Myanmar from lens of India :: Missed Oppurtunities :: Way forward !!

In the minds of the New Delhi elite, India’s South Asian neighbourhood is made up of solely the seven members of South Asian Association for Regional Cooperation, even though we share no land borders with three of its members. In the process, we tend to forget that four of our North-East States — Arunachal Pradesh, Nagaland, Manipur and Mizoram — share a 1,640-kilometre land border with Myanmar. 

Scene kya hai ??

• Not only is Myanmar a member of Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation, the Bay of Bengal Grouping linking Saarc and Association of South East Asian Nations, it is also our gateway to the fast growing economies of East and Southeast Asia. 

• While successive leaders of Myanmar, who are devout Buddhists, have looked on India predominantly in spiritual terms, as the Home of Lord Buddha, they recognise that an economically vibrant India provides a balance to a growingly assertive China. 

• Sadly, we have not been able to take full advantage of either our shared Buddhist heritage by facilitating increased pilgrimages, or used our economic potential effectively to promote our interests.

Past ties with India !!

• Ties between India and Myanmar have quietly blossomed over the past two decades. 
• Mechanisms have been built between the militaries and security agencies of the two countries, which have facilitated cooperation across the border. 
• This has led to taking effective action to deal with cross border insurgencies and narcotics smuggling. 
• Myanmar’s Information Minister recently reiterated to India’s new Government, his Government’s readiness to crackdown on Indian insurgent groups like the United Liberation Front of Asom, PLA (Manipur) and the NSCN-K (Nagaland). India, in turn, has acted firmly against Myanmar insurgents.

Myanmar in current context !!

• Myanmar has moved steadily in easing the rigours of military rule, since the elections that swept President Thein Sein to power in 2011. 
• The military still has a crucial role in national life, as negotiations are in progress to achieve a comprehensive ceasefire with 16 well armed insurgent groups, drawn from ethnic non-Burmese minorities. 
• This is no easy task, but is a prelude to negotiations on the highly sensitive issue of federalism and provincial autonomy for ethnic minority areas. 

Myanmar's growing apprehension against  China !!

• After years of bonhomie during military rule, which accompanied its international isolation, Myanmar’s relationship with its largest neighbour China is facing strains.

• China’s Yunnan Province borders the sensitive and insurgency-ridden Kachin and Shan States in Myanmar.

• China has helped significantly in building Myanmar’s infrastructure and equipping its military. India’s fears of Chinese bases in Myanmar were not borne out. 

• But, differences between China and Myanmar have grown recently, especially on large projects like the Myistone Dam, which had to be junked, and a proposed railway line, to connect Yunnan to the Bay of Bengal. 

• There is also growing opposition to Chinese projects in copper and nickel mining and sentiments expressed that China has taken Myanmar for a ride, on an oil pipeline linking Yunnan to the Bay of Bengal Port of Kyaukphu. 

• There are also concerns of Chinese involvement with insurgent groups like the Kachin Independence Army and the United Wa Army, in Shan State.  

• Despite this, border trade across the Yunnan-Myanmar border is booming, reaching $4.17 billion in 2013, against a mere $35 million of border trade across the India-Myanmar border, though the ‘unofficial trade’ (smuggling) across this border is estimated at around $300 million annually.

Attitude of NORTH BLOCK towards Myanmar ?

• India’s former Ambassador to Myanmar VS Seshadri has authored a recent report spelling out how India has proceeded tardily in building up connectivity through Myanmar to Thailand and Vietnam and in securing access of our landlocked North-East to the Bay of Bengal.
   

• Our border trade regulations are formulated by mandarins in North Block and Udyog Bhavan, who have no idea either of the ground situation along the India-Myanmar border or the pragmatism that China shows in treating the markets with its neighbours — not as foreign markets, but as extensions of China’s own markets. 

• Opening up such trade will also enable our North-East to meet its growing requirements of rice, at very competitive rates.

