To the NL Hafta team,

I have been a paid subscriber to Newslaundry for a while now and really love it, from NL Hafta, to “The Awful and Awesome” and TV Newsance.

This email is in regards to Hafta 186 where a subscriber emailed you regarding the quality of material not being up to the mark these days ( the email written in epic Hindi). I agree with her on that and also that I would love to hear more from Manisha on it as sometimes I feel she gets relegated to the background. I also disagree with her that Netflix shouldn’t be recommended. Just because it’s commercial, doesn’t mean its accessible. There is a plethora of content on Netflix begging to be found and seen.

For NL hafta, I think documentaries are a great recommendation and Netflix has plenty of those.

On a side note, Reporters without Orders has become so good with Cherry Agarwal at its helm.

I know Abhinandan and team will bring back Hafta to its original glory.

A small recommendation from me. Dirty Money on Netflix (with episodes on the Volkswagen and Valeant being the best).

A great book to read is Sapiens by Yuval Noah Harari which is an out-of-body observation and critique of mankind and evolution.

Regards,
Rohit Bhat.

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Hi NL team,

I still haven’t recovered from Abhinandan’s comment about the sexual harassment case between a PhD student and his abusive advisor and he is already fucking up again. I was disappointed to hear him pronounce Dinkar sexist as Anand read just a few verses of the poet’s work. Anand rightly pointed out that Abhinandan had not even read the work to be making such a sweeping statement but Abhinandan replied by saying something about how Urvashi is made a trophy etc etc and then Hafta was over without Anand getting to say anything. This is the worst possible way to talk about a work of literature. Good literature is never morally self righteous. We have literature because academicians couldn’t solve all our problems with their grand theories and inability to engage with the real world. I haven’t read the work of Dinkar that Anand recommended but I will say that when apartheid was ending in South Africa and all kinds of patronising stories and poems were being written about Black people, Njabulo Simakahle Ndebele, a black man, wrote a story where the protagonist, a black man too, cheats on his wife and rapes his student. When questioned why he created such a monstrous character, his response was that he was sick of seeing Black people being dehumanised in patronising works of literature. I am sorry to say this, but Abhinandan’s comments these days make me feel like his attitude towards women is downright patronising. So much for his frequent usage of the phrase “extreme wokeness”. It doesn’t make him look smart to call out apparent sexism in a work of literature when he hasn’t even read it. It just tells us that he is using issues of feminism to try to look smart. I mean, did he really say that a man cannot be sexually abused by a woman? And does he think he is doing us women a favour by taking that stand? If Abhinandan cannot humanise women and allow them to have human flaws and engage with those flaws just as he engages with the many flaws of men, then he cannot be a feminist. Having flaws and making mistakes is a privilege, in case it wasn’t already clear, and being accepted or rejected with those flaws is too. I hope I don’t hear Abhinandan exploiting the serious and very complex issues of sexism and misogyny and sexual abuse in the future to paint a certain image of himself. Thank God for Anand and Manisha who call his BS although maybe not enough. 

I am a subscriber and this criticism comes from a place of love. I literally went to bed and woke up just to write this email because I have faith in NL and Abhinandan and living in the States, NL is the closest I come to feeling at home every week. Keep up the mostly good work.

Best,
Kritika Pandey.
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Hello people of NL,

I have been a long time listener and subscriber. I appreciate how Newslaundry has stayed true to its values of fearless and true journalism.

While I understand Hafta is a News Media critique podcast, but like Many others, NL Hafta serves as my source of news. A suggestion to get away from such a situation would be to start a short bi-weekly podcast that gives a roundup of the news.

One thing I always admire about Hafta is the diversity of opinions. But off late it sounds more like an echo chamber. I understand the struggle of getting new guests every week given the policies of their organisations, but you must find a work around. 

Can you have a arrangement with other online News organisation like Wire, Scroll or Swarajya Mag where in you can appear on each other’s podcasts. Just a wild thought.

Kudos to Kartik Nijhawan, Anil Kumar and Satish Kumar for going through all the gyan-baazi that goes on the Hafta and still delivering the podcast week on week.

PS: I don’t know the importance or impact, But Cyrus Broacha called Abhinandan “a handsome man” on his podcast “Cyrus Says”.

With warm regards,
Pranay Nikam.
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Hi hafta team, 

Thanks for a great show. I like all the regulars like Anand, Madhu, Manisha and Abhinandan. I cannot say the same about some of your guests. This is a news analysis podcast and everyone should stick to analysing the week’s news and not general debate and hypothesis. I love Anand Vardhan and his varied point of views are fantastic. Even his recommendations are great. So kindly request your guests to stick to the point and edit their comments when they stray from the topic. 

Every week there is a story about some journalists or the other. Though stories about your own brethren are very important to you, I don’t know if they are the most important stories of the week for the common people. Kindly check and evaluate the inclusion of such stories in the podcast.

On a lighter note, the Awful and Awesome podcast is the most fun I have every week. The casual banter is hilarious. Thank you Abhinandan and Rajashree. 

Love,
Gautam Moharil.
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Hello team NL,

Writing in despite your twitter word-limit rule.

