Court’s nudge on hospital charges, a reform opportunity
Supreme Court Intervention
- The Supreme Court of India, responding to a Public Interest Litigation (PIL), instructed the government to regulate private hospital procedure rates.
- It cited the vast disparity between government and private hospital costs, particularly for cataract surgeries.
Legal Framework and Pricing Benchmark
- The Court referenced Rule 9 of the Clinical Establishments Act, emphasizing the need for government-set rates.
- It proposed using the Central Government Health Scheme rates temporarily if the government fails to establish regulations.
Need for Regulation in Healthcare Markets
- Healthcare markets, being imperfect, require regulation to address inefficiencies and inequities.
- Unregulated markets can lead to profit-driven practices and overprovision of care.
Identified Problems and Solutions
- One solution involves setting benchmark prices based on market observations.
- Relying solely on government hospitals for competition is inadequate due to various factors.
- Standard treatment guidelines (STGs) can help establish clinical needs and appropriate care levels.
Required Actions
- Over half of India’s health expenditure is out-of-pocket, necessitating effective regulation.
- The predominantly small-scale private sector may struggle with standard rate implementation.
- Formulating STGs requires aligning provider revenues with fewer payers, possibly with government support.
Challenges in Implementation
- Weak enforcement mechanisms lead to temporary effects without lasting change.
- Limited adoption of the Clinical Establishments Act and weak implementation hinder regulation effectiveness.
- Similar issues have been encountered with pricing regulations for pharmaceuticals.
Data Limitations and Future Directions
- Initiatives like the Pradhan Mantri Jan Arogya Yojana and STG development show progress.
- Efforts are underway to develop an Indian version of Diagnostics-Related Groups.
- Challenges such as limited data and stakeholder alignment must be addressed in future reforms.
Why are unclassed forests ‘missing’?
Compliance with Supreme Court Directive
- The Ministry of Environment, Forests, and Climate Change (MoEFCC) has published State Expert Committee (SEC) reports on its website, following a Supreme Court order.
- This action was prompted by a public interest litigation challenging the Forest (Conservation) Act Amendment (FCAA) 2023.
Forest (Conservation) Act Amendment Details
- The FCAA could potentially remove legal protection from unclassed forests, as defined in the TN Godavarman Thirumalpad (1996) case, leading to their diversion.
- SEC reports affirm that all types of forests, regardless of ownership or notification status, fall under the Forest (Conservation) Act, 1980.
- Unclassed or deemed forests would require Central government approval for non-forest use, including those owned by various entities or privately owned but not officially notified.
Identification of Forests
- The release of SEC reports addresses concerns that the proposed amendment might exclude unclassed forests from protection.
- However, there are discrepancies between the SEC-identified unclassed forests and reports obtained through RTI applications.
Report Content and Concerns
- Only 17 out of 23 States’ reports align with Court directives, with nine States providing information on unclassed forests.
- The accuracy of Forest Survey of India reports is questioned, as seen in the case of Gujarat’s discrepancy in forest area.
- The absence of on-ground verification by SECs may have led to significant forest destruction.
Potential Effects of FCAA
- Loss of unclassed forests may be widespread, necessitating further investigation.
- Non-adherence to the SC’s Godavarman order and failure to implement the Indian Forest Policy’s goals could jeopardize ecological balance.
- Implementing the FCAA without proper examination of SEC reports reflects negligence on the Ministry’s part and threatens India’s ecosystems and ecological security.
The physics and maths of keeping elections fair and representative
Historical Perspectives on Elections
- Elections globally encompass a range of emotions, ideologies, and occasionally, violence.
- Ancient Athens had an early form of elections based on luck, where campaigning had no influence.
- The Chola dynasty in tenth-century Tamil Nadu practiced a similar random selection system called ‘Kudavolai’ for village representatives.
Critique of the ‘First Past the Post’ System
- The ‘First Past the Post’ (FPTP) system, utilized in India, the U.S., and the U.K., faces criticism for discrepancies between popular vote share and seat allocation.
- Winners in FPTP often secure less than 50% of the vote share, and no Indian government has surpassed this threshold in the Lok Sabha.
Condorcet Systems and Borda Method
- The Condorcet system, originating from Ramon Llull’s works, ensures winners receive more than 50% votes when compared against other candidates.
