Articles by Alex George

This is a study on orphan children conducted by Save the Children in six districts of Jammu and Kashmir, which were chosen on the basis of intensity of conflict. The article underlines the urgent need of a child protection policy in the state to ensure the rights of large numbers of orphan children.

This article critically reviews the laws (and rules thereof) related to micro health insurance, with special reference to the rural and social sector obligations of insurers and the regulations governing the sector, including those of third-party administrators. The underlying perspective is to serve those who are dependent on the informal economy for their livelihood and for whom expenses on health are a major burden.

Big Fish Eating Small Fish Alex George LEGISLATIONS to control private and voluntary health care institutions are at different stages of enactment or implementation in a number of states. These legislations in Tamil Nadu, Bihar, MP and Andhra Pradesh are supposed to regulate the functioning of private and voluntary hospitals, diagnostic centres, clinics, dispensaries, etc. No doubt, they are certainly the result of several years of consumer pressure, particularly from the by now transnationally sought-after Indian middle class articulated through various mass media. That due to its much trumpeted consumption capacity, the concerns of this class are being taken as representative of India and finding their way into international policy formulations for the country is clear from the observation of a leading international expert on health policy in his foreword to a paper on the country's private health sector. According to him "talk of India's 5,00,000 villages is giving way to attention to the country's emerging middle class of 250 million consumers, One of the things that members of this class consume is medical care" which rhcy are increasingly doing so from private providers Gwatkin D R in Bhat R 1995], The legislations discussed here are coming up against the background of increasing capitalist investment in the health sector which is being promoted by the World Bank and other international funding organisations as was clearly reflected in the WDR1993. The World Bank's prescription for public financing in the health sector in developing countries includes only public health and essential clinical services both defined in extremely narrow terms and just a sprinkling of low cost effective interventions, thus leaving the rest of the field wide open for the private sector [World Bank 1993: George 1997].

Health indicators of Maharashtra and Punjab show that they have attained relatively high growth against the background of a high per capita income (PCI) and good economic development while Kerala shows a good development in the health sector in the context of low PCI, low level of industrialisation but relatively good infrastructural indicators. While the first pattern could be attributed to the trickling down effect of capitalist modernisation of the industrial-cum-agrarian variety in Maharashtra and of predominantly agrarian variety in Punjab, the second is rooted in socio-political, geographic and demographic particularities of Kerala. This article looks into the specifics of Maharashtra's development in health in the context of other socioeconomic indicators to examine the relationship between health sector development and capitalist growth.

Reaction to Frustrated Federal Ambitions THE Congress(I)'s sweep of the Lok Sabha elections in south India when it was routed in atl other regions of the country except in the micro states of north east and in Maharashtra where it made just a face saving performance is generally attributed either to a vote for change against the respective state governments or to a vote for stability. Success in any election is the result of multiple factors and to that extent the antipathy of south Indian voters to their respective state governments is reflected in their verdict. But what is noteworthy here is the near-total rejection of state rulers in all four southern states with little variation amongst them. In Tamil Nadu the DMK ended up without any seat. The CPI its alliance partner got one seat. In Karnataka the Janata Dal succeeded in just a single seat. The Tblugu Desam, the major opposition party in the eighth Lok Sabha was reduced to just two seats and in Kerala the LDF managed only three seats. In Karnataka and Andhra the JD and Telugu Desam respectively failed to retain their state assembly majorities. Such a total rout of all the south Indian ruling parties indicates that there was an over all voting pattern in the south in favour of the Congress(I) in the Lok Sabha elections, which perhaps influenced the two simultaneously held assembly polls. If there was no pro-Congress(I) ground swell all over the south, the voting pattern would have shown greater state-wise variation in tune with the degree of alleged corruption or inefficiency of the respective state governments.