I was free last evening, so I just went through the Maharashtra Govt circular for Ayushman Bharat Yojna (Or Pradhan Mantri Jan Aarogya Yojna-PMJAY). The health reporting/analysis is abysmal in India, as most of us would agree. So, I hope you can do something to improve the scene, so thought of giving you some pointers, in this hope. I have attached the circular for your perusal- though it is in Marathi, the disease/procedure table is in English. There is a co-existent scheme called Mahatma Jyotiba Phule Jan Aarogya Yojna (MJP JAY) which also covers many of the procedures/diseases and has been mentioned in the table.

I have a few observations about it:

1.       As you may notice, the package proposed for the same
medical/surgical procedure differs in both the schemes (PMJAY and MJPJAY)- sometimes very substantially, PMJAY usually (not always) offering lower package in such cases.

E.g.: Sr. No. 23- Thrombolysis for peripheral ischemia- has Rs 10K under PMJAY v/s Rs. 60K MJPJAY, for essentially the same procedure.

2.       Some procedures are priced in impossibly low packages.

e.g. Sr. No. 431- VP shunt or Ommaya reservoir in paediatric patient- package price Rs 5000.

It is one of the neurosurgical procedure in which the extra fluid from the brain cavities is diverted to the abdominal cavity. The tube remains under the skin layer so that it cannot even be seen from outside. It is lifesaving intervention till the time definitive brain surgery (if possible) can be performed.

It has a range of possible complications including serious brain and abdominal infection risks and death.

Needless to say, it needs to be performed in a sterile operating room, with sterile instruments, wearing sterile gowns/gloves/googles.

The OR requires a good light source and experienced nursing staff. It requires post-operative care in ICU or a high-dependency unit. The hospital/nursing home building is either bought or rented out- both are not subsidised by the govt, the electricity and water bills are at commercial rates.

All this doesn’t even factor in the paediatric neurosurgeon required for this procedure needs a minimum of about 12 years of medical education to be licensed to perform the procedure.

You may Google search the price of just the Ommaya reservoir- I did it- Rs. 3054.

I leave it open for discussion whether the package justifies the input costs incurred by the hospital/nursing home.

3.  Sr. No. 405 to 410, and 412 to 429: The packages in PMJAY are all 10 times less compared to the MJPJAY. I really hope the rate published are “per day” package- which may still be barely enough to break even. If it is for the entire stay/disease- it is not even laughable.

4. Talking about laughter- the govt does have its dark sense of humour intact. Please look at Sr. No. 236 and 237. For the same surgery- excision of breast lump- the package for the right breast is higher than the left breast- ab left breast bhi Maoist ho gaya, lags hai.

My conclusion:
I am delighted that a more inclusive, and supposedly seamless pan-India, health insurance scheme has taken shape in India, finally. But like most of this govt’s policy decisions- it looks half-baked at best. It will have to be amended, adjusted and corrected with many more updates (remember DeMo & GST to remind a couple). Some of the packages are priced reasonably to allow survival of the hospitals too, none of the package is a creamy layer to the revenue of the institutes.

Maybe the govt line of thought is that even with such low margins, hospitals may survive eventually if the number of
admissions/procedures increase. While the thought is not totally incorrect, but we really need to see what type of hospitals have the “holding capacity” to sustain at these prices. Mostly, it is going to be corporate and large capital tertiary-care institutes.

But the majority of India is still served by nursing homes and smaller, mostly single-doctor, hospitals. Withstanding the competition against the large corporates is difficult as it is. With this scheme, which targets specifically the population group which may have attended their hospitals, has put them in a Catch-22 situation: if they accept these packages, they can’t survive for long; if they don’t accept the packages, they’ll lose out even more patients to corporate hospitals. Providing good quality healthcare at affordable prices is not easy- especially when the nursing homes have to pay all their rentals/utility bills at commercial rates as well as pay their staff adequately to retain the good workers- and recently, keep reliable security guards/bouncers to avoid getting assaulted by patients and their attendants. More healthcare professionals are either going to change their profession or change their country of residence to escape
this scenario.

I have not gone into the issues I don’t understand- the difference between ‘insurance’ and ‘assurance’. I have also not elaborated over “Third Party Administrators”- usually, all businesses hate them, but they are somehow essential in medical/health insurance claims. And the hospitals need to open an account in SBI to be a part of PMJAY, if I interpret it properly. I also don’t know how the income slabs/ration cards will come into picture eventually; and whether that is a sufficient determining factor for people availing this scheme. There is definite of collusion/babugiri too, especially when the TPAs come into action- as they are notorious for charging commissions/facilitation charges in most sectors.

I still feel for the patients, it can be a game-changer. But whether it is sustainable if there will be no smaller and mid-level hospitals? And what about the predisposing chronic conditions- diabetes, high blood pressure, cholesterol- there seems to be no mention of any outpatient treatment/diseases. As a primary health care provider, I can guarantee if those issues are not brought under control- the real cost reduction in healthcare is not possible (e.g. improving sanitation was a great step to reducing acute illnesses).

I think I may not have been able to explain the complex issue
adequately. I am attaching a costing study report by IMA Tamil Nadu State Branch- Nursing Home Board, done recently on “Sustainability of smaller and Medium Hospitals”. That might be more detailed and easier to understand.

Please get a detailed study highlighting both the positive and negative aspects of it, which may help both the general public to better utilise, and the govt to improve the scheme further.

Thanks
Rahul Pandey.