quickly often comes at the expense of good protection analysis, and steps that would reduce the risks of unintended harm — including sexual exploitation and abuse — are skipped or deferred.”

The UK report has put aid agencies on notice. Image is crucial if donations are to continue. They will — are finding a way.

Of course it would help if Western Governments provided additional funds to assist agencies in properly screening, and properly remunerating aid workers for the appalling risks they take.

 

Instead, the first world is sitting back and accepting the chaos spreading over large areas of the planet. Aid budgets are being slashed and in many cases the arms they sell into these areas are active contributors to the slaughter.

The United Kingdom report has identified one huge problem — but it is by no means the only one.

*Graham Cooke is a regular and long-time donor to UNICEF and intends to remain so.

Turkish turmoil in era of ultimatums

An obscure American clergyman, currently under house arrest in Turkey, has been the trigger for turmoil that is ratcheting up of the trade war, possibly leading to a global economic crisis and the break-up of NATO.

Of course, no one should really blame Pastor Andrew Brunson, who until his arrest accused of spying and being part of the failed 2016 coup against the Government, headed the Izmir Resurrection Church on Turkey’s Aegean coast.

His detention is almost certainly in response to the US refusal to extradite cleric Fetullah Gulen who Turkish President Recep Tayyip Erdogan believes, rightly or wrongly, was behind the coup. Thus Brunson has become a pawn in a game of power politics.

Worse for him, his detention comes in an era of megaphone diplomacy where threat and counter-threat are bandied about through press release and social media with the whole world looking on.

As a result Erdogan will not back down and his United States counterpart, Donald Trump, is ready to bludgeon Turkey with massive trade sanctions.

Turkey’s economy is already in trouble, largely due to the populist president’s financial illiteracy and fears that now he has managed to secure himself dictatorial powers following the June elections, he will put many of his harebrained schemes into action.

One of which is his belief that interest rates should be kept low as higher rates lead to more inflation. The opposite is the case.

Turkey’s Central Bank should be raising rates in order to tame inflation and support the currency which is in freefall. The fact it has not suggests Erdogan has robbed it of the independence so necessary in a modern functioning economy.

His comments would hardly have instilled confidence in already concerned international investors: “This will be my people's response against those waging an economic war against us. If they have their dollar, we have the people, we have Allah."

If Trump really does put the blowtorch to Turkey’s exports to the US, which include steel and aluminium, then it is highly likely Erdogan will seek a saviour in Russian President Vladimir Putin, possibly even cutting ties with NATO.

Nothing would please Putin more in his quest to disrupt NATO and the European Union — a welcome addition to the mischief he is already planning for Montenegro and Bosnia and Hertozgovena.

As for Trump, his actions have become so erratic that diplomatic observers have virtually given up trying to understand him.

The tried and true system of quiet negotiation using back channels and intermediaries to achieve results in difficult situations has been thrown overboard.

We seem to have re-entered the era of public demands and ultimatums that led nations into catastrophic conflict in the early years of the last century.

As for Pastor Brunson, freedom remains an elusive dream.

Education must never be a political football

Australian writer Erin Stewart has posed the question: Why should young people bother going to university when the rewards for their hard work are increasingly problematical.

She cites surveys that show teenagers are being turned off further education with only 57 per cent planning to go onto university and other training after leaving school, down from 71 per cent in 2003.

Stewart notes a report from the Brotherhood of St Lawrence which claims a 50 per cent reduction in entry-level jobs over 12 years with 16 job seekers for every vacancy. The report states that youth unemployment in Australia is at 12.5 per cent and under-employment at 17 per cent.

She rightly says that education is not the problem; rather it is a national plan “to put people who understand Wittgenstein or who can solve partial differential equations behind cash registers.”

Education is never the problem. It enriches lives, broadens thought and creates people who seek and find solutions. Education, properly directed, has the ability to solve all obstacles facing us, from climate change, to poverty and homelessness.

The problem comes when education is mishandled for ideological ends. In Australia there is a relentless push of the so-called STEM subjects — science, technology, engineering and mathematics.