A way forward for India !!

• Unless we learn to look at our neighbours like China does, bearing in mind the inherent strengths of our economy, we can never match the economic influence of China on our borders in the North-East. 

• The new Minister for North Eastern Affairs, General VK Singh, has long experience of the North-East. One hopes that as a pragmatist, he will liberalise procedures and practises and permit trade across borders with Myanmar in currencies traders mutually agree upon. 

• Vehicles should move freely across the borders on roads now envisaged through Myanmar, to Thailand and Vietnam. 

• Moreover, the ‘Kaladan Multimodal Corridor’ linking our North-eastern States through the Port of Sittwe in Myanmar will be useful only if Sittwe becomes the key port for India-Myanmar trade.

India's minimal success as far as Myanmar is concerned !!

• India has done remarkably well in projects in Myanmar intended for the development of human resources. It has played the lead role in the establishment of the Myanmar Institute of Information Technology, an Advanced Centre for Agricultural Research and Education, an Agricultural University and welcomed many Myanmar professionals for training in its medical and engineering institutions. 

How India kept on missing OPPURTUNITIES in past to harness MYANMAR !!

• But, we would be less than honest if we did not admit that in project and investment cooperation, our record has been tardy and has not exactly enhanced our image as a modern, emerging economy. After having secured exploration rights for gas in the Bay of Bengal, we conducted our project planning and diplomacy so clumsily that we did not have a strategy ready for taking the gas to India through a pipeline across Myanmar and our North-East, or as LNG. China deftly stepped in and took away all this gas, expeditiously building a pipeline to its Yunnan Province.

• In the mid-1990s, Myanmar offered us hydro-electric projects with a potential of over 1000 MW, across rivers near our borders. We took years to scrutinise these projects, which companies in South Korea earlier offered to construct. After nearly two decades, we backed off. Our private companies have similarly not been able to avail offers of land for plantations across Myanmar. India was offered hundreds of acres of land for agriculture, and bamboo plantations for making paper pulp, close to its borders.

• Two private sector companies signed the Memoranda of Understanding with their Myanmar counterparts. But Myanmar officials found that our private sector was even more bureaucratic than our Government organisations. India lost access to huge bamboo resources to a Thai company, which clinched a deal in weeks- something our companies could not achieve for nearly two decades.

A RoadMap for "Universal Health Care" in India

Present state of Healthcare in India !!!

• Healthcare in India is a story of insufficient resources and poor outcomes. 
• Investment is well below WHO guidelines in both qualitative and quantitative terms. 
• Bed density is low (less than 1.5 beds per 1000 persons as compared to WHO guideline of 3.5), doctors few (less than 1.8 per 1000 as compared to WHO guideline of 2.5), and out of pocket spend high (86% as compared to an average of around 40% for low income countries). 
• Rural India lags even further behind, with around 30% of the rural population having to travel over 30km for treatment.

Significant inequality in access is worsened as the existing healthcare workforce is inadequate and under-utilised. With low salaries, insufficient incentives, lack of career growth, inadequate training and inconsistent policies, the majority of the medical workforce chooses not to practice in the formal sector. India’s regulatory system hardly keeps up with the very diverse set of medical practitioners.

Meanwhile, infectious and chronic diseases continue to prevail. Health indicators continue to lag, healthcare spending is growing slower than GDP growth, out of pocket spending continues to be high, and infrastructure gaps remain substantial.

Universal Healthcare around the WORLD !!

• Universal healthcare offers the one solution, by extending access to healthcare as widely as possible and providing quality care through minimum standards. 
• Soviet Union implemented it in 1937, with the UK following nearly a decade later. 
• Most nations have funded it through general taxation, supplementing it by specific levies and private payments.
• Compulsory insurance utilising common risk compensation pools and a choice of insurance funds, such as in the US and Switzerland, have helped reduce inequality and increase access. 
• Lives have been saved, with resultant growth.

