PC478 Vikas Swarup / US Health Jan 2010
Slumdog Millionaire - Good Indian Writing by Vikas Swarup
- Slumdog Millionaire was on telly this week so I watched it. I rarely watch movies cos most are crap, but this wasn't a bad film. It wasn't Shakespeare, but unlike most movies it did have a proper story.

- I can't believe so many Indian commentators criticised the movie saying "it's a disgrace cos it's foreigners coming here and portraying India in a bad light". In a movie it's the writing that's the most important part. It's a reasonably good movie and the writer is Indian... and also all the Indian actors including the children acted very well. So it is Indians who are the main reason for the success.
- The UK filmaking team do show good craftsmanship due to their professional experience, creating a pacey story and dramatic tension.
- Although the writing is good though it is still perpetuating lies that you can be poor and oppressed, but you'll be lucky and end up with rich and with love.
- I don't think it dealt well with the character who became muslim and joined the bad guys. I suppose by having the 2 characters he's trying to say that they have 2 possible paths: turn to crime and have a rough life and risk dying young or the good path. But the good path shouldn't be "stay good and then win a competition" as it's just a likely that a bad guy might win a competition. The message should be "stay good work hard and take your opportunities and build a better life". The lead character should have worked hard and become a stable small businessman or something.

- Coincidentally the BBC radio is playing the novel Six Suspects by Vikas Swarup http://www.bbc.co.uk/programmes/b00pk6w1
- the character Vicki Rai was so evil in the 2nd episode I had to switch it off for 1 minute
- The writing was better than Slumdog..good story, good dramatic moments, strong characters, good message : "we have to do something about the Indian rich oppressing the poor, and getting away with it .. and murder".
- And I guess he wrote it cos he feels like metaphorically killing them.

- However in reality it would be an unsatisfactory ending you can't have the good character killing the bad guy and then owning up to it so he himself is jailed.
- No you want the bad guy to understand that he himself is vulnerable and the safest thing for him is to change path and fix all of the bad things he has done in the past. and therefore gain eternal security for his family. He himself is in the best position to help all the disadvantaged : He could be helping them get educated, change their outlook start businesses etc so they can get their families out of eternal poverty.

- The stories moral could have been done better : The journalist should have saved Viki from the bullet and Viki would have turned round and said "man you saved your life let me give you $10,000" and the journo should have turned around and said "I won't be there to save your life next time... let me explain to you how you can do it by changing your life path" ...end

Those soft Westerners - don't help the poor
- In other programs the secret millionaire and Kevin Mcloud visted the slums they were totally overwhelmed by dirt. He must me soft as shit ...many places are dirty like that.
- They didn't understand the circumstances ..that poverty is caused by culture. Our culture has a principle of equality, but in other countries it's not the same so rich don't care to help the poor neither do the poor expect to be helped nor do they fight for their rights, and they like to live on top of each other and don't value privacy, and will spend any money they can borrow on big expensive weddings.
- Also they didn't get the full picture that people had left a better life in the countryside so what the Indian government has recently started to do by helping the country people first is the best thing.

- throwing 50 quid at someone at someone might feel good, but We can help the poor sustainably by trading with these countries, so there are jobs for these workers. To ensure that the upper class factory owners don't just exploit the workers we should insist in adding adding extrenal factors to quality control i.e. that the workers get good conditions and are paid a minimum wage. - Maybe Tesco could pay contract factory workers wages directly into their bank account.

Healthcare in US costs double, delivers lowest life expectancy of industrialised world
- Which country spends double on healthcare what other comparible countries pay at 16% of GDP or $15,000 family, yet has the lowest life expectancy and comes 46th in Infant Mortality ? ..ooh and has 62% of all it's personal bancruptcies due to medical bills ?

- There was an interesting BBC World Service Radio prog that gave US health statistics
- 47 million uninsured
- at "treat all hospitals" 80% of costs are paid by Medicaid, but it hardly covers the real cost
- The US spends $2.4 Trillion/year on healthcare
- that 16% of GDP or $15,000 family
- that's double what other developed nations pay
- 62% of all US personal bancruptcies are due to medical bills even though many people are insured

- but for double expenditure of other industrialised countires the US get less
- it's life expectancy is terrible it's lowest of all industrial nations
- Infant mortality is 46th in the world, that's below Cuba's

A Simple Idea to use the Market to Incentivize health prevention
- Make a law that every time the insurance company takes on one rich customer it should have to take one poor customer.
- If the US governmentwants to go the private insurance route they should do that. Thus in a chase to get all the rich they should mop up all the poor also. In theory the insurance companies profits should be bigger the less money they pay out. If the insurance companies want to pay out as little as possible they should put resources into prevention like encouraging people to stay off junk food, drugs and dangerous sport.

- However there are huge market incentives from business outside insurance sector to get the insurance companies to payout more : the drugs companies, medical equipment companies, doctors unions etc. The government would have to keep a close watch on them e.g. Make sure drug companies don't buy up the insurance companies etc. But insurance companies should be allowed to employ doctors and run hospitals . The rest of the health market is incentivized the wrong way the more sick you are the more drugs thy sell, the more operations they do the more equipment they sell.

- Problem : insurance companies don't like old people or people already sick - they is a high riskthey need treatment so the insurance companies are better off if you are dead, they have no incntive to keep old people alive, unless they earn a huge premium
- How do we make it so insurance companies don't drop you when you get sick.

- We could share the cost between us ..all pay $500 a year to the government who would them give the contract to a hospital insurance company if they get paid $6m and they can give all the treatment everyone needs then they make $2m profit.
- But how do you decide that everyone has had all the treatment they need ? In this case the doctor has an incentive to get you dead instead of treating you "Youv'e got cancer there's nothing we can do", when he knows that if he spends $50,000 there is a 50% chance you will live. You'd need a second doctor to fight on your behalf against the insurance companies doctor and who would pay him ? the government ? maybe it would be good to always have a second opinion.
- It's a minefield : insurance companies have incentive to kill sick and old people. And then what about compensation for other costs and lost earnings ...what about paying a flat weekly amount per complaint ? what about when you have a combination. maybe


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