Professor Amartya Sen, with the current numbers as they are, the Indian Government worried about the growth being down, industrial development being down. Many of us ask that India needs to look at its ambitious welfare programmes like NREGA and Right to Food Bill. What do you think the priority for a country like India needs today?
Professor Amartya Sen: I think ultimately, in terms of welfare they want us to see what makes a difference to the lives of people. And so, growth is after all, important for the sake of something else, namely generic resources which could be spent sensitively. When it is sensitively spent, enhancing human lives, education, healthcare, various projects of intervention undernourishment being handled by food being available relatively cheap, I'm told. So, I think you need growth. We've known from Aristotle onwards that he said very eloquently in Nicomachean Ethics that "Wealth and Income are not we are seeking, we are seeking them when we do something else. That something else is human life and how that could be enhanced". So, development is the central thing. Now growth versus development because growth is one of the means of development .But we bear in mind that having a faster rate of growth is important, particularly because it generates public resources, and it's important especially when the public resources are employed in a way that makes it different to the human living. Now, the welfare, the happiness and the freedom today and the future by building human capability to get employment, generate output. So, I think that we should take it away from that 'versus' part of it to say growth for development. I gave a talk one day at the World Bank, when I was asked to do that key note address in May and I called it ' Growth Mediated Development' and that's actually a term that Jean and I had used in our first book together. That was the first book, wasn't it? Hunger and Public Action. So, that's the line that I still would like to take, I think.
Sonia Singh: Professor Jean Dreze, really your work on hunger, why is it do you feel that in a country like India, the recognition of a fact that such a large amount of our population actually goes hungry, and how that should not be acceptable, is so hard to get across, because you've seen the kind of resistance there has been on that. How much is too much, even on the Right to Food Bill?
Professor Jean Dreze: Well, I think that pattern doesn't just apply to hunger, it applies to basic education, it applies to healthcare and it applies basically to a lot of other things that are people's basic needs. These don't really pinch privileged people or people who actually matter most of the time. So, basically that's nothing new. This is an aspect of Indian democracy that was understood right from the beginning for example, by Dr Ambedkar, and he saw that as a basic challenge of Indian democracy, of bringing people's basic needs to the foreground and I think that's going to be a constant battle as long as we have massive inequalities, whether it's inequalities of wealth, of cast, of gender all compounding each other.
Sonia Singh: I actually just wanted to play, because we just went and asked some people in different cities in India, what they felt about the Food Security Bill. Let's just hear what they had to say.
Girl 1: I personally feel that if a country cannot feed its children, there is no point in calling it a developing nation.
Question: Do you know anything about Food Security Bill?
Man 3: No. No, I don't have too many details of it.
Man 4: I've heard that they will provide seven kilogram which to me is very less, this won't solve the purpose.
Man 5: Even today, we have enough grains but it doesn't reach where it should.
Girl 2: No, I don't know much.
Sonia Singh: Professor Amartya Sen, any immediate reactions to that?
Professor Amartya Sen: Well, it's very sad because I think there are three things to answer your questions Sonia, that why is the case that it's so hard to do it? I think one is the issue of visibility. Famines are very easy to publicise, people die of hunger is one thing. But people being under weight, stunted, their life style, their probability of survival being diminished, their brain power being affected, their schooling being badly neglected. All that is not so visible. That's one question. Secondly, there is this issue of ignorance which we saw some of that. People don't know much about it and that's why public media and public agitation is so important to get it be known. I mean if we have to get the fact that India has a higher proportion of undernourished children as a percentage of total population than almost any other country in the world. That fact is not known and we need to, those who feel about it feel strongly about it, to get it across. But the third reason is of course, is that those who suffer most tend to be people who don't have a voice in the media or who don't have the ability to put their point across.
Sonia Singh: So, in fact we look at the current Food Security Bill and it's been deferred though. Of course, the Cabinet met on it today, some of these figures which both of you actually brought out, that when we compare ourselves to countries, just like our immediate neighbours, Bangladesh and Nepal, even though our per capita income is double that of Bangladesh, we find that they do better than us on many issues like infant mortality and we have the highest number of underweight children in the world.