What can India do in this regards ?

• India’s government needs to play a stewardship role. By focusing on universal healthcare as a long term journey, with consensus on political backing and hard choices along with secured long term funding, universal coverage for good quality healthcare can be achieved. 
• By building an effective regulatory framework and consistent policies across states and the Centre, workforce shortages can be overcome, along with integrating healthcare facilities across the village, town and district levels. 
• Patient interest can be kept as a primary focus by reforming such bodies as the National Rural Health Mission and Rashtriya Swasthya Bima Yojana (RSBY).

Role of Private sector !!

Private sector can help improve India’s healthcare infrastructure. But without faster accreditation, few private players will gain credibility, or raise standards, resulting in low customer satisfaction, longer hospital stays and poor governance. The National Accreditation Board for Hospitals and Healthcare Providers needs to roll out incentives encouraging accreditation and make it a mandatory process.

Finding of a Kolkata Group led by AMARTYA SEN !!

• The Kolkata Group led by Amartya Sen, in its 2011 Public Declaration, pointed to the many limitations of the private sector in health. “Influential policymakers in India seem to be attracted by the idea that private health care, properly subsidised, or private health insurance, subsidised by the State, can meet the challenge. However, there are good analytical reasons why this is unlikely to happen because of informational asymmetry (the patient can be easily fooled by profit-seeking providers on what exactly is being provided) and because of the ‘public goods' character of health care thanks to the interdependences involved. There are also major decisional problems that lead to the gross neglect of the interests of women and children in family decisions.” It is also well known that insurance schemes (whether funded by the Central and State governments) at best provide limited health care and at worst divert a large part of the health budget to expensive hospitalised tertiary and secondary care, to the great neglect of primary care.

• Clearly, there is no alternative to a progressive strengthening of the public facilities and thereby reduce people's dependence on private providers. However, the public system may need to “contract-in” the services of willing private providers, to fill gaps in its capacity to deliver all the services assured under UHC. Such “contracted-in” private providers will have to deliver cashless services and would be compensated on the basis of pre-determined cost per package of health services rather than “fee for service” for each visit or procedure. In such an arrangement, the private sector acts as an extension of the public sector where needed and will not compete for the same set of services for the same people.

PPP projects !!

• Public-private partnerships or build-operate-transfer or operations and maintenance contracting schemes can utilise private capital for provisioning healthcare services. 
• With our growing population, the need for treatment of non-communicable and lifestyle diseases will increase, particularly in Tier 2 and 3 cities. 
• Affordable healthcare programmes (rolled out as public-private partnerships) will offer significant margins (in volume) for private players, while helping to address talent resourcing and under-utilisation issues. 
• Initiatives like Ayush Graham Bahawali Project, in Nainital, running on a build-operate-transfer mode, provide alternative medicine and low cost affordable healthcare, partly based on land grants by the government.

Insurance Coverage !!

• Insurance coverage is also abysmal in India, with just around 25% of the population covered. 
• To achieve universal access, a coverage ratio of around 75% needs to be targeted, with the remainder offered access through government payments via RSBY. 
• Access with low out of pocket spending can be achieved through an expansion of healthcare insurance, with the government playing a payor or guarantor role instead of providing services.

Social insurance schemes really need to be rolled out at scale, with the government deploying a greater share of healthcare funds for RSBY. Pilot programmes launched at a state level can help us determine the best model for the Indian market. 

Community health insurance schemes like those launched by the Karuna Trust in Karnataka help improve access and utilisation of health services by the rural poor. Those left behind in India’s growth should be offered a helping hand.

Drug Pricing !!

• Universal healthcare requires cheaper drugs. Capping drug prices has become controversial. But pharma firms are coming under pressure to lower drug prices across the world.

