The latest issue of the New York Review of Books carries an incisive essay by Nobel laureate Amartya Sen on India's political economy. Sen goes about it comparing the quality of life in China and India. Indians, of course, are so obsessed with catching up with China’s GDP growth that they overlook that the judicious yardstick ought to be how growth advances living standards and reduces poverty in the two countries. Sen gives a jolt to them.
China beats India hollow with regard to the range of development indices such as life expectancy at birth, infant mortality rate, mortality rate for children under five, nutrition and availability of immunization vaccines for children, mean years of schooling for children, maternal mortality rate, adult literacy rate, etc. India’s “growth mania” presupposes that high GDP growth should have precedence over allocation of resources for social sectors whereas, China is maintaining high growth rate even while paying attention to ‘social objectives’. High growth generates public resources that could be turned into greater allocation for social sectors but this is not happening in India. China spends about 2 percent of its GDP on health care whereas the figure is 1.1 percent for India. This has led to “shameful exploitation [and]...sheer unavailability of health care in many parts of India.”
India, no doubt, is leagues ahead of China in terms of its democratic system, free press, freedom of expression, etc. The common Indian hypothesis is that their country's democratic system acts as a “barrier to using the benefits of economic growth in order to enhance health, education and other social conditions.” Sen emphatically refutes this plea and puts his finger at where the problem lies: despite India's open democracy, the reality is that social conditions graduate as political issues only if they assume acute forms. Whereas, in China, the leadership doesn’t require any such ‘prompting’.
“The Chinese leaders, despite their skepticism about the values of multiparty democracy and personal and political liberty, are strongly committed to eliminating poverty, undernourishment, illiteracy, and lack of health care; and this has greatly helped in China’s advancement.”
The flip side is, of course, there: for example, China’s authoritarian leadership could ride over such a horrendous happening as the famine of 1959-1962 which killed 30 million people and, again, could overnight dump as part of the 1979 reforms the guaranteed health care which provided a great safety net for poor people. “In a functioning democracy an established right to social assistance could not have been so easily—and so swiftly—dropped. The change sharply reduced the progress of longevity in China. Its large lead over India in life expectancy dwindled during the following two decades—falling from a fourteen-year lead to one of just seven years.”
Interestingly, however, China's leadership can also be highly responsive. The leadership saw the folly of the reform and began a corrective course in 2004 “reintroducing the right to medical care.” The impact has been immediate. “China now has a considerably higher proportion of people with guaranteed health care than does India. The gap in life expectancy in China’s favor has been rising again, and it is now around nine years; and the degree of coverage is clearly central to the difference.”
On the contrary, “Whether India’s democratic political system can effectively remedy neglected public services such as health care is one of the most urgent questions facing the country… For a minority of the Indian population—but still very large in actual numbers—economic growth alone has been very advantageous, since they are already comparatively privileged and need no social assistance to benefit from economic growth… an exaggerated concentration on the lives of the relatively prosperous, exacerbated by the Indian media, gives an unrealistically rosy picture of the lives of Indians in general. Since the fortunate group includes not only business leaders and the professional classes but also many of the country’s intellectuals, the story of unusual national advancement is widely and persistently heard. More worryingly, relatively privileged Indians can easily fall for the temptation to focus just on economic growth as a grand social benefactor for all.”
Sen concludes on a highly critical note: “My primary concern, however, is that the illusions generated by those distorted perceptions of prosperity may prevent India from bringing social deprivations into political focus, which is essential for achieving what needs to be done for Indians at large through its democratic system. A fuller understanding of the real conditions of the mass of neglected Indians and what can be done to improve their lives through public policy should be a central issue in the politics of India.”