Professor Jean Dreze: That's right.
Sonia Singh: When the argument comes the food versus fuel subsidy, as it were, you've seen political classes, key allies will come out and make sure that there is no petrol price hike, but we lack that political unity in India on this issue of Food Security. How do we actually resolve that?
Professor Jean Dreze: Firstly, the fact that India has the largest number, not the largest number, the largest proportion, not just the numbers, the largest proportion of undernourished children, that I think is beginning to be known. But I still think that the penny is not dropped. We are somehow not waking up to that fact, because if you actually look at it in a phase, it's a kind of national emergency that should be the top priority of the public policy. I mean you cannot allow the future of these millions of children to be wasted, and of course not just the future but today's immediate well-being, because you are not ruling to provide for them.
Since you've referred to the deferment of the Food Security Act and the debate around it, I'm actually a little puzzled by the arguments that are going on because I don't think they are right arguments. The deferment of the, the clearing of the Food Security Bill earlier this week by the Cabinet, I feel is both a concern and an opportunity. It's a concern because it shows that there is a kind of opposition somewhere to this Bill, which I feel is quite unbelievable when you look at the importance of the problem, and the fact it's really not a big deal. I mean people think that some kind of ton of bricks is going to come crashing on the economy and break the back of the finance and all that. It's just not like that at all. It's just a consolidation of things that are already happening. You know the revival of the PDS, the interruption of mid-day meals in primary schools, the universalization of ICDS. All these things have been happening now for some years. And you are actually only asking for little bit of consolidation and putting in place a framework of actions for ending hunger.
You know, it's really not to believed, I think, anyone in his or her senses would object to the principle, but I do agree that one has to look at the soundness of the framework, because you know the advantage of a law, it's a very strong and potentially powerful thing, and it can really help to make the state accountable to the underprivileged people. But the other side is that it can also be inflexible and somewhat indiscriminate, it's a kind of national framework and we have to make sure to get it right, because it's for the next 50 years, possibly even more. So, I think the debate should not be about can we afford it, can we put it, because I think these are completely bogus concerns. The debate should be about the framework and is it really sound? And I do feel that there is at least one very major flaw in the moment in this Bill, which is that it is too complicated and unnecessarily complicated and confusing, impractical and basically, a continuation of the failed approach of BPL targeting. It's not called BPL but actually it's still based de facto on BPL targeting. In fact further complicated by multiple layers, three categories instead of two, imposed across the country in a very rigid manner, and actually I think there are ways of sorting that out quite easily and simplifying and making this Act much more effective. So I think that's what we should be looking at. And improving the Bill radically, before it is passed or even tabled in Parliament. Instead of, you know, raising bogus concerns about the financial feasibility or the procurement. I mean the procurement, the food grain requirements, just to illustrate, the food grain requirements of the Act are around 60 million tonnes, now that is already what we have been procuring in the last few years. It's nothing more, and the procurement figures have been going up and up and up at about five per cent per year in the last 20 years. So, you don't even need a continuation of these growth trends. You just need to do what you are doing today. Which is leading exactly, to accumulation of stocks, because we don't know where to put the food. So, you know, all it involves is continue the level of procurement, but make good use of the food, it's really not a mystery.
Bureau 4: Why are political parties against this bill?
Bureau 5: We live in an area where our children don't get proper nutrition, they get affected by malnourishment and sometimes they get sick of Encephalitis. When will the government pass this bill so that our children can fight malnourishment and this disease?
Sonia Singh: Professor Sen, when you look at people asking you those questions, the last one is I think from a Gorakhpur hospital where his child is sick from Encephalitis. The Media attention seems to have moved away from there, the government attention seems to have moved away from there. What is the answer India's policy makers need to give these people?
