TR EMERITUS

(25 Jun) - How in the world does the government expect us to trust the economic numbers that they give us anymore?  For a long time, many have suspected that they were being manipulated, and as you will see below we now have stone cold proof that this is indeed the case.  But first, let's talk about the revised GDP number for the first quarter of 2014 that was just released.  Initially, they told us that the U.S. economy only shrank by 0.1 percent in Q1.  Then that was revised down to a 1.0 percent contraction, and now we are being informed that the economy actually contracted by a whopping 2.9 percent during the first quarter.  So what are we actually supposed to believe?  Sometimes I almost get the feeling that government bureaucrats are just throwing darts at a dartboard in order to get these numbers.  Of course that is not actually true, but how do we know that we can actually trust the numbers that they give to us? Over at shadowstats.com, John Williams publishes alternative economic statistics that he believes are much more realistic than the government numbers.  According to his figures, the U.S. economy has actually been continually contracting since 2005.  That would mean that we have been in a recession for the last nine years. .... Another number that many have accused of being highly manipulated is the inflation rate. But we don't have to sit around and wonder if that figure is being manipulated.  The truth is that even those that work inside the Federal Reserve admit that it is being manipulated. .... Right now, the Federal Reserve tells us that the inflation rate is sitting at about 2 percent. But according to John Williams, if the inflation rate was calculated the same way that it was in 1990 it would be nearly 6 percent. And if the inflation rate was calculated the same way that it was in 1980 it would be nearly 10 percent. So which number are we supposed to believe? The one that makes us feel the best? And without a doubt, "2 percent inflation" sounds a whole lot better than "10 percent inflation" does. [Read more:  The Economic Collapse]  Read More →

A doctor showing an X-ray to the attendant of a Nigerian patient who underwent surgery at the Apollo Hospital in Chennai. Australian doctor David Berger has stirred up a debate about corruption in Indian health care with an article in the British Medical Journal. It is based on his six months as a volunteer physician in an Indian hospital. (Photo AFP) ST published an article by a New Delhi-based BBC journalist today ('Graft leaves Indian health care ailing', 11 Jul), reporting about the rampant corruption situation in India's healthcare system. The author cited a study by Transparency International, confirming the personal experience of millions of Indian nationals that India's healthcare system is the most corrupt institution which they encounter in their daily lives, after the police. Transparency International, in fact, found that 80% of Indian citizens classified as impoverished had to pay bribes for health services. These included a hospital bed, a test, outpatient treatment or surgery. 90% of the bribes were paid directly to doctors and staff. It is said that to generate the required revenue in some of the Indian hospitals, doctors are given "quotas" by the management to prescribe the necessary number of tests and procedures to their patients. The author then mentioned that an Australian doctor, Dr David Berger, has in fact stirred up a national debate in India recently about corruption in its healthcare system. Dr David Berger volunteered to work as a physician at a charitable Indian hospital some time ago. He later wrote an article revealing the extent of the rot inside India's healthcare system. His article was published in the prestigious British Medical Journal in May, 2 months ago ('Corruption ruins the doctor-patient relationship in India'). He wrote, "I knew this (corruption) was the case before I went to work as a volunteer physician in a small charitable hospital in the Himalayas, but what I didn’t realise was how far the corruption permeates the world of medicine and the corrosive effect it has on the doctor-patient relationship (in India)." Dr Berger noted that India's healthcare system itself is one of the most privatised in the world, with out-of-pocket expenditure on healthcare at more than 70% (this is not that far from that of Singapore where more than 60% of costs are paid by patients themselves - 'Easing the cost of healthcare for Singaporeans – NCMP Gerald Giam'). Dr Berger recounted his experiences in India: One day in the outpatient department, I was writing a request for an exercise electrocardiogram at a private heart clinic when the devout young resident consulting beside me said, “Give me that. I have to sign it.” Perplexed, I handed it over, and the story unfolded: all investigations attract a 10-15% kickback to the referring doctor. One day, the marketing executive for this clinic had turned up at the hospital with an envelope full of cash - the commission for investigations ordered in the past few months. The senior doctor refused it and stipulated that in future the commission was to be paid back to patients, which is why the resident had to sign the form. The country’s doctors and medical institutions live in an “unvirtuous circle” of referral and kickback that poisons their integrity and destroys any chance of a trusting relationship with their patients. Given these practices, it is no surprise that investigations and procedures are abused as a means of milking patients. I saw one patient with no apparent structural heart disease and uncomplicated essential hypertension who had been followed up by a city cardiologist with an echocardiogram every three months, a totally unnecessary investigation. A senior doctor in another hospital a couple of hours away was renowned for using ultrasonography as a profligate, revenue earning procedure, charging desperately poor people Rs1000 (£10; €12; $17) each time. Everyone who works in healthcare in India knows this kind of thing is widespread. There is also widespread corruption in the pharmaceutical industry, with doctors bribed to prescribe particular drugs. Tales are common of hospital directors being given top of the range cars and other inducements when their