These subjects are important and there is an international need for more young people to follow them, but the sledgehammer tactics employed by the Australian and other governments is essentially relegating non-STEM subjects to the second rank, while bludgeoning young people into areas for which they are unsuited.

By all means groom and encourage those who have the potential to be new Einsteins or Hawkings, but let us not end up with unhappy and unmotivated maths teachers who might otherwise have shone as linguists or literary critics.

An even greater problem has been the recent rise of populism and with it anti-intellectualism, in which facts become fake news and expert opinion is derided simply because it is the opinion of experts.

This phenomenon was gathering pace before United States President Donald Trump came to the White House, but he has given it a tremendous kick-along and it is dangerously close to becoming mainstream thinking.

Populism purports to produce simple answers to complex problems and in doing so denigrates those who protest this can never be. It is eventually doomed, as past experiments in it have inevitably shown, but in the meantime it has the potential to do a great deal of damage.

So it is easy to see, as Stewart has shown, why young people are discouraged to the point of turning away from university and other forms of further study. Why work hard and get into debt in a world where your eventual qualification is not only undervalued but derided?

However, in taking this attitude they are falling into the trap of believing the current situation will remain, if not forever, for at least the foreseeable future. This was never the case and is less so today than at any time in history.

By the end of a three-year degree Trump may have gone, trade wars a bad memory, the essential flaw in the populist argument exposed, and saner courses charted. The figures Stewart quotes above will then be radically different.  

Students of history know it comes in cycles, and this one will surely end, probably sooner than later. Then we will need the bright young leaders — scientists and technicians certainly, but also artists and philosophers — both to clean up the mess populism created and to move on to the next stage.

Throwing Montenegro under the bus

So, how much do you know about Montenegro? Probably not a great deal if you are the average person in the street.

Most people would have difficulty finding it on the map.

Yet it could be the flashpoint that starts World War III. At least United States President Donald Trump seems to think so.

Or the break-up of the NATO alliance and the European Union and the spread of Russian hegemony over the European countries the old Soviet Union once dominated.

So it is worth knowing a bit more about this country of 640,000 people in south-eastern Europe, once part of the old Yugoslavia and a sovereign State for just 12 years.

Some analysists believe it will be the next staging ground in Russian President Vladimir Putin’s campaign to destabilise the Western alliance, a follow-up to his intervention in Georgia, annexation of Crimea, invasion of Ukraine’s eastern provinces and rescue of Syrian dictator Bashar al-Assad.

At first sight this seems strange. Montenegro shares no border with Russia, and to get at it forces would have to cross countries that are members of both NATO and the EU, but a traditional invasion is not what Moscow has in mind.

The Balkan country would be just the test for Western resolution that Putin would like to exploit. It is a member of NATO, but not yet of the EU, although its current President, Milo Djukanovic, leans towards the bloc.

Russia tried unsuccessfully to engineer a pro-Russian coup there to prevent it from joining NATO, and has learnt from that mistake.

In addition, Putin has been virtually given the green light by Trump who in an interview on the Fox News network accused the Montenegrins of being “a very aggressive people…they may get aggressive and congratulations you are in World War III”.

Trump essentially threw Montenegro under the bus as far as supporting any NATO action against Russian interference in that country.

Without the US would other members of NATO be prepared to take action in support of the alliance’s newest and weakest member? Would the EU risk confrontation for a country outside its jurisdiction?

I hope they would, but I fear they would not.

The traditional thinking is that Putin’s next meddling will be in the Baltic republics of Lithuania, Estonia and Latvia, which after all share a border with Russia, but the trio are more firmly established in the Western sphere, members of both NATO and the EU.

Putin knows any perceived Russian interference there would almost certainly provoke a response from both institutions, with or without US support. He is not ready for that.

Montenegro is a different case.

I do not believe, as Jeffrey Stacey wrote in a recent article in Foreign Policy magazine, that Putin would risk a military invasion using his air and sea power.

Far more likely is a program of continual destabilisation, using Moscow’s proven methods of hybrid warfare — pressure diplomacy, fake news and electoral intervention — building up to the right conditions for another coup, allowing the White House to dismiss it as an internal affair in a little country far away.

Haven’t we heard something like that before?