Professor Amartya Sen: Well, I think it's not only Indian policy makers but Indian politicians, more broadly, who have to answer the question. That was a very good question and you know, I can see the concern of the parent about the child and of course it was an adult illness as well. I think the neglect of illnesses and ill people, ill with illnesses for which cures are known and lives could be made better, and they could be made to survive and not undergo so much debilitation and sometimes death. All that could be avoided by averaging broad based health care across India which we haven't done. And you know, we don't spend enough money on healthcare. There are other issues, the institutional arrangements, the relation between doctors, medics and other staff. All those questions remain. But I think the central issue is to recognize these as commitments. So, you are asking the right question. The gentlemen who was lamenting the fact that there is no remedy for the ailment for which he was seeking remedy. I mean, there is remedy medically, but not available to him. I think that is a very central question, because once we recognize it as priority, we have to recognize that we have to spend much more on healthcare. For example, China spends maybe more than 60 per cent per capita terms, I'm sorry, as a percentage of GDP. China of course is a bigger GDP and a larger population. So, together, they spend about four times or five times as much as India does. But overall, even forgetting that, even as a percentage of GDP, they spend much more. There is a greater commitment there and they are not even a democracy in the sense we are. Now, this is what they have been able to do because of a kind, intelligent, caring at the top that cannot be matched by the caring that our democratic system should have provided. More plentifully rather than less plentifully. That's a failure. That's our failure.
There are institutional changes needed but all that has to happen simultaneously rather than saying, until the institutions change, we are not going to do it. It's like the way some people say, let's first raise the Gross Domestic Product and then we will redistribute it, which is a very silly way of thinking about it. You have to do these things together. But the moment the government gives the priority, and have the support of the political system, including opposition parties, on an agreed platform, because the shame of Indians dying without medical care, Indian children being more underweight and undernourished than any other country, is a shame, not only of the ruling party but every one of the opposition parties. And if the opposition parties don't press that issue, and go into much more esoteric issues or issues that affect much smaller groups of the population, on the basis of class, then that's a total failure of the political.
Sonia Singh: So, for instance, when you see the opposition to FDI and multi brand retail, but you don't see the kind of coming together of opposition parties to push the government doing more? Do you think that's the irony of India?
Professor Amartya Sen: Exactly. Whether the FDI is a good thing or a bad thing depends on what kind of investment is tethered. Quite often it's a good thing, sometimes it's not. But it's amazing that there could be a kind of union around a cause of that kind, where you do not get the unity when it comes to undernourishment of kids, interior unity, I agree also. But it doesn't translate. I don't see the blood boiling, and one's blood ought to boil even listening to what these people were saying in your interview. So, I think it's wonderful that you get their voices heard but they have to react to that, across the board.
Professor Jean Dreze: If I can add one or two points on health care because it is so absolutely vital, and that appeal from the person in, I think it's Gorakhpur, was really quite moving and unfortunately the Food Security Act is not going to solve his problem. And he is talking about the problem of health care, and there are many related needs. So there is food security, there is nutrition, which is more than food security, there is health care, there is water, there is sanitation, education. All these things complementing each other. So Food Security Act is a kind of, it will be hopefully one step in right direction, but there are so many other things, and there is such a huge backlog of neglect over so many decades, but the agenda is really massive. Now another way of looking at this gaping hole of health care is to look at the proportion of public expenditure. Sorry, public expenditure on health care as a proportion of total health care expenditure. In India it is one of the lowest in the world. It's about 15-20 per cent compared to something like 80-85 per cent in a country like UK, or for that matter most of the western European countries, which are supposed to be, what we call capitalist countries. But actually they very socialise health, well certainly in the field of health care, they all very socialise the health care system with the partial exception of the United States, with dreadful consequences. And public intervention in health care is absolutely fundamental. I mean the private health care system does not work very well, that's fairly well understood even in ministry, in governance.
Sonia Singh: And 80 per cent of our health care today is private?
