Sunday, July 26, 2009

Saturday, July 18, 2009

Oysters for Health Care - For the Insurance Industry it is all out War

t r u t h o u t | Oysters for Health Care

Oysters for Health Care

Saturday 18 July 2009

by: Bill Moyers and Michael Winship, t r u t h o u t | Perspective

Obama with Regina Benjamin.

President Obama with his surgeon general pick, Dr. Regina M. Benjamin, and Health Secretary Kathleen Sebelius. (Photo: Haraz N. Ghanbari / AP)

This is a story of health care and two Americans; a tale of two citizens, if you will.

This week, Regina Benjamin was nominated by President Obama as our next surgeon general, charged with educating Americans on medical issues and overseeing the United States Public Health Service. She was the first African-American woman to head a state medical society, a member of the board of trustees of the American Medical Association and last year was named the recipient of a MacArthur Foundation "genius award."

But more important, she's a country doctor, a family physician along the Gulf Coast of Alabama, serving the poor and uninsured - white, black and Asian. After Hurricane Katrina destroyed her clinic - the second time a hurricane had done so - she mortgaged her own home to rebuild it. The day it was to reopen, a fire burned the clinic to the ground. Moving to a trailer, Dr. Benjamin and her staff never missed a day of work.

Stan Wright, the tobacco-chewing mayor of Bayou La Batre, the small shrimp-fishing community in which Dr. Benjamin practices, told National Public Radio, "She'll do whatever she's gotta do to make sure everyone's taken care of."

Benjamin will no doubt bring that same ethic to the fight for health care reform. When President Obama announced her nomination in a Rose Garden ceremony Monday, Dr. Benjamin said, "These are trying times in the health care field, and as a nation, we have reached a sobering realization. Our health care system simply cannot continue on the path that we're on. Millions of Americans can't afford health insurance or they don't have the basic health services available where they live." Although the clinic has not been able to give Dr. Benjamin a salary for years - Mayor Wright says she's owed over $300,000 - she buys medicine for her patients out of her own pocket.

In fact, many of the folks in Regina Benjamin's bayou town are so poor that sometimes she's paid with a pint of oysters or a couple of fish. She's fine with that. And she makes house calls.

Now meet H. Edward Hanway, chairman and CEO of CIGNA, the country's fourth-largest insurance company. At the beginning of the year, CIGNA blamed hard economic times when it announced the layoff of 1,100 employees, but it reported first-quarter profits of $208 million on revenues of nearly $5 billion. Mr. Hanway has announced his retirement at the end of the year, and the living will be easy for him, financially at least. He made $11.4 million in 2008, according to The Associated Press, and some years more than that.

That's a lot of oysters, although he lags behind Ron Williams, CEO of Aetna Insurance, who made $17.4 million last year, or John Hammergren, the head of McKesson, the biggest health care company in the world. His compensation was $29.7 million.

Here's the difference. To Dr. Regina Benjamin, health care is a public service, helping people in need with grace and compassion. To Ed Hanway and his highly paid friends, it's big business, a commodity to be sold to those who can afford it. And woe to anyone who gets between them and the profits they reap from sick people.

That's what Wendell Potter, the former CIGNA executive turned health care reform advocate, told us on last week's edition of "Bill Moyers Journal."

"Just about every time there has been significant legislation before Congress, the industry has been able to kill it," he said. "Yeah, the status quo works for them. They don't like to have any regulation forced on them or laws forced on them. They don't want to have any competition from the federal government, or any additional regulation from the federal government. They say they will accept it. But the behavior is that they will not."

As we reported last week, that behavior includes spending nearly a million and a half a day to make sure health care reform comes out their way. Over the years, they've lavished millions on the politicians who are writing and voting on health care reform. Now it's payback time.

Proposed legislation finally is coming out of House and Senate committees, and Thursday's Los Angeles Times reported "signs that the debate was moving into a more bruising phase in which insurance companies, hospitals and others fight to shape the details of legislative provisions that affect them."

It's going to get ugly, especially now that some Democrats, according to ABC News, are contemplating new taxes on health insurance and pharmaceutical companies to help pay for reform, perhaps as much as $100 billion worth.

In other words, no more Mister Nice Guy. Those TV commercials you've been seeing from the health care companies about their generosity and miracles of modern medicine are about to change, as the opposition shifts gears from charm to alarm. It's the war against the Clinton health care plan all over again.

