Where Wealth is Health!

While India's economic growth is on the media radar, and articles
about how Americans and other westerners are going to India for it's
high quality, yet relatively cheap healthcare get written, the truth
is that there are many millions of Indians who are getting poorer and
are unable to receive proper healthcare. Capitalism is on the rise.

From a New York Times article, titled, "Royal Care for Some of India's
Patients, Neglect for Others" -- "Mr. Steeles, 60, a car dealer from
Daphne, Ala., had flown halfway around the world last month to save
his heart, at a price he could pay. He had a mitral valve repaired at
a state-of-the-art private hospital here, called Wockhardt, and for 10
days, he was recuperating in a carpeted, wood-paneled room, with a
view of a leafy green courtyard.

A dietician helped select his meals. A dermatologist came as soon as
he complained of an itch. His Royal Suite had cable TV, a computer, a
minirefrigerator, where an attendant that afternoon stashed some ice
cream, for when he felt hungry later. Three days after surgery, he was
sitting in a chair, smiling, chattering, thrilled to be alive.

On his bed lay the morning's paper. Dominating its front page was the
story of other men, many of them day laborers who laid bricks and
mixed cement for Bangalore's construction boom, who had fallen gravely
ill after drinking illegally brewed liquor. All told, more than 150
died that week, here and in neighboring Tamil Nadu State.

Not for them the care of India's best private hospitals. They had been
wheeled in by wives and brothers to the overstretched government-run
Bowring Hospital, on the other side of town. Bowring had no intensive
care unit, no ventilators, no dialysis machine. Dinner was a stack of
white bread, on which a healthy cockroach crawled while a patient,
named Yelappa, slept.

Wockhardt has 30 ventilators, including some that are noninvasive, so
the patient does not have to have a tube rammed down his throat. At
any one time, a half-dozen are in use. An elderly woman had been in
its intensive care unit for a week, on dialysis; her family wanted to
do whatever possible to keep her alive, no matter the cost.

At Bowring, one of the young doctors, named Harish, said a ventilator
and a dialysis machine would have allowed him to keep half of his
patients alive. The most severe case, Mohammed Amin, was breathing
with the aid of a hand pump that his wife squeezed silently. Dr.
Harish sent the relative of one man to get blood tests done at the
nearest private hospital; there was no equipment to do the test here.
Then the doctor rushed to the triage section in Bowring's lobby, where
the newest patient, writhing, resisting, disoriented from the poison
in his gut, had to be tied down with bedsheets."

Universal healthcare is not just needed for the US, it is required for
other capitalistic societies like India as well.

Read the full NYT article at--
http://www.nytimes.com/2008/06/01/weekinreview/01sengupta.html?emc=tnt&tntemail0=y

Outsourcing is a Two-way Street

"So long as America remains one of the world's largest consumer
markets and there are enough economic incentives to move production to
the U.S., the flow of global employment will run both ways," says an
article in Forbes. The author writes, "Some pundits and politicians
love to complain about how Americans lose their jobs because of
cheaper labor overseas. But many foreign companies create jobs for
Americans by investing and operating in the U.S."

Not many think of it this way, unfortunately. Many view outsourcing as
a one way street, when in fact it goes several different ways, truly
making this world a global village.

Another excerpt from this article says, "Even Indian
information-technology outsourcing companies are bringing operations
to the U.S. Despite its far-flung location, Applabs, a large
independent IT quality-assurance provider, has opened offices in
Philadelphia and Lindon, Utah.

How could America's workforce be as appealing to outsourcers as
India's? "Companies are already seeing in Bangalore, India, that there
is such a tight labor market that their wages have gone up
dramatically in the past couple of years," Heijmen says. A more
expensive labor market, compounded by the relative weakness of the
dollar, has made operating within the U.S. an increasingly attractive
option for foreign companies.

To be sure, American companies continue to offshore all manner of
duties to other nations around the world. But experts say its
converse, foreign hiring of American workers, won't cease anytime
soon."

Read the full article at --
http://www.forbes.com/opinions/2008/05/25/foreign-labor-auto-oped-cx_jhb_outsourcing08_0529america.html

The Global Village...