• Our inconsistent drug pricing regime offers high volatility. The last drug pricing control order fixed the prices of 348 drugs based on the simple average market price of the product, with no relationship to manufacturing cost. The latest order adds a further 100 drugs to this scheme, with little consultation. Such ad hoc policies create uncertainty, reducing incentives to foster innovation or bring new drugs to the Indian market.

While drug providers could crib about purported losses, the domestic pharma market is 75% of the volume exported. Drug providers should take a price cut and benefit from India’s healthcare expansion. Public interest can also be private interest, in greater volumes.

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• Regulatory systems need strengthening — from hospital accreditation to health professional education and from drug licensing to mandatory adoption of standard management guidelines for diagnosis and treatment of different disease conditions at each level of health care. 
• A national inter-operable Health Information Network  is needed to improve governance, accountability, portability, storage of health records and management. 
• Community participation must be supported to actively engage people in the design, delivery, monitoring and evaluation of health programmes.
• And finally, larger investments should be made in health promoting programmes in other sectors such as water, sanitation, nutrition, environment, urban design and livelihood generation.

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High Level Expert Group (HLEG) by Planning Commission on UHC !!

• The High Level Expert Group (HLEG) established by the Planning Commission has submitted a comprehensive framework for providing UHC in India.
• A health entitlement card should assure every citizen access to a national health package of essential primary, secondary and tertiary care, both inpatient and outpatient. 
• The HLEG is very clear that services included under UHC must be tax funded and cashless at delivery. 
• User fees are to be abolished because they are inefficient, inadequate and iniquitous. 
• Contributory social insurance is not appropriate for countries like India where a large segment of the workforce — close to 93 per cent — is in the unorganised sector and vast numbers are below or near the poverty line.

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Moral of the STORY !!!

It is time to recognise that everyone, not just the poor, needs to be protected against rising health costs that can impoverish any family. We are on the threshold of a historic transition to guarantee health security for all Indians. UHC will greatly reduce out-of-pocket expenditures and provide much needed relief to people. Apart from improving people's health, adopting UHC is likely to generate millions of new jobs, enhance productivity, and promote equity. Statesmanship must assert itself to create a national framework of UHC that is capable of State-specific adaptations. It is time to give the people of India the efficient, affordable and equitable health system they desire, deserve and demand.

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Miscellaneous fact  !!

• India's public spending on health — just around 1.2 per cent of GDP — is among the lowest in the world.

Central Mission Mode Projects !

Central MMPs

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Income Tax

The Income Tax Department of India is implementing a plan for setting up a comprehensive service that enables citizens to transact all businesses with the Department on an anywhere, anytime basis. Return of income for companies, has to be filed compulsorily online every year.

The objective of the Income Tax MMP is:

• Systems Integrator and Databases Migration & Consolidation: Have a single ITD application running over a single national database with BCP and DRS.
• PAN Module and PAN Related Services: Provide PAN card to citizens and improve authentication for all major financial transactions.
• Electronic filing of Income Tax Returns: To enable all taxpayers to fulfill their statutory obligation of filing their Income Tax Return electronically- 'Anytime', 'Anywhere', securely and conveniently using the Internet.
• Tax Information Network (TIN): Deliver more than 18 e-services to the taxpayers through digitization of all processes, filing of forms/applications, digitization of tax payments, authentications, tax credit verifications and refund processing. Many TIN services are disseminated through 1750 NSDL facilitation centers set up all over country. TIN infrastructure also serves the ITD manpower and the Central Government in day to day monitoring of taxpayers data and in taking informed policy decisions.
• Refund Banker Scheme: Fast track issue of refunds through agency bank (SBI) and enable web based tracking of refund status.

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Central Excise

• The Central Board for Excise and Customs (CBEC) has brought about a major change in the way the Central Excise and Service Tax formations conduct their regular business vis- Ã -vis the trade & Industry, by developing and deploying a software application called Automation of Central Excise and Service Tax (ACES). 

• ACES aims at improving tax-payer services, transparency, accountability and efficiency in the indirect tax administration in India. This application has automated all major processes in Central Excise and Service Tax through a web-based and workflow-based system.