This time, don't let them scare you. "It should not be this hard for doctors and other health care providers to care for their patients," Dr. Regina Benjamin said when she was nominated this week. "It shouldn't be this expensive for Americans to get health care in this country."


Bill Moyers is managing editor and Michael Winship is senior writer of the weekly public affairs program "Bill Moyers Journal," which airs Friday nights on PBS. Check local airtimes or comment at The Moyers Blog at Research provided by producer Gail Ablow and associate producer Julia Conley.

Speech at UNAMA Kabul, Afghanistan, 8 July 2009 by Shabana Azmi

Where almost half of the population lives below the poverty line.
Where adult literacy for women over 15 years of age is less than 15 percent and in many areas even less than that.
Where one woman dies every 27 minutes due to pregnancy related complications, amounting to around 25,000 deaths per year.
Where violence against women, both in the public and private sphere is a normal every day occurrence for many women. Many of whom are subjected to sexual violence and find that, not only are they the ones who are condemned to a lifetime of stigma and shame if this crime becomes public, but that they are further victimized in a justice system that fails them and may prosecute and convict them for the crime of the ZINA.
Where women participating in public life are threatened, harassed, attacked and even KILLED.
This unfortunately, ladies and gentleman is the reality in Afghanistan today. We have gathered here in solidarity and sisterhood knowing that SILENCE is VIOLENCE and that together we must break this vicious cycle.
We know that violence against women and girls has the tacit approval of society, not just in Afghanistan but all over the world. In the United States for example, one out of every six American women have been the victims of an attempted or completed rape in their life time. In India, in spite of the great strides women are taking, it is also a sad fact that female foeticide is being practiced, even in big metropolitan cities cutting across class structures. More often than not, violence against women is practiced across countries due to patriarchal mindsets, often under the cover of religion. Harmful traditional practices are often about not challenging the misconceptions that are reinforced by skewed and distorted views of religion that are allowed to propagate.
But identity is fluid and has many aspects. If you ask me who I am, I will say I am a woman, an Indian, a wife, a daughter, an actress, a Muslim and an activist etc. My being Muslim is only one aspect of my identity. Unfortunately however, there seems to be a concerted effort to compress
identity in to the narrow confines of the religion one was born into, erasing all other aspects so I become a Muslim, she becomes a Christian and you become a Hindu. This construct of identity is a tool to control, to subjugate, to deny visibility to women. Fortunately there are forces of
resistance that exist against this domination and are gaining strength with
each passing day.
All over the world it is being recognized that the progress of a society or a country can not be measured in terms of its GDP alone. It must be measured in terms of its human development index in which empowerment of women must become the most important yardstick of progress and development.
I was very fortunate to be born to parents who were progressive and liberal. My father, the noted Urdu poet Kafi Azmi, wooed my mother, theater actress Shaukat Kaifi, 60 years ago by reciting his poem Aurat/ Woman. In an age when the women were expected to stay confined to the four walls of her home while the husband braved the world, my father wrote .., Jannat ek aur hai
jo mard ke pehlu mein nahin, uth meri jaan mere saath hi chalna hai tujhe, which roughly translated means, There is another heaven that awaits you that is not in the arms of your man. Arise my love, come march with me.
India has a long history of democracy. I believe democracy is a critical factor in the empowerment of women. I have a stake and a claim in the democratic space my country gives her citizens. I shout from the roof top when my community is victimized but also have the freedom to tell my fellow Muslims that it falls upon them to tell the world that Islam is not a monolith. It resides in more than 53 countries in the world and takes on the culture of the country in which it resides. It is moderate in some, liberal and others, intolerant and fanatic in some. The liberal moderate must stand up against the intolerant fanatic of his own faith. It is not one religion against another. Unfortunately all too often the debate descends in to a clash of civilizations theory that closes the door on sane dialogue and intervention. Deliberate distorted views of religion must be challenged or else the space that women get will continue to shrink even further.
I repeat that democracy is a critical factor in empowerment of women. Not just in terms of their vote, but in how democracy responds to women gives public space to get messages across and their voices heard and responds to their needs.
This belief is reinforced by my own experience as a parliamentarian for six years in the Upper House of the Indian Parliament. Our participation in all aspects of political life enables us to bring attention to issues that concern us, be involved in the processes that affect us and challenge laws and policies that restrict us.
The key issue in Afghanistan is that the very space that women have negotiated for themselves is under attack.
Women not only need to be encouraged to enter public life, society also needs to welcome them and the state needs to protect them in the face of any kind of threat. Women want to be included in local, national and global dialogues and discourses - they need to be able to participate fully and on an equal footing with their male counter parts.
I was heartened when I learned that Afghanistan has 25% of parliamentary seats allocated to women. Of course this does not automatically translate into effective participation but this figure is huge. Civil society needs to support these women parliamentarians so that they get informed by the women’s agenda as a primary concern. Access to security, health, education, employment access to equal rights must be non-negotiable. If a quarter of Parliament speaks and acts as one, let alone other male defenders of women rights who join them, then the results could be better than the best.
Across Asia, we women must unite and challenge ideas, theories, beliefs and indeed laws that keep our sisters in servitude. When discrimination against women is endorsed by society, or the state, then we all become partners in crime. We cannot remain silent, we must not remain silent.
India is in my view getting it right because it is placing women at the centre of development and support for the girl child. We have strong laws in place to protect women. For example, in the past rape victims were silenced into not reporting rape because the kind of proof that was demanded, the verbal assault they were subjected to, where it was assumed that the victim must have somehow “invited” the rape, the shame and stigma that the girl’s family had to face, the ostracisation by society was terrifying. But because of relentless advocacy by women’s rights groups and parliamentarians things are changing. Convictions for rape are rising and there has been greater sensitization of the police on these issues. Women also have the freedom of in-camera proceedings. The onus of innocence lies on the accused and there is a seven year non-bailable imprisonment at the very least if found guilty.
In Afghanistan laws on rape and protection of rape victims needs to be similarly strengthened. I understand from Afghan activists that this process is underway. I sincerely look forward to following this process and I salute all the activists in this room who have campaigned against the sanctioning of sexual violence and for the rights of victims.
We all know well however, that laws alone can not bring about change. Legal reform does represent an important first step but what is needed is a mindset change that treats women as second class citizens.
I end with a couplet from the famous Urdu poet, Faiz Ahmed Faiz
Bol ke lab azaad hain tere Bol Zabaan ab tak teri hain Bol yeh sutwan jism hai tera Bol ke jaan ab tak teri hai Bol ke sach zinda hai ab tak!
Speak: your lips are free Speak: your tongue is still yours Speak: this lissome body is yours Speak: this life is yours Speak: so that the truth can prevail.
Thank you