"Which company is more "American"—Mumbai-based Tata Consultancy
Services, or Armonk (N.Y.)-based IBM (IBM)? Evaluate the two based on
where they make their sales, and the answer is surprising. TCS,
India's largest tech-services company, collected 51% of its revenues
in North America last quarter, while 65% of IBM's were overseas." --
excerpt from a Business Week article titled "IBM vs. Tata: Who's More
American?"

It never ceases to amaze me how truly global the world is becoming. I
remember studying about Marshall McLuhans concept of the Global
Village during my Masters program in Mass Communications, and it now
seems like this is increasingly happening in front of my eyes.
Centrifugal forces are at work bring ideas, groups and people closer.
However the centripetal forces are doing their part as well, by
isolating cultures, traditions, and concepts further away. During this
process of self discovery, we need to arrive at a happy medium without
disrupting the unstable equlibrium that currently exists in our world.
How are we going to do that, only time will tell!

Read the full Business Week article at--
http://www.businessweek.com/magazine/content/08_18/b4082000234598.htm?chan=technology_technology+index+page_best+of+the+magazine

Collecting Debts From India

A new trend in outsourcing to India is in debt collection says this
article in the New York Times titled, "Debt Collection Done From India
Appeals to U.S. Agencies."

An excerpt from the article --
"Americans are used to receiving calls from India for insurance claims
and credit card sales. But debt collection represents a growing
business for outsourcing companies, especially as the American economy
slows and its consumers struggle to pay for their purchases.

Armed with a sophisticated automated system that dials tens of
thousands of Americans every hour, and puts confidential information
like Social Security numbers, addresses and credit history at
operators' fingertips, this new breed of collectors is chasing down
late car payments, overdue credit card debt and lapsed installment
loans. Debt collectors in India often cost about one-quarter the price
of their American counterparts, and are often better at the job, debt
collection company executives say.

"India will be the only place we grow this year," said J. Brandon
Black, the chief executive of the Encore Capital Group, a debt
collection company based in San Diego. India is the company's largest
operating area, with about half the company's collection force of more
than 300.

Although the stereotype of a collector may be "some guy with chains
and a cut-off shirt," Mr. Black said, collectors in India are "very
polite, very respectful, and they don't raise their voice." He added,
"People respond to that."

Read the full article at--
http://select.nytimes.com/mem/tnt.html?emc=tnt&tntget=2008/04/24/business/worldbusiness/24debt.html&tntemail0=yv

Outsourcing Stress

The nature and being of Indian Society has changed drastically over
the last few years, there is no doubt about this. For those of us who
visit every other year we see the rapid changed fast forwarding in
front of our eyes with every visit. Each time I visit, I notice the
latent stress that did not exist several years ago, when life was more
laid back and priorities were very different. Today, everyone is more
preoccuped with work, managing dual income households, where money is
not the issue but time is.

I saw this article in the Chicago Tribune, and I felt that it was
right on. Read this excerpt below.

"After two years working nights at a U.S. company's computer call
center, Vamsi knew it was time to quit when his 6-year-old son brought
home a school portrait he'd drawn of his father, asleep in bed.
"He was asked to draw a picture of his mom and dad, and he drew me
sleeping. That's the only way he ever saw me," remembers the
31-year-old, who like many southern Indians goes by only one name. "He
never saw me doing anything else."
Indians may have taken over three-quarters of the world's call-center
jobs, but they've also taken on the stresses of those jobs: weight
gain, depression, boredom and, often, relationship troubles."

Call centers are just one example of an industry that is catering to a
different part of the world. So many other sectors are in the same
boat. Friends and family that live in India, maintain the same hours
and schedules that I maintain on the east coast. I can see the stress
that this puts on their family life and their personal relationships.

With stress come otehr problems such as substance abuse,increasing
divorce rates, unstable children and the list is endless.
"A study last year in the Indian Journal of Sleep Medicine found that
40 percent of call-center workers surveyed smoked, compared with 7
percent of a control group, and 36 percent had more than two alcoholic
drinks a week, against 2 percent of the control group. Another 27
percent of call-center workers also reported using sleeping pills or
other drugs, often in an effort to combat the sleep deprivation that
nags overnight workers," says the Tribune article.

