
India Virtually Eliminates Tetanus as a Killer - Garbage
http://www.nytimes.com/2015/09/01/health/india-virtually-eliminates-tetanus-as-a-killer.html
======
hackuser
> The program succeeded despite corruption. The Times of India recently
> reported that an audit had found clearly fraudulent payments — including
> some to a 60-year-old woman registered as having been pregnant five times in
> 10 months.

I'm uncomfortable with the meme of corruption in public welfare programs (and
I may be overreacting to the author's implication, but I still think my point
applies more generally). There is corruption in every program and institution,
from private business to religion to government to little league baseball. If
you have thousands or millions of people involved, some will behave badly;
it's the nature of humanity. We can't wait to do things until the institution
or the people it services are saints.

Not all corruption is equal, and absolutely we should find ways to minimize it
(which usually involves looking in the mirror and making systemic changes, not
complaining about the inevitable, well-established consquences of our current
system). But considering the string of massive corruption scandals on Wall
Street, for example, I'm surprised when people think government and welfare
programs are particularly corrupt.

~~~
merpnderp
In the US there have been recent papers discussing how roughly 10% of the
medicare budget goes to people who live less than a year, with the implication
that perhaps we shouldn't be spending so much on people with so little time.

It is a well established fact by the CBO (Congressional Budget Office) that
roughly 10% of the medicare budget is wasted on fraudulent claims (even though
their rejection claim rate is roughly 1000 times that of most private
insurance).

So there are some cases where the status quo is untenable, fraud is blatantly
obvious, and people could die untreated do to a lack or resources.

Yes, fraud and corruption should always make the headlines and should always
be a priority to eradicate.

[EDIT for typo of medicaid instead of medicare]

~~~
sophacles
Fraud should be a concern, however at some points, the attempts to eliminate
it outweigh (in terms of cost and effort) the effect of its existence. At that
point it becomes a morality issue rather than a practical one.

For comparison, I wonder if the CBO was given full investigatory power into
private insurance, would they discover a higher or lower fraud percentage? It
would not surprise me if they were higher, and that at some point they just
accepted that fraudulent claims would be cheaper to ignore than to uncover,
based on dollar amounts and so on. It similarly of course wouldn't surprise me
if they were lower being able to deny more people at the outset, or were able
to use more information to find high risk claims (that privacy concerns
prevent the government from using for the exact same purpose).

~~~
th0waway
I would expect it to be the reverse: there is no incentive for government
programs to root out fraud, if they fall short, they just raise taxes. For
private companies - if they are being defrauded, it directly affects their
bottom line, and the bottom line of their executives (who would be VERY
interested to make sure bonuses increase).

If we are talking about fraud within the company/government, I would expect
the same - less in the company than in the government. Not zero, but less
overall.

~~~
afarrell
The people in charge of trying to root out fraud don't have the power to raise
taxes. They aren't congresscritters.

That doesn't imply that they aren't demoralized, ineffective, or hamstrung,
but still.

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middleclick
This news and polio eradication is good news from India.

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univalent
This is very cool. I remember as a kid every time I had a cut or scrape my
parents would rack their brains for the date of the last 'booster shot'. I was
also told cautionary tales of tetanus seizures (?) that could break major
bones because of the stress of the convulsion.

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rm_-rf_slash
>India has reduced cases to less than one per 1,000 live births, which the
W.H.O. considers “elimination as a public health problem."

One in one thousand of over a billion is still a rather large number.
Shouldn't the WHO use proportional statistics for populations over, say, 100
million?

~~~
GFK_of_xmaspast
"One billion" is not the live birth rate.

~~~
rm_-rf_slash
At the risk of being further downvoted: no shit.

~~~
trextrex
I'm not sure if you're implying that the population growth rate of India is
very high, but if you are that's not true anymore. It's actually very close to
replacement levels with parts of India where it's actually below replacement
levels [1]

[1] [http://qz.com/317518/finally-indias-population-growth-is-
slo...](http://qz.com/317518/finally-indias-population-growth-is-slowing-
down/)

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PhearTheCeal
Now if only they could eliminate defecating in the streets. [1]

    
    
      In India, nearly half of the population 
      - more than 590m people - 
      relieve themselves in the open
    

[1]
[http://www.bbc.com/news/health-33980904](http://www.bbc.com/news/health-33980904)

~~~
GFK_of_xmaspast
People say the same thing about California.

~~~
adventured
No people don't say the same thing about California.

In California it's a rare occurrence among the 38 million people that live
there, caused by a tiny fraction of the population - almost exclusively a
subset of the homeless.

In India, it's ~45% of 1.2 billion people.

~~~
jessaustin
_...almost exclusively a subset of the homeless._

And late-night alcohol drinkers! Maybe you've never done it, but lots of
people, of both genders, have.

~~~
praneshp
Yes. I live in downtown San Jose, and well-dressed folks (ie clearly not
homeless) do it outside the apartment community I live in. I've taken pictures
a couple of times, but never sent them to the cops for fear of ruining their
lives. (I've heard of people getting charged with "lewd" behavior and being
put on sex offenders lists)

~~~
palmer_eldritch
Oh, so you've got a collection of pictures of people relieving themselves in
the streets?

Nothing strange at all, congrats!

~~~
jessaustin
Yes he might ought to worry about getting on one of those lists himself...