Friday, July 17, 2009

P. Sainath: How the World Depression Hits Orissa

P. Sainath: How the World Depression Hits Orissa
July 13, 2009
"In This Region, You Migrate When You're Weaned From Breast Milk..."
How the World Depression Hits Orissa


The recession in US and Europe is having a profound impact on villages in the deep rural interior of Orissa. Well over half a million migrant labourers from Orissa state in eastern India work in Surat city in the western state of Gujarat. Over 400,000 of these are from a single district in Orissa called Ganjam. The recession in the West has hit the export units of Surat and, laid off or pushed out in large numbers, large numbers of those workers are returning to Ganjam which they left in the first place because there was no work to be had. Orissa is the Indian state with the highest proportion of people living below the poverty line (BPL).

“The media write about drought and starvation in Orissa, the channels show a grim picture of agriculture here — and our employers in Gujarat use this to depress our wages,” says Bikala Swain reproachfully. “The malik says: ‘I know you have nothing in Orissa, so don’t complain about what we give you here.’”

Bikala, whose name translates roughly as ‘desperate’ is speaking to us in Lathipada village in the Sorda block of Orissa’s Ganjam district. He is one of hundreds of thousands who migrate from here each year in search of work. Most from this village of some 3,500 people, where there is a migrant from almost every single household, go to Surat in Gujarat to work in that city’s textile units. Some from this region, though not from Lathipada, also worked in Surat’s diamond industry.

With the export-based units there taking a severe hit due to the recession in the West, tens of thousands of workers have returned to villages like Lathipada. A homecoming filled with problems and complexities. Over 600,000 Oriyas are estimated to be working in Surat and adjoining areas. Of these, researchers and the workers themselves believe that more than four lakhs are from Ganjam.

