23June2017

Goa's Spirited Online Weekly Magazine.

Calling their bluff

Remember the number of times Luizinho Faleiro said industries would be forced to employ Goans although we just can't seem to live on those miserly salaries they pay, or the times Aleixo Sequeira, Vishwajit Rane and the Dhavlikar due have echoed that? 

It happened that the MLA Damodar Naik asked for the names, addresses and date of joining of all workers employed by Cipla group companies in Goa in the Goa Assembly late in 2007.  The routine answer from Digambar Kamat was: "Details such as names etc are not maintained by government."  Einstein could not have been cleverer.

 

Sons of which soil?

Yet, another question asked was how many Goan workers Cipla employed.  Cipla replied: "The total number of local recruits/Goan origin is 1,728 (contract and regular employees.)"  For the record, Cipla cleverly parceled off its group (you can guess why) into seven different companies employing 2,396 workers.  You wonder why he even asked.  If you are in the mood to Google, do check on a report I think was released in 2007 by the Manila-based Asian Development Bank (ADB), which sharply criticised the Indian government for offering unnecessary tax incentives to developers of SEZs.  These incentives can open loopholes for tax evasion and undermine investments in firms located outside the SEZs, the report argued.  The ADB report added: "Some of the loudest political opposition to SEZ projects comes from the landless, who may not receive compensation for the land conversion and who lack the capital to become self-employed."

 

Oath of Hypocrites

The Hippocratic Oath clearly spelt out how doctors should ethically practice medicine.  That was in another millennium.  Times have changed and there is a new pledge in force now.  It swears that doctors must get commissions for their referrals, that incredibly a Margao-based hospital had the gall to publish, without a care in the world, which is how I have a copy.  If Hippocrates were to come alive somehow today, he would have to be wheeled into intensive care quickly.  The list speaks for itself.

Laparoscopic surgery

Gall stones surgery -cost Rs 25,000, doctors commission Rs 3,500; laparoscopic appendix Rs 12,000, Rs 1,500; laparoscopic hernia Rs 15,000, Rs 2,500.

Cancer

Ca breast surgery -cost Rs 20,000, doctors commission Rs 2,500; thyroid Rs 20,000, Rs 3,000, Ca colon stomach Rs 25,000, Rs 3,500.

Urology

PCNL (kidney stone) surgery -cost Rs 25,000, doctors commission Rs 3,500; URS (ureteric stones) Rs 15,000, Rs 2,500; TRUP (prostate) Rs 20,000, Rs 3,000; bladder stone Rs 10,000, Rs 1,500.

Gyneacology

LAP hysterectomy (hyst) surgery -cost Rs 30,000, doctors commission Rs 3,000; Lap myomectomy Rs 30,000, Rs 3,000; Diag hyst + lap for infertility Rs 10,000; Rs 1,000; open hyst Rs 20,000, Rs 2,500; open myomectomy Rs 20,000, Rs 2,000; LAP for cyst, ectopic pregnancy, adhesiolysis Rs 20,000, Rs 2,000; hysteroscopic procedures fibroid Rs 15,000, Rs 1,500.

Physician heal they self

So far, the central government’s efforts to curb doctors getting a monetary fix have been like giving the fox the job of guarding the henhouse.  This, despite the fact that more than a quarter of the Organisation of Pharmaceutical Producers of India (OPPI) accounting for 70% of the drug market in India and who are subsidiaries of companies that have been penalised in the US for illegally promoting various drugs through inducement.  Recently, Pfizer was fined $2.3 billion in one of the biggest healthcare fraud settlements.  It wined and dined doctors sending them on exotic trips.  Eli Lilly was fined $1.42 b.  Glaxosmithkline (GSK) has reserved $400 million to settle charges of promoting unapproved use of drugs and of kickbacks to doctors related to several products.  Bristol-Myers Squibb was fined $515 million in 2007.  There’s more to this.

The huge profits big pharma companies make, allow them these luxuries which is why small-scale manufacturers of drugs have always maintained that drug prices can easily be brought down 50 per cent.  But if big pharmas did that, where would the stimulus money come from?

 

Healing or self-healing

A doctor told me a rep of a Chennai-based pharmaceutical company (name withheld) whom he described as ‘paan chewing and looking more like a thug’ offered him free encyclopaedias to begin with (he was starting out his practice) and a laptop next.  The rep’s complaint was that pharmacies in his jurisdiction in Tiswadi were not prescribing his company’s drugs.  A representative of an ethical pharma company said he received complaints from doctors of bribes being offered.  Pharmaceutical companies pressurize pharmacies to sell their drugs, even if a doctor prescribes another drug; which is precisely why you never seem to get the drug you were prescribed.  Which is why, often what should be a quick visit to the family doctor turns into a merry-go-round if you dare insist on every letter of the word on your prescription.

‘Vitamin M’ is also administered by a certain hospital into the veins of your traffic cops and the 108 ambulance service, to ‘induce’ them to rush trauma patients to the hospital.  Breaking the Hippocratic Oath in Calangute and the coastal tourist belt extends to bribing hotel staff and taxi drivers to become ‘inclined’ towards certain private clinics, especially one near Mapusa, and particularly dental clinics.

I myself got an attack of gastritis in the night at a resort in Anjuna and had to shell out Rs 800 as doctors’ fees.  The irony was that the resort owner was a friend whose friend the doctor was!  This particular doctor makes a killing (quite literally) by preying on foreign tourists at resorts! 

 

Government in intensive care

Sent there by the mushrooming of private hospitals, the government sees to it that all the major hospicios, including the health centers, are virtually redundant.  The common refrain of doctors is ‘we are short of drugs and consumables.’  The Corlim health centre, built in a remote part of the village, is as a result, barely accessible.

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