Medicine & Doctors · Politics · Public health

Why Indians need to abandon the ‘Gujarat model’ style of thinking

Recently the Maharashtra state govt hiked the user charges and fees in government hospitals. In a country where more than 60 million persons are pushed below the poverty line because of healthcare expenses and many millions more have to take huge loans, government hospitals raising their fees – while at the same time government employees and politicians continue to enjoy completely free and high quality healthcare – did not go down well with many civil society activists. Some said that Maharashtra is trying to implement the ‘Gujarat model’, this accusation intensified by steps taken by Mah to begin ‘privatising’ some district government hospitals.

The comparison with Gujarat and its dominant capitalist/privatised healthcare system is significant here, as after more than two decades of its so-called ‘growth’, we can actually look at the results and decide if the model is worth implementing by other states.

In November/December 2017 I wrote two analyses of the poor state of healthcare in Gujarat, despite a steady economic ‘development’ and high per capita income. While more detailed analyses are needed, Gujarat’s mediocre performance in healthcare apparently proves that such a heavily capitalist model (where govt is obsessed with favoring big businesses and corporates and neglects its social responsibilities towards the common people) will only benefit the already wealthy, while at the same time causing both social and economic oppression of underprivileged communities.

This was published on Dec 7 in ScrollGujarat’s model of development has done little to improve health of its people

Observers have noted that Gujarat’s social and healthcare indicators are mediocre to poor because Narendra Modi, since he became chief minister, ​diverted government funding for social sectors and development of the poor to the development of big industry: through easy​​ access to land, credit, and infrastructure​, ​as well as tax breaks and subsidies ​for the latter.

Economist Amartya Sen, whose constant warnings that Gujarat should refrain from purely capitalist conceptions of development have never been heeded, says that with the policies of India’s current government, we are the only country in the world trying to become a global economic power with an uneducated and unhealthy labour force. The Gujarat model has failed to substantially to improve basic social sector indicators compared to the rest of India and yet the BJP continues to push this substandard model aggressively as a template for the entire country.

This was published in Wire on 27 Nov: State’s Tuberculosis Rampage Exemplifies the Failure of the ‘Gujarat Model’

Interestingly, the difference between Gujarat and other comparable large states, like Maharashtra and Tamil Nadu, was not that stark a decade back… In fact Gujarat has so utterly failed in controlling TB that it is the only state, apart from Uttar Pradesh, where the incidence of TB has actually increased over the last decade; every other state has effected a reduction of the ratio.

To be sure, Gujarat is not a ‘backward’ state. What matters, however, is that in no way is it a model state either. In the run-up to the 2014 elections, hundreds of millions of Indians were fleeced by a well-funded campaign that projected the Gujarat model as a saviour for a ‘decadent’ India, and we now have perhaps the strongest proof for it. With state assembly elections coming up in Gujarat, the so-called Gujarat model is hardly invoked by the Bharatiya Janata Party party. If it did, it would have a hard time explaining why it neglected the state’s TB crisis.

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