Now, as many as 50,000 have returned to Ganjam — a district that sees labour migration each year from all its 22 blocks. “From 10 of them,” says Lokanath Misra of the NGO Aruna that has researched the subject here, “there is a migrant from every household.” “There is always a steady traffic to and from Surat,” say people in Lathipada. “But this time many will stay back or move on to other places.” Still more might follow those who have come back. And tension is building in the villages. “Who will eat? Who will provide?” asks Ganesh Pradhan who has worked over 25 years at operating looms in Surat. “People left here in the first place because there was no work in Ganjam. Now things are changing in Surat also. Apart from those laid-off, there are countless thousands of others being made to work for much less there.” That in turn hits the villages of Ganjam hard as remittances from migrants run to hundreds of crores of rupees each year.

The recession in the West is having a profound impact on the deep rural interior of Orissa. (At least two returning workers in the village actually used the word ‘recession.’) About a hundred workers returned to Lathipada alone from Surat just days before our visit. “If someone comes home for a few weeks, it’s all fine,” says Achyutananda Gouda. “But if you hang on much longer, there is pressure on the family’s resources.” In Gujarat, says Ganesh Pradhan, “it was possible to earn up to Rs. 200 or Rs. 250 a day. (US $1 = 49 rupees.) You do that by working 12-hour shifts each day under awful conditions that have grown worse in recent months. If you are skilled and can do dyeing and printing or embroidery, you might earn up to Rs. 500 a day. That is Rs. 15,000 a month.” Now, it’s falling apart.

Nilamani Guru has two sons in Surat. “One is skilled and was earning that Rs. 15,000 a month (No holidays, weekends, nothing, you are only paid for the days you work). The other was earning the standard Rs. 200 a day. Since the past few months, the skilled one’s earnings have collapsed to the same level as his brother. The malik says take it or leave it.”

In part, the collapse of the diamond industry has also meant a surplus of skilled and semi-skilled labourers in Surat. “This means that the owners can further push the wages down,” says Kalu Panda, convenor of the CITU, Ganjam, which is working amongst the returnees.

“The employers know we have few options,” says Ganesh Pradhan. “Earlier, there was more money. There was a proper one-hour recess. Quite some time ago, there was even a day off. Now a man handling four machines at one time might have to handle six. Work is up, pay is down. The lunch break has gone. The malik says how we eat is our concern — his concern is that the loom should not stop working for a minute. Not at any time in the day. So if you take a half-hour break for food, the men beside you have to operate your machine till you return. Then you do the same for them. Our 12-hour shifts could be day or night. We’re losing money and strength.”

The fall in wages makes Surat less attractive than it once was. “Here,” say Achyutananda Gouda and Shriram Pradhan. “those who have BPL cards get rice at Rs. 2 a kg. Those who don’t, buy it in the market — at Rs. 12 for that quality. In Surat, it is a minimum of Rs. 22-24 a kilo. Everything there is costlier by Rs. 10 a kilo.”

“Even the rents are climbing,” says Santosh Gouda. “Understand how we live. In those slums, seven to eight of us share a tiny room that we might pay Rs. 1,000 for or more. In any case, the landlord takes an advance of Rs. 5,000 when we strike the deal. (In some cases, workers have rented space in shifts, for sleeping time only.) There is no latrine of any sort and we have to make it each morning to the banks of the Tapi river for that. If many of us hire a very small place with a bathroom, that rent is upwards of Rs. 2,000, often more. And now wages are falling.”

That’s when Bikala speaks about media coverage hurting wages. But many disagree. They want journalists to highlight the desperate state of their village and insist on showing us there now almost-empty water tanks and other problems. And they do not see many ways of halting the village’s loss of income.

Ganesh Pradhan, though, says he will try his luck again in Surat. “It’s not as if we know that things are much better anywhere else.”

And when they look for work, they ride the trains.

“This is the busiest ‘labour-travel’ railway station in Orissa,” says R.C. Behera, smiling. He is Station Manager at Berhampur, Ganjam, from where about 7,000 passengers travel out each day on average. Around 5,500 of those are ‘unreserved’ travellers - overwhelmingly labourers migrating for work in Surat and Mumbai.

Most of those aboard the Ahmedabad-Puri Express are normally bound for Surat. There are at least 25,000 headed for that city each month. Which means that in ‘normal’ times, there could be 300,000 passengers out of this station headed that way each year. And that’s with only five trains weekly to Surat. Locals have long demanded a seven-day service.