hospitals sign contracts to prescribe particular antibiotics preferentially. I met a former pharmaceutical sales executive who left the industry, sickened by the corrupt practices he was supposed to employ. Working for one of the largest drug companies in the country, he was expected to bribe doctors with money and luxury goods. The crunch came when a doctor demanded that the company fly him to Thailand for a holiday and then provide him with prostitutes at his home. When the company representative queried this, his manager told him to comply, and he felt he had no choice but to resign, protesting that he was “not a pimp.” Dr Berger said that a common complaint he heard from the poor and middle class people is that they don’t trust their Indian doctors. "They don’t trust them to be competent or to be honest, and they live in fear of having to consult them," he said. Even the pharmacists in India seem to to have a similar lack of ethics, selling inappropriate drugs over the counter at exorbitant prices to people who often have to borrow the money to pay for them, noted Dr Berger. Corruption extends to medical studies in India During his stay in India, Dr Berger also noted that medical students have to pay very large “donations” (perhaps US$200 000 or more, some 20 times the average doctor’s annual salary) to get into the "rapidly increasing number of private medical colleges" and to get on to sought after postgraduate training schemes. This means that Indian doctors can have high levels of debt or family obligation when qualifying, which is a strong incentive against working as generalists in rural areas and favours them practising technological medicine for maximum profit in urban areas to try to recoup their investment. Dr Berger also warned about other countries taking in doctors trained in India lacking in ethics: Medicine has globally accepted standards of conduct. The Indian profession should want to adhere and be held accountable to these. Currently, however, it seems to be failing in this regard. This is not only bad for India but bad for other countries that take doctors trained in India. In wanting to draw attention to these problems, I am holding my Indian colleagues to the same standards of ethical behaviour as I would my colleagues at home. He suggested reforming the private medical colleges, the number of which is burgeoning as the Indian government tries to expand the number of medical graduates. He further warned: "As long as places are available for sale at astronomical prices at these institutions, and as long as they resort to fraudulent practices and bribery to pass their inspections, then the integrity and competence of their graduates will remain questionable and the cycle of corruption will remain unbreakable." Dr Berger even went so far to propose that if reform in India's healthcare system is not forthcoming, Western countries could withdraw recognition from all suspect private Indian medical colleges: "If prompt reform is not forthcoming from within the country (and the will seems to be lacking), then the spotlight needs to turn global. The medical licensing authorities of the United Kingdom, the US, Canada, Australia, and New Zealand could withdraw recognition from all suspect private Indian medical colleges, sending a signal that there is no longer such a thing as “local corruption.” These countries are popular foreign destinations for Indian medical graduates, but they do not want to accommodate potentially corrupt doctors of uncertain competence, and neither do the people of India. The BBC journalist also echoed some of Dr Berger's observations and remarks: If India now has a gigantic problem, the reasons are numerous. They include greedy doctors and the overall tolerance for corruption in a culture that has rationalised the giving and taking of bribes. Another reason is the reliance on self-regulation. The Indian Medical Council is the only body responsible for regulating doctors. Sadly, it has been ineffective. Some doctors who have reported corrupt colleagues to the IMC's ethics committee have complained publicly about its failure to act. The council has not even managed to deal with the problem of quackery, or the fact that some medical students pay bribes to ensure that they are admitted into medical college. It does not keep statistics on how many doctors are struck off in any given year either. The journalist concluded in his article: But the wider point to be made is that doctors are a part of a society steeped in corruption... If Indians think the medical profession can be honest in a culture pervaded by dishonesty, they are deluding themselves. Given that Singapore is also importing large number of doctors trained in India to work in Singapore's healthcare institutions, it's not known how many (if any) are similarly lacking in ethics or competency. Singapore Medical Council (SMC) should take note of Dr Berger's article published in the prestigious British Medical Journal. If even one Singaporean died due to the incompetency of a doctor poorly trained in India as described by Dr Berger, but was admitted by SMC nonetheless, then SMC should also be held accountable. What do you think?    Read More →

One of my favorite novels is Jeffery Archer’s “First Among Equals” published in 1984. It’s a political novel based on the British Westminster model – multi-party parliamentary system similar to ours. I first read this novel nearly 30 yrs ago. I keep going back to read it from time to time especially if I could not recall some of the sequence of events as my memory fades. The last time I referred to it was many years ago. Anyway, I could still recall the intense and exciting political drama unfolding stretching over a period of 30 yrs when four ambitious young men entered parliament on their own merits through elections and eventually one of them rises to the coveted post of Prime Minister. Hence, the title of the novel – “First Among Equals”. First Among Equals (front cover) From the novel, I got to know much about politics and government in a democracy based on the Westminster model. Our system is quite similar to them but without the GRCs of course. Four aspiring politicians have to make their impact in local elections winning every single vote especially if they are contesting against