Read the full piece at--
http://www.chicagotribune.com/news/chi-india-stress_nu_goeringapr20,0,6517218.story

Outsourcing Scientific Discoveries

An article in the New York Times titled, "How Scientific Gains Abroad
Pay Off in the U.S." asks the questions, "AT a time of economic
belt-tightening, might cheap science from low-wage countries help keep
American innovators humming?"

While outsourcing is the name of the game, to cut costs and increase
growth, it has been widely adopted in various segments of
manufacturing and industry. "Americans have long profited from
low-cost manufactured goods, especially from Asia. The cost of those
material "inputs" is now rising. But because of growing numbers of
scientists in China, India and other lower-wage countries, "the cost
of producing a new scientific discovery is dropping around the world,"
says Christopher T. Hill, a professor of public policy and technology
at George Mason University," says this article in the New York Times.

Another excerpt from this article--
"We shouldn't fear the rise of science in Asia and other poorer
countries. We should figure out how to take advantage of it," says
Patrick Windham, a lecturer in technology policy at Stanford and a
former staff member of Congressional science committees.
Optimism about scientific globalization is a wrinkle on the familiar
story of outsourcing. Just as United States companies have contracted
out physical production, they can do the same for scientific "goods,"
which range from formulas and ideas to the results of experiments.
In the short-term at least, higher spending on scientists by India and
China could create a glut of them in these countries, driving wages
down further and making the costs of acquiring science even lower.
"Science is the ultimate global activity," says Richard B. Freeman, a
labor economist with the National Bureau of Economic Research. "You
can outsource research."
Mr. Freeman, among others, questions whether there is a shortage of
scientists in the United States. He cites evidence suggesting that
American dominance in science will decline over time and that we
should worry less about purported shortages at home and more about
"developing new ways of benefiting from scientific advances made in
other countries."

For a while now, the critics were wary of this, of innovation moving
away to these fast growing economies of China and India. Lack of focus
on immigration policy, and increase in Reverse Brain Drain, add to
this phenomenon of outsourcing innovation and scientific discoveries,
but as the article says either way it seems like a win-win situation.

Read the full article at --
http://select.nytimes.com/mem/tnt.html?emc=tnt&tntget=2008/04/20/technology/20ping.html&tntemail0=y

Outsourcing Childcare to India...

For those of you out there, who like me are fans of the Onion!

TCS's new Cincinnati Headquarters

One of the Indian companies that is making waves, expanding rapidly in
North America is Tata. TCS recently opened a delivery center in Ohio
and plans to staff it with about a 1000 employees.

Here is an excerpt--
"More than a century after the company's great forbear Jamshedji Tata
scoured Ohio looking for steel expertise, India's tech major Tata
Consultancy Services (TCS) opened a 1000-seat delivery centre outside
Cincinnati on Monday, marking a small but significant counter to
overwrought reports about job flight from the United States.

Eminences ranging from the state governor to the local school
superintendent turned up for the inauguration of the new facility, to
hear and exult about 1000 jobs being created in the area. It was a
rare moment of relief, pride, and vindication too for India - and an
Indian company - which has been under attack from protectionist forces
in the US for taking away American jobs.

The delivery centre, located in the Cincinnati suburb of Milford, will
take in mostly local hires over the next three years after TCS cranks
it up with associates from India. It will handle design, development
and delivery needs of TCS' key North American customers such as
Boeing, Nielsen and General Electric."

Read the full article at--
http://timesofindia.indiatimes.com/Tata_jobs_bloom_in_middle_America/articleshow/2879247.cms

And the most H1B goes to...

The controversy over visas for high-skilled workers from abroad looks
like it's about to get even hotter, says Business Week.

An excerpt --

"The program for what are known as H-1B visas was originally set up to
allow companies in the U.S. to import the best and brightest in
technology, engineering, and other fields when such workers are in
short supply in America. But data just released by the federal
government show that offshore outsourcing firms, particularly from
India, dominate the list of companies awarded H-1B visas in 2007.
Indian outsourcers accounted for nearly 80% of the visa petitions
approved last year for the top 10 participants in the program. The new
data are sure to fuel criticism of the visa program from detractors
such as Senators Chuck Grassley (R-Iowa) and Richard J. Durbin
(D-Ill.). "These numbers should send a red flag to every lawmaker that
the H-1B visa program is not working as it was intended," said
Grassley in an e-mail."