That might not happen just now. The recession in the West has hit several textile units they work in as powerloom operators in Surat. It has also fractured the diamond industry there which employs a smaller percentage of Oriya workers. Large numbers have come back and the Ahmedabad-Puri Express empties itself at Berhampur, Ganjam’s main station. The “Sethu” project of the NGO Aruna which works “to bridge migrants from Ganjam and their homes” finds that the “Surat shock” is having a big fallout. “There are always lots of people coming and going at any time,” says Lokanath Misra of Aruna. “But the number at home at this point is way above normal. We estimate some 50,000 are back who might find it difficult to return to the old employment.”

The same project has surveyed Oriya workers in Surat and found “more than 600,000 of them living in 92 slums in that city. Of these, over four lakhs are from Ganjam.” As elsewhere, one of the problems accompanying the migrants home is HIV Aids, something the NGO Aruna focuses on.

This been a high-migration district from British times, particularly after a great famine in the 1860s, and Ganjam’s migrant workers can be found at countless towns within India. But for two decades, the bulk of its labour force has gone to Surat. “It worked for our people,” laughs Simachal Goud in Kamagada village of Aska block. The village has about 500 households and an estimated 650 migrants. “In Surat, unlike if we went down south, no education is required. In Surat we can make Rs. 250 a day.” There is a tendency amongst many workers to slightly exaggerate their earnings in Gujarat. Not so much to impress us, says one local, as “to set their dowry rates higher. So Rs. 250 could mean Rs. 200.” Yet, even the illiterate amongst them managed Rs. 170-180 a day. “Where can we get anything like that in Ganjam?” they ask.

This worry now grips the district. How will it absorb tens of thousands of these workers if they give up on Surat? District Collector V. Karthikeya Pandian, under whom Ganjam topped Orissa as the best performing district in the NREGS, recognises the seriousness of the problem. “Skilled labourers won’t be easy to absorb,” he told The Hindu. Surely not in the NREGS, though that has embraced 150,000 of the district’s 5,00,000 families. In the villages, they agree with the Collector. “Not more than ten or 15 per cent of those coming back can return to agriculture,” says Simachal Goud. “After years of working textiles or the gem industry for years, you simply cannot do that kind of work anymore.”

The Collector hopes the upcoming Port expansion and Indo-Russian Titanium projects will help absorb many skilled workers. He however sees the mismatch in scale and numbers. The returning migrants are too many. He is hopeful, though, of increased investment in agriculture since the returnees have some money and do buy land.

The return of large groups has other effects, too. Group clashes over long dormant feuds has been one of these. A rise in some kinds of crime is another. Family disputes, alcoholism and other tensions are on the rise. And people have returned to a dismal job scenario. As Hindu correspondent Shib Kumar Das points out: “these are still on a low burn, thanks to the elections which kept everybody employed for two months. With those over, worse might follow. “

There might, of course, be new destinations. “You could find lots more of us going to other cities and towns in other states,” says Achyutananda Gouda in Lathipada village. “Many already do. This trend will rise.” He and his friends rattle off the names of at least 20 other cities outside of Gujarat that people from their village already go to. On Surat, Gouda says “It won’t die out. People will still try their luck there, but it will decline.” A few believe some recovery is possible if and when government steps in to bail out the export-linked units.

A surprise destination often discussed here is -- Kerala. But why Kerala? “Because,” says a few who have been there, “there are jobs there those people won’t do. The minimum we’d get is Rs. 150 a day. There the work would be for eight hours with a lunch recess unlike Surat’s 12-hour shift without a break. You can also make the roughly the same amounts (i.e. Rs. 170-200) because you will surely get two hours of overtime. There’s no such thing in Surat. In Kerala, there are proper timings and a day off, the labour laws are strictly enforced (because the unions are strong). In Surat we are treated like dirt.”

The money difference is fast shrinking, says Dukhi Shyam in Lathipada, who has operated looms in Surat for 14 years. “Now each of us handles six looms where earlier we managed four. That too is a way of cutting our wages.”

Many ‘returnees’ do not like to see themselves as grounded at home base even if they suspect they are. Many speak of returning to Surat “in some months” and might well try their luck. Others are looking to newer venues. As one old cynic put it in Lathipada. “What is there to stay for? In this region you migrate when you’re weaned off breast milk.” And return, his neighbour chips in, “when the hair on your head, if you have any left, is grey.”

P. Sainath is the rural affairs editor of The Hindu, where this piece appears, and is the author of Everybody Loves a Good Drought. He can be reached at:

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Arise Awake Stop not till the goal is reached. - Swami Vivekananda Swami ji is my inspiration, not as a monk but as a social reformer and for his universal-ism.