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e-office

• The Government of India has recognized the need to modernize the Central Government offices through the introduction of Information and Communications Technology. 
• The e-office Mission Mode Project has been taken up by the Department Of Administrative Reforms and Public Grievances (DAR&PG) in order to improve efficiency in government processes and service delivery mechanisms. 
• NIC is the technology partner of DARPG for implementing e-Office MMP. 

• e-Office is aimed at increasing the usage of work flow and rule based file routing, quick search and retrieval of files and office orders, digital signatures for authentication, forms and reporting components.

• e-Office framework presently consists of e-File, e-Leave, e-Tout, Knowledge Management System , Personnel Information System, Collaboration & Messaging Systems.

e-Office is not merely an initiative for office automation but also a highly citizen oriented reform. As a result of e-Office, the offices would have less paper work, and the ambience of the office will substantially improve. The delays in the movement of papers and files will be greatly reduced. The common citizen will get much better services from the Government Departments, and will also find the atmosphere pleasing and welcoming.

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Insurance

• Insurance is perceived to be a big opportunity business in India today. 
• The huge population base and largely untapped market areas have provided a strong growth to this business in the last few years. Despite the impressive growth, the penetration of insurance in the country continues to be low. A large majority of the Indian population do not have Life and Health Insurance cover. This only highlights the growth potential of this sector in the coming years. 
• Through the General Insurance Business (Nationalisation) Act, 1972, 107 insurers were amalgamated and grouped into four companies viz. the National Insurance Company Ltd., the New India Assurance Company Ltd., the Oriental Insurance Company Ltd. and the United India Insurance Company Ltd.

The opening up of the Insurance sector for private participation has led to dynamic changes. In the last few years, a fairly large number of insurers, both life and non life, have established their presence in India leading to increased competition for the Public Sector Insurance Companies. Private players rely on technology to attract new customers through Innovative products, smart marketing and aggressive distribution. Customer service is the hallmark of this sector and hence it became imperative for the Public Sector Insurance Companies to computerize their operations and leverage the latest technology to provide a world class service experience to the customers through personalized products and services. With this view, the Insurance MMP was conceptualized.

The Mission of the Insurance MMP is:

"Development of an Integrated Information technology solution for better service delivery mechanism of Public Sector Insurance Companies"

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Immigration, Visa and Foreigner’s Registration & Tracking (IVFRT)

• India has emerged as a key tourist destination, besides being a major business and service hub. 
• Immigration Check Post is the first point of contact that generates public and popular perception about the country, thus necessitating a state of the art system for prompt and user-friendly services. Within the generic objective of facilitating legitimate travellers without compromising security, it is necessary to develop a secure, integrated service delivery framework to enhance security and facilitation in the Visa issuance process, and the Immigration function besides fortifying the Foreigners registration processes for effective tracking of foreigners. 
• The Passport, Visa issuance & consular matters, Immigration, Foreigners registration & tracking and Emigration are inter-related subjects involving the Ministries of Home Affairs (MHA), External Affairs (MEA), Overseas Indian Affairs (MOIA), Central Board of Excise & Customs, and Civil Aviation. 
• Many other Ministries in the Government of India (M/o Health and Family Welfare, M/o Tourism, M/o Commerce, etc.) also have a stake in this project. 
• The project for modernization and up-gradation of Immigration services is identified and included as one of the MMPs to be undertaken by the Ministry of Home Affairs under the National e-Governance Plan (NeGP).

The project will be implemented across 169 Missions, 77 ICPs (Immigration Check Posts), 5 FRROs (Foreigners Regional Registration Offices), and FROs (Foreigners Registration Offices) in the State/District Headquarters.

