Ration card

The PDS system in India has the 'ration card' system so well entrenched- it is a form of identity proof. I do not think it exists any other country.


"--A hospital bed is a parked taxi with the meter running"- Groucho Marx


Read this article about health rationing in the US.

The PDS system in India has the 'ration card' system so well entrenched- it is a form of identity proof. I do not think this exists any other country.It is something we have grown up with, our few liters of kerosene and few bags of rice to keep it going. Then we had gas stoves and microwaves.

To hear the R word in American commontalk is ironical in this land of the HOV meaning 2 people in a car.For all the talk of having access to the best health care in the world, where it gets spent is apparent to see- 1/2 of all the healthcare you have in your life is in your last year of life. In this year of life, on the day that you die, your average life expectancy would have read out as 6 months more, and so the extra spoon of salt tipped your CHF over, or the strain of jumping over the parapet wall increased myocardial oxygen demand > oxygen supply and infarcted the jeopardized myocardium, and you had a heart attack.


Atherosclerosis started in teenage- after that you are just playing a game of hide and seek. That one will not die, or should not die is an insult to the rules that apply. You cannot fool with Insulin pens and Tarceva and play Tweedledee tweedledum with telomerases that build up as you age.


I come from a different type of healthcare system, and to see young patients die of infectious disease illness, for lack of access to good critical care, while Octreotide is being pumped in day in and out to decrease fistula output in a multiinfarct dementia patient makes me sneer sometimes in irony at the refrain, " whats a life worth"

I would mention-we need to ration moneys all over the world- the apalling disparities are out of sight, out of mind for the ones that demand FULL CODE.

Think of a flu pandemic with acute respiratory illnesses overwhelming the number of ICU beds available.I would think of lives saved, then QAL saved than QALY saved.when deciding who needed to come to the ICU when beds are less.

I found this hard to explain to a foreign medical student who was visiting during my residency in India- we aren't Gods who mete and dole, no one is losing his dignity in being told that it is the end of the road for him and that we do not have anything to offer, or to eat and sleep well and not worry about advanced HIV/AIDS which will kill him one day, for buying medicines for that is 10 times more expensive than his monthly income. My intentions are as noble as Bill Gates', but I don't have a fraction of his chauffeur's fortune.

If I have 10 syringes and 20 pts- I have to decide who needs a test and who does not. If I have 200 syringes and ten patients i decide how many different tests I can run on each patient as 'work up", If I have 20 syringes and 10 patients ( and were in America) I will decide which 3-4 pts need all the "work up", whereas if I were in Canada i will be racking my brain deciding what 2 tests to do in the 10 pts.

She got the drift of it.


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