Merits Of Reservation

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Merits of Reservation: efficient health system and social equity emerging evidence from south India S. Venkatesan, OneWorld South Asia May 1, 2006: “MEN ARE NOT BORN GOOD OR EVIL” “It is impossible for man to be endowed by nature from his very birth with either virtue or vice, just as it is impossible that he should be born skilled by nature in any particular art. It is possible, however, that through natural causes he may from birth be so constituted as to have a predilection for a particular virtue or vice, so that he will more readily practice it than any other”. (from The wisdom of Israel, Lewis Brown ed. 1948 quoted in Kenneth Harrow et.al eds. 2001) The current debate on reservation for OBCs in higher and professional education started hot discussion at two folds. One had the government says that it’s the duty and constitutional obligation to frame special policy including reservation to development of educationally backward classes. The students from upper caste, on the other hand, protest the government mo ve and arguing that the reservation in higher educational institutions would eroded the merit and efficiently of our economic system. In order to discusses systematically, one needs to understand better the concept of merit, how its defined and what is its consequences for society at large. Here we document some of emerging evidences of merits of reservation in equally access to health care and efficient working of health care system from south part of India where the reservation policy there for longer period and while comparing the inefficient health care system and unequal access from northern part of India where the merit argument dominant at the current debate. Table 1. Merits of reservation in efficient health care system of south India

S.No. 1 2 3 4 5 6 7 8 9 10 11

health indicators total fertility rate death rate infant mortality rate institutional delivery medical assistance during birth vaccination of children TT vaccine iron/folic tablets maternal mortality rate average population per PHCs poverty rate (HCR)

South 2 7 44 70

North 4 10 78 18

AllIndia 3 9 68 34

76 75 91 88 158

28 18 64 36 582

42 42 76 58 407

24044 17

29574 32

27364 26

23 12

human development (HDI) 0.516 0.393 0.472 Source: National Human Development Report, 2001

The impressive progress in health equity and availability of health care services are not confined to Kerala, the trailblazer in this field. Substantial parts of southern and western regions in India are now witnessed rapid imp rovement in the same direction. This is remarkable in Table 1 show us the comparability of health care services and its efficient working system in large parts of south India includes the states of AP, Karnataka, Kerala and Tamil Nadu. Nobel prize-winning economist Amartya Sen, with Jean Dreze (2002) in their recent study “India Development and Participation” brought out the emerging evidences of the efficient of reservation policy as very important factor for achieving health equity and efficient health system in Tamil Nadu. The study, points out that a number of enabling factors that have facilitated Tamil Nadu’s rapid in health status. Apart from a commonly cited factor include good infrastructures, the study also provide interesting clues to the social context that has facilitated Tamil Nadu’s achievements in this field. One observation of major interest, for instance, is that the ‘social distance’ between medical officers/doctors and patients are almost nil in Tamil Nadu. This is helped by the fact, that a large proportion of doctors are SC/ST, OBCs and women (about 45-50 %) of medical officers are women in Tamil Nadu. In addition, social reforms movements, the policies of affirmative action (69 % of Reservation) have substantially eroded the privileged access of upper castes to the medical profession. (Jean Dreze and Sen 2002). Anther study by Leel Visari (2000) found in her survey was that, ‘A visit to the primary health centers in the state (Tamil Nadu) would convince anybody that many medical officers have non-brahmanical backgrounds and are very similar to many rural patients in dress, mannerism, language as well as overall values and attitudes’ Considering that, in northern parts of India where the so-called meritorious and efficient doctors present, the social distance i.e. relationship between medical officers/doctors and patients, the manner in which the doctors behave, the language and overall values and attitudes contributes substantially to the poor and inefficient functions of health care system and widening social inequality in access to health care in northern India. The foundation of south India’s success also draws on a widely accepted recognition of the centrality of public action including affirmative action including reservation for OBCs in higher education and professional/medical education and employment. It is worth noting that the responsiveness of reservation policies have tended to matter a great deal in south India, in a way that does not apply in north India, where the reservation policy was absent and the medical profession typically dominated by the upper caste. These features of south India policies help to explain the merits of reservation quite prominently helped in widening access of health care services and made the system working efficiently. Thus, the current protest against reservation stating that erode merit and lead to inefficient seems to be lack of intelligibility and evidences.