Professor Jean Dreze: That's right and that produces bad health care, not just for the poor, certainly for the poor, starting from there. But even we would say for many people, who are not so poor and think that the private health care system will never do, is public health, you know, preventive public health measures, because if public health care system thrives on people's illness, not on people's good health, and Gorakhpur encephalitis, it's really a public health problem. I mean you have been there. You know what kind of, you know, hygiene, water situation, sanitation is on. And the private health care providers or the health insurance companies will never do anything about that, because actually it benefits them, that is, the poor level of health care, so this is within the neglected field of health care. Public health probably is the most neglected. So we have to do huge amount of work on all these fronts and as I might say it's begin by making them political issues, which is so badly lacking at the moment.
Sonia Singh: Professor Jean Dreze you were one of the main people behind NREGA, and you have seen that example often cited that, oh good it has worked, but has not worked as it should. Many people ask you on this whole entitlement versus empowerment that we are approaching this completely in a wrong way, with schemes like NREGA, with schemes like Right to Food. What is your response to that?
Professor Jean Dreze: I like to respond to that, but also to take the opportunity to this corruption issue to come back to what I see at the moment, the main flaw in the Food Security Bill. I think the one big protection against corruption is when people are clear about the entitlement, their means to defend entitlements, and I think here there is interesting distinction between the Empowerment Guarantee Act and PDS. In both the cases there have been threats of corruptions and there have been attempts to deal with this. In Asia, for example, paying through the banks and post offices which has really helped reduce the impersoniment of wages in PDS through other means. But there is an important distinction. In Asia the main problem is that lots of people are trying to make money just by forging records. So they are not depriving anybody, they are paying workers their dues, and then they inflate the records or produce false bills, and they try to make money just by forging records. In PDS it's not quite like that, because PDS is pure transfer. You just procuring food here and transporting and giving it to other people there, and it's quite difficult to make money out of that, unless you deprive somebody of their due. So that the best protection against that is the people should know what their entitlements are, and then they will fight for it, and that, I think, that is what we have seen to a large extent for years in many states. But the PDS, the coverage of PDS is being expanded so that more people could be taken in, if not universal like in Tamil Nadu, near universal like in Chattisgarh, Andhra Pradesh, Uttar Pradesh, Karnataka, Odisha, Rajasthan, in fact in large number of states now. And also people have been given very clear entitlements that means lot to them. So for example in Chattisgarh, today everyone knows that we are entitled to 35 kilos grains per month at two or one kilo, and there is no question of not getting it. You know if the ration shop is closed people immediately make a fuss, so that is, I think, big protection, and in fact last summer we did a survey on PDS in nine states, and even today, before these reforms, national reforms, actually begin we already saw that about 80 per cent of BPL houses, I am sorry, BPL survey in these nine states were already getting today about 85 per cent of the entitlements, which is a pretty good start. I mean still of course 15 per cent leakage is totally unacceptable, but now people have much more clarity to what they are entitled to. Now coming back to Food Security Act, what is very crucial, is that this Act should put in place clear, simple, transparent entitlement that puts a lot of people on board, on the same board. And this, in that respect, this division of the population between, first you exclude 25 per cent in rural areas, and then after that you still insisting on dividing the rest between the so called priority group and general category. You give the general category actually the token entitlements that's actually not worth very much. So you are really left with a priority group which is basically BPL, and that will be so much simpler and more effective if you must really scrutinize five per cent, which I personally do not support. But if you do that do not go further, leave everyone in same boat. Give them common basic entitlement and it will, it will take off.
Professor Amartya Sen: You see also this issue that you made and I often hear when I am back home about entitlement versus empowerment is very hard. To think of a completely unviable contrast is extraordinarily large, and this is a good example of that. I think entitlement is often the way in which you get empowerment. It is like saying, "Oh I do not believe people are entitled to equal treatment under the law." I want people to be empowered, but how the hell are you going to make them empowered, unless their entitlement is to be treated equally under the law? So this whole debate is, I am against entitlement, I am in favour of empowerment, is lack of thinking. Of course we want empowerment, because after all, that's we are concerned with, more freedom, more capability, ability to lead a kind of life you like to lead. But some people have it because they are rich. They went to good schools and have their means of medical treatment. Others do not have it. In order to empower them, you need to give something which they could actually demand, and get, and that's where entitlement comes in. That's not to say that the language of entitlement could not be corrupted to do something that really does not work. I am not philosophical, but to say there is contrast in idea and the idea of entitlement really is very confounded thinking.