established MPs of the constituencies. They really have to slog it out working their butts out canvassing for every vote often more than 15 hours a day in the heat of the elections. The battle for the hearts and minds of the electorate started at grassroots level even before the MP-elect is sworn in to office. That’s how competitive the UK system is. The four young men came from various backgrounds belonging to different political parties. They belong to different camps – the two biggest political parties – the Labour and the Conservatives. In the end, the butcher’s son Ray Gould, a commoner, becomes the Prime Minister. I am impressed by the speech he delivers in his school speech day – where only the top student usually delivers the keynote speech – where he spells out what he will do when he becomes PM of UK. Yes, WHEN he becomes the PM not IF he becomes the PM. Another ambitious young man of the cohort, Simon Kerslake tries all means to get into Oxford University even though he’s denied a place initially. When the term opens, he goes around personally to every college in Oxford asking for a place. Incidentally, he takes over the place of a freshman tragically killed in an accident after meeting the 22nd College Don. He is overjoyed when History is the subject of his studies. He says that future PMs all come from Oxford and not the rival Cambridge or any other universities. I note that the four of them study only humanities not some hardcore sciences. They are never engineers or other professional degree courses except maybe law degree. The four of them got admitted to parliament based on personal merits even though some of them got some connection with political office holders. Most importantly, they are all full-time MPs working very hard in their own constituencies and have to rush back to London to attend parliament sittings. They often rush back to their own constituencies over the weekends only to rush back again for week day parliamentary debates. We must remember that UK is a big country comprising Scotland, Wales and Ireland – unlike Singapore where it is so small. Yet, we have MPs here not able to attend parliament sessions resulting in two bills not being able to pass. When I was reading the novel, I could not resist comparing their attitudes with our own MPs. The UK MPs are serious in their work working tirelessly struggling through parliamentary debates and then rushing back to their faraway constituencies cuz they need to attend local events or attend to their constituents’ needs. Failing to do so risks getting voted out in the next election. UK MPs are also full-time career politicians treating their MP jobs seriously. They treat their MP jobs with first priority and the other jobs such as own legal practice or business venture on part-time basis. Whenever parliament is in session, they will put away all other private businesses or appointments with parliament sessions being the top priority. The dedication to public office is impressive. Some even rent a room near to the parliament so that they could rest and shuttle back for any emergency session or party meeting. The four newly elected MPs have to really prove themselves in parliamentary debates to impress their party leadership so as to win for themselves political posts in the government. If the political party is the government, the novice MPs have to fight hard in parliamentary debates to win a political office. Once the party elders notice any potential office bearers amongst them, they will be head hunted and accorded a junior post. There is no short cut to a full fledged cabinet minister post until after few successful elections. In other words, the MP must keep winning every local election in order to get promoted within the party ranks to full ministerial rank. After every successful election, the seasoned MP is promoted to higher political office. For example, it takes nearly 30 yrs when a young MP Ray Gould first enters parliament to the time when he realizes his childhood dream of Prime Ministership – the day when he gives a speech in school on “When I become the Prime Minister of UK!” Maybe in UK, there are many political parties with so many aspiring politicians. There is intense competition to enter parliament through the democratic process of elections. I could sense the tenseness and treachery as the political drama unfolds revolving around the four main characters from different backgrounds and different areas of the country. Luck also plays an important part besides political acumen, tenacity and commitment of the ambitious politicians in the UK multi-party system. High pay or other forms of monetary rewards are never on their agenda. They are after pure glory, fame and power. They pursue their dreams single-mindedly with the intention of leaving their mark in their beloved country’s history as great statesmen in the likes of Winston Churchill or Margaret Thatcher. However, when they lose in an election, they accept their defeat with dignity and honor. When they win, they extend their humility to the defeated. They never resort to the court to sue even though the local newspapers may not side them or malicious allegations made publicly against them. The court of public opinion holds supreme there. The well informed electorate shall decide on their political destiny. The UK system is truly a First World Parliament where people all over the world admire. After all, many other countries including us copy or emulate their Westminster system of parliament. But sadly, we have not matured and reached that level yet. It will never happen in our lifetime. Hopefully, it will happen in our children’s lifetime. The signs are there for all to see. To those readers who like political drama novels, I recommend that you read this book. I think it is the best political novel based on the Westminster model of parliamentary democracy. Thirty years since “First Among Equals” was published in 1984, it is still getting rave reviews. It’s an instant hit when it’s adapted into a mini television series. Maybe, it is due to Jeffrey Archer himself being an MP at one time where he could really draw on his immense experience to write this all-time bestseller. I never grow tired of reading it. Gintai_昇泰 * The author blogs at Gintai.Wordpress.com.  Read More →