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MCA21

• The vision of the MCA21 project implemented by the Ministry of Corporate Affairs (MCA), Government of India, is "to introduce a service-oriented approach in the design and delivery of Government services".
• Its mission is "to build up a secure portal that offers availability of all registry related services including filing of documents, registration of companies and public access to corporate information. The portal services can be accessed/ availed from anywhere, at any time that best suits the corporate entities, professionals and the public at large".

The project will be integrated with the National e-Governance Services Delivery Gateway (NSDG),which will help extend MCA services to businesses via multiple front-end delivery channels, and which will also help provide other value-added services over and above the base services offered by MCA21.

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UID

The unique identification project was conceived as an initiative that would provide identification for each resident across the country and would be used primarily as the basis for efficient delivery of welfare services. It would also act as a tool for effective monitoring of various programs and schemes of the government.

The concept of a unique identification was first discussed and worked upon in 2006 when administrative approval for the project Unique ID for BPL families was given on March 3rd, 2006 by the Department of Electronics & Information Technology, Ministry of Communications and Information Technology. This project was to be implemented by the NIC over a period of 12 months. After several rounds of discussions by various stakeholders and on the recommendation of the Empowered Group of Ministers (EGoM) for collation of the two schemes - the National Population Register (NPR)/MNIC under the Citizenship Act, 1955 and the Unique Identification Number (UID) of the Department of Electronics & Information Technology, the Unique Identification Authority of India (UIDAI) was constituted and notified by the Planning Commission on 28th January, 2009 (vide notification no A- 43011/02/2009- Admn -I) as an attached office under the aegis of Planning Commission. The UIDAI was given the responsibility of laying down the plan and policies to implement the UID scheme, to own and operate the UID database and be responsible for its update and maintenance on an ongoing basis.

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National Population Register

• The National Population Register (NPR) is a Register of usual residents of the country. 
• It is being prepared at the local (Village/sub-Town), sub-District, District, State and National level under provisions of the Citizenship Act 1955 and the Citizenship (Registration of Citizens and issue of National Identity Cards) Rules, 2003. 
• It is mandatory for every usual resident of India to register in the NPR. 
• A usual resident is defined for the purposes of NPR as a person who has resided in a local area for the past 6 months or more or a person who intends to reside in that area for the next 6 months or more.

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Pensions

The pensions MMP is primarily aimed at making the pension/ retirement related information, services and grievances handling mechanism accessible online to the needy pensioners, through a combination of interactive and non-interactive components, and thus, help bridge the gap between the pensioners and the government.

The pensioner's portal operates at three levels, which are interlinked:

• Pensioner's Association level (at State Headquarters initially)/ Pensioners Level
• Central Ministry/Department level
• Central level (Nodal) - Department of Pension & Pensioners' Welfare

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Passport

• The Consular, Passport and Visa (CPV) Division of the Ministry of External Affairs (MEA) provides passport and consular services to Indian citizens through the Central Passport Organization (CPO), and consular and visa services to foreign nationals and Indians residing overseas through the passport, visa and consular wings of over 160 Missions and Posts abroad.
• The Passport MMP is an attempt by the Central Passport Organization to keep pace with such phenomenal increase in the workload, by innovative measures involving change in processes and infusion of technology.

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Banking

• The Banking MMP is yet another step towards improving operational efficiency and reducing the delays and efforts involved in handling and settling transactions. 
• The MMP which is being implemented by the banking industry aims at streamlining various e-services initiatives undertaken by individual banks. 
• Implementation is being done by the banks concerned, with the banking Department providing a broad framework and guidance.

Evolution of core banking technology in India has brought in the convenience of "anytime, anywhere banking" to Indian customers. There is now a movement towards integration of core banking solutions of various banks, which is expected to bring in operational efficiency and reduce the time and effort involved in handling and settling transactions, thereby improving customer service and facilitating regulatory compliance.

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Posts

• Modernisation of Postal Services has been undertaken by the Department of Posts through computerization and networking of all post offices using a central server-based system, and setting up of computerised registration centres (CRCs).