Sonia Singh: And finally Sir, as we end tonight, since I have a Nobel Laureate with me on economy, the question being asked from many or the timing is not right. Look at the numbers, our growth rate is down, our industrial output is down. India's fiscal deficit would go up if we put this huge bill of an estimate of 40 thousands crore of added subsidy with food subsidy. Can India afford this? You are good friend of the Prime Minister as he battles to try the second phase of reforms. What would be advice that you would give really at this point? Is this either, or a situation, where do numbers go? And when the first phase of reforms, the first 20 years, you see income disparity has actually increased in India. Why did that go wrong and how can we change it as we look to next 20 years? I have asked too many questions.
Professor Amartya Sen: No, you have not, they are linked. You are right. I think the fact that we are in a situation of growth declining and halting makes these issues much more important to face, for two different reasons. One is that when growth is proceeding at a very rapid rate, you are drawing more and more people in a net of advantage not adequate enough, you still have to go beyond, but at least things are moving in that direction. When that's slack and the need for that becomes greater, but the need for it becomes greater also for expanding growth rate. Why we are in this position, because in my jugdement, you carry an extraordinary quality of going for austerity, at the time when they needed to stimulate their economy. I mean there is kind of confounded thinking. If there is confounded thinking in India, Europe can outmatch it enormously on many times over, and now to some extent America, because of politics of Democratic and Republican things. But the Republicans would not allow Obama do too many things which will reduce unemployment, because high unemployment is good thing for next elections. It's caught in a dilemma which produces very silly policy, even when the Americans think very clearly on that subject. What we have to recognise is that, if there is as a result of lack of stimulation, demands for good of Indians, Chinese, Brazilians, South Africans, Mexicans, Argentinians are going down, the way is to stimulate our economy. That requires more expenditure in many ways rather than less expenditure. So the idea to say, is this is a bad time, would not do it, that's the classic argument against. Keynes argued in 1930, how could you spend money? Spending money is one way of dealing with it. Now one has to be careful about the inflation, especially about the essential commodities, that is very, very important. But it is beyond the wits of economy to be able to see which is the way to stimulate the economist, which has the least impact on prices, especially the prices which affect the lives of relatively poor people. Now there is a technicality in each issue. There is technicality in inflation, and how to manage economy, but you know, I do not think much of Nobel by the way. On the other hand good economic thinking is quite important.
Sonia Singh: Professor Dreze why this has been so crucial for India, I think, it's very important not to get mesmerized from short term constraints, to look at the longer term trends. What are the longer term trends? Runaway growth for 20 years, even more rapid growth in public revenue as Amartya Sen mentioned earlier, public revenue is booming now for a long time, large increases in procurement, in PDS solutions, and also in recent years the revival of public distribution. Many states are trying to look at the political value of it and trying to improve it, and the Act that you are talking about is up for the next 50 years, which can be put in place for the period of two to three years. So the current crunch situation it is, or even with the slowdown growth, India is growing pretty fast. I think of most countries in the World we are satisfied with the growth rate that India has. So when you look at it within the context of that trend, I think what we are trying to do in the Food Security Act is actually very modest, as I say, it is kind of a consolidation, a step in the right direction and certainly affordable from a medium point of view. And if there is short term constraint which actually, by the way with these food stocks in place, does not look very real to me, but if there is, you can do it in two to three years. The other thing which I really feel we should welcome is having a tool to make a distribution. You know there is absolutely a need for distribution in Indian economy, not just for more action in social sectors, as we have been talking about for some time today, but also some economical distribution and there are not many ways of doing it. You know economy is growing so fast for so long, but there are poor results for a majority of under privileged people. So it's not the question of health and nutrition, of course it's extremely important, but also some economical distribution and there are not many ways of doing it.