- The Borda electoral method, proposed by Jean-Charles de Borda in 1784, employs rank-based voting to ensure the winner secures at least 50% of the vote through vote redistribution.
Real-life Application of Rank-based Voting
- India’s Presidential elections utilize rank-based voting. In 1969, V.V. Giri won after securing 50.8% of the votes through redistribution.
- In an example election with three candidates, withdrawal of a candidate can alter the outcome, showcasing the system’s nuances.
Role of Mathematics and Physics
- Analysis of election data over two decades reveals consistent patterns, aiding algorithm refinement.
- Mathematics sharpens election algorithms, while a physics perspective ensures fair implementation.
- Despite ongoing advancements, elections remain a beacon of hope for millions globally, including the 2024 elections.
The EVM-VVPAT case judgment is disappointing
Recent Supreme Court Directive
- In the fields of science, mathematics, and statistics, truths cannot be dictated by the executive, parliament, or judiciary.
- The Supreme Court of India cannot simply mandate a uniform sample size of 5 Electronic Voting Machines (EVMs) per Assembly Constituency for Voter Verifiable Paper Audit Trail (VVPAT)-based audits nationwide.
- This sample size lacks adherence to fundamental principles of statistical sampling theory.
Illustrative Case and Methodology
- VVPAT-based audit of EVMs resembles “lot acceptance sampling,” a statistical quality control technique widely used in industry.
- If the number of defects in a random sample is within an “acceptance number,” the entire lot is accepted; otherwise, it is rejected.
- A defective EVM is one with a discrepancy between the EVM count and VVPAT count due to malfunction or manipulation.
Flaws in Calculation and Execution
- The Supreme Court and Election Commission of India (ECI) failed to specify the population of EVMs to which the sample size applies and the protocol for dealing with defective EVMs.
- Statistical theory indicates a high probability of failure to detect defective EVMs with the mandated sample size.
- Despite ECI’s claim of no mismatches, reasons could include well-functioning EVMs, flawed sample size, or both.
- The Court’s judgment lacks transparency regarding defining the population and next steps in case of discrepancies.
Way Forward
- India requires a statistically robust VVPAT-based EVM audit system with 99% or 99.9% accuracy in detecting mismatches.
- Matching should occur at the start of the counting day, not the end, with manual counting of VVPAT slips for all remaining EVMs in case of discrepancies.
A lesson from Taiwan in quake resilience
Global Occurrence of Earthquakes
- Over the past two decades, major earthquakes have struck various regions worldwide, including Indonesia, Japan, China, Italy, and Nepal.
- Taiwan, prone to earthquakes due to shared tectonic characteristics, experienced a 7.4 magnitude earthquake on April 3.
Plate Tectonics and Regional Bands
- Earthquakes predominantly occur within specific regional bands, a phenomenon explained by plate tectonics theory.
- The Earth’s lithosphere, divided into 15 major plates, constantly shifts relative to each other.
Case Study: Taiwan Earthquakes
- Taiwan lies at a convergent boundary between the Philippine Sea plate and the Eurasian plate, with the former moving faster towards the latter.
- The recent earthquake near Hualien caused minimal damage compared to the 1999 earthquake, despite similar magnitudes.
- Notably, Taipei 101, Taiwan’s iconic building, remained undamaged.
Disaster Resilience Measures
- The 1999 Chi-Chi earthquake prompted Taiwan to implement administrative reforms, including the Disaster Prevention and Protection Act and establishing national earthquake coordination centers.
- Taiwan boasts advanced earthquake preparedness with sophisticated monitoring networks and early warning systems.
- Public awareness campaigns and safety drills have enhanced understanding and preparedness.
- Government initiatives incentivize compliance with earthquake safety standards through subsidies and updates to building regulations.
Implications for India
- Given India’s infrastructural expansion in seismic regions like the Himalayas, earthquake safety should be a priority.
- Infrastructure projects must adhere to seismic safety regulations, drawing lessons from Taiwan’s experiences.
- Emphasis should be placed on constructing engineered structures compliant with seismic codes and addressing enforcement deficiencies.
- India’s seismic code, IS 1893, mandates seismic designs based on zonation maps to prevent building collapses.
- Exploring traditional architectural styles resilient to earthquakes could also be beneficial in certain Indian regions.