Read the full article at --
http://www.businessweek.com/magazine/content/08_11/b4075062465238.htm?chan=top+news_top+news+index_best+of+bw

Now They Call It Reproductive Outsourcing!!!!

Talk about taking advantage of the poor, the surrogate mom saga
continues, and is in full swing it sounds like.

Read this excerpt from a New York Times feature article --
" An enterprise known as reproductive outsourcing is a new but rapidly
expanding business in India. Clinics that provide surrogate mothers
for foreigners say they have recently been inundated with requests
from the United States and Europe, as word spreads of India's mix of
skilled medical professionals, relatively liberal laws and low prices.
Commercial surrogacy, which is banned in some states and some European
countries, was legalized in India in 2002. The cost comes to about
$25,000, roughly a third of the typical price in the United States.
That includes the medical procedures; payment to the surrogate mother,
which is often, but not always, done through the clinic; plus air
tickets and hotels for two trips to India (one for the fertilization
and a second to collect the baby)."

Read the full article at --
http://select.nytimes.com/mem/tnt.html?emc=tnt&tntget=2008/03/10/world/asia/10surrogate.html&tntemail0=y

Outsourced Wombs

An article by Judith Warner in the New York Times opinion section is highly thought provoking --

Outsourced Wombs
Tags: India, surrogate motherhood
The voice was commanding, slightly disdainful and officious.

“The legal issues in the United States are complicated, having to do with that the surrogate mother still has legal rights to that child until they sign over their parental rights at the time of the delivery. Of course, and there’s the factor of costs. For some couples in the United States surrogacy can reach up to $80,000.”

This was “Julie,” an American thirtysomething who’d come to India to pay a poor village woman to bear her baby. She went on:

“You have no idea if your surrogate mother is smoking, drinking alcohol, doing drugs. You don’t know what she’s doing. You have a third-party agency as a mediator between the two of you, but there’s no one policing her in the sense that you don’t know what’s going on.”

Would you want this woman owning your womb?

The Indian surrogate mothers quoted along with Julie in a report on American Public Media’s “Marketplace” on NPR last week didn’t much appear troubled by that kind of thought. After all, the money they were earning for their services — $6,000 to $10,000 – might have been a pittance compared to what surrogates in the United States might earn, but it was still, for their families, the equivalent of 10 to 15 years of normal income.

They couldn’t hear Julie speaking in her awful, entitled tone. And if they had, would they have cared? “From the money I earn as a surrogate mother, I can buy a house,” said Nandani Patel, via a translator. “It’s not possible for my husband to earn more as he’s not educated and only earns $50 a month.”

We, however, can hear the imperious tone, so much more audible in radio than in the troubling print reports that have surfaced lately on Indian surrogate mothers’ “wombs for rent.” And we should care about how things sound.

Because what’s going on in India – where surrogacy is estimated now to be a $445-million-a-year business — feels like a step toward the kind of insane dehumanization that filled the dystopic fantasies of Aldous Huxley’s “Brave New World” and Margaret Atwood’s “Handmaid’s Tale.” (One “medical tourism” website, PlanetHospital.com, refers to the Indian surrogate mother as a mere “host.”) Images of pregnant women lying in rows, or sitting lined up, belly after belly, for medical exams look like industrial outsourcing pushed to a nightmarish extreme.

Surrogate mothers are seen at Kaival Hospital in Anand, India, in 2006. Photo: AP Photo/Ajit Solanki
I say “feels like” and “look like” because I can’t quite bring myself to the point of saying “is.” And in this, I think, I am right in the mainstream of American thought on the topic of surrogate motherhood.

Read the full essay at --
http://warner.blogs.nytimes.com/2008/01/03/outsourced-wombs/?em&ex=1199682000&en=8bf9729c4f2c5a0c&ei=5070