Jan Aushadhi: Is it making an impact

Recently I am hearing a lot of of articles on promotion of generic medicines & capping the profits in healthcare. However is it really making an impact?

In my opinion, the reasons why generic medicines have yet not reached mass adoption is because:

1. the doctors prescribe medicine brand and not the inherent salt/generic name.
2. the patients when they buy generic medicine see a different name in the label than what is prescribed (brand name). so they believe they have compromised. (which is a wrong feeling to have when your loved one is in trouble)
3. historically the quality, packaging of generic medicines has been in trouble.
4. the availability of generic medicines has always been difficult to get. beyond the dispenceries around the government hospitals they are hard to get.
Tata Memorial hospital had a generic dispencery (very affordable) but it will not give medicines unless prescribed by a an oncologist at its hospital. So I could not walk in there with a valid doctor’s prescription and buy the drugs.
so whatever you are reading is baby steps …. miles away from potential of making a real impact.
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Art of Deterrence, blackmail & threats

How does a country North Korea able to hold the entire world ransom? This belligerent state is in open hostility with three of the world’s super powers USA, Japan & South Korea. Even its staunch ally is fed up with its whimsical policies but tolerates it because the alternative would be US troops at Chinese borders. Rogue nations have a limited lifespan but this country has established a multi-generational hereditary rule.

10th March 1959 paper “ Theory and practice of blackmail” by Daniel Ellsberg (infamous for releasing 1971 Pentagon Papers on American Military strategy during Vietnam War) has some relevant insights applicable to the current Korea situation. Here are few notes that I made:

  1. There are 4 kinds of solutions that two parties can negotiate (Win-Win, Win-Lose, Lose-Win and Lose-Lose) Although we all want to have most of the dealings in area where we win, loose-loose is not something that can be overlooked.
  2. The more civilized, advanced & cultured your target is the more they are susceptible with the consequences of your extortions. Infamous precedence & demonstrations of ruthless action/culling of non-compliant is important to create a right aura. Most diplomats spend years posturing before firing a bullet or declaring war. Having a single minded obsession is what it needs to win the war of deterrence. A sheep in wolves’ clothing often gets away with the best deal.
  3. Understand the notion of Critical risks. A threat need not be credible to ensure compliance. If the pitfalls of disobedience are grave enough and the benefit of resistance low, you can expect favorable response. Simply put, a servant is more likely to hand over their employer’s assets than their own.
  4. The problem with any blackmailer is convincing that they are ready to punish for non-compliance even if it comes at great cost/hardship to them. If your threat is not “sufficiently likely” or sufficiently damaging, then the victim’s behavior cannot be altered. Nobody is likely to pay up for a long-shot. A party prepared for annihilation is toughest to handle diplomatically. To be successful in blackmail you need not be wearing the vest but you need to convince the other party that you are prepared for it. Without the credibility, guts & commitment, all your ultimatums will be discounted as bluffs.
  5. Sun Tzu: in his famous “Art of war” had once said on how to project for a nihilistic standoff: “When an army feeds its horses with grain and kills its cattle for food, and when the men do not hang their cooking-pots over the camp-fires, showing that they will not return to their tents, you may know that they are determined to fight to the death.” Today A suicide bomber wearing a vest might lose everything, but he can also inflict serious damage in the process.
  6. Successful extortionist doesn’t try to alter the victim’s behavior but influence their rational decisions & choices amongst the alternatives. The choices are dependent on the subject’s expectations on outcome & preferences.
  7. Also the word rational should not be confused with reasonable (one can be insane/ unrealistic and yet perfectly rational) Only a rational man can be blackmailed. Hence it is important for the extortionist to keep the tempers of its victims under check, pushing them over the edge will only lead to bad repercussions. However it is important that all the time the victim should be fearful of the blackmailer.
  8. Coercion operates on “your expectation of my behavior”. So not only my choices should make a difference to your behavior, but also impact the outcomes of your actions/inaction. A successful coerce “to influence you to choose the action I prefer you to take, by increasing your expectation that if you do not, I will choose some response leading to an outcome still worse for you than compliance.”
  9. Not all rational people can be coerced. Some find it distasteful, against their principles or as a trendsetter making them vulnerable to greater demands later that they refuse to comply irrespective of the severity of the punishment. So coercion is a lot to do with psychology & mental build of the subject.
  10. Nothing unleashes creativity than stress of impending doom and loss of rationality. If you box someone in a tight corner, you will get the most unexpected of the responses. So be prepared for the most unusual & ingenious counteracting strategy from your victims. It is important to stay credible and your demands within permissible limits, if you wish to expect a rationale human response from your victims.
  11. Threats fail because of variety of reasons:
    1. If the perpetuator underestimated the required credibility needed to sway the action.
    2. If the victim did not find the perpetuator’s commitment credible.
    3. If the victim was irrational, impulsive or careless
    4. If the victim is committed in the action, we are trying to deter.
  12. What if the victim fails to comply? The coercer has 4 options:
    1. The blackmailer can irreversibly give up his “freedom of choice” to carry out the threat. This means that agents/associates (who have no incentive to disobey) get clear irrevocable instructions. This limits the blackmailer options by “tying one hand” and making the world know that “failure to punish” is not an option. This might reduce his payoff and up his stakes, but sends out a clear signal that is loudly heard. Companies enter agreements/contracts/obligations (poison pills) to show commitment.
    2. Rather than making it irrevocable, he can make failure to punish costly. National leaders make public pledges (long emotional speeches), mobilize the army to make it abundantly clear that failure to act would lead to grave danger (like losing face & political leadership). Making a “low likelihood” threat imminent often leads to prompt compliance. By making the opponent know that it will be irrational to break the pledge, compliance of the victim is achieved.
    3. Suicidal threats: He can punish himself for the victim’s resistance. By staking his reputation, honor or prestige he can make it known that the threat is real. Essentially he is making aware that backing off is going to hurt him more than it would in a rational transaction. By proving his irrationality, he is trying to convince the subject that their ability to predict him is completely wrong. It should be noted that the blackmailer is still trying to appear to be rational but unrealistic in the first two strategies. However academicians are still debating on efficacy of the credibility gained through this tactic.
    4. The blackmailer first tries to exploit the uncertainty in the opponent’s mind making him unsure of the true risk-reward equation. Then by appearing irrational (erratic, inconsistent & unpredictable), the blackmailer convinces the opponent that their understanding of the situation is faulty. A civilized, gentle opponent not used to such dealings might decide to limit the losses and run away from the situation rather than investing more through a standoff. This diplomacy is highlighted in Hitler’s policy of “Political Uses of Madness.”
  13. The ability to go on the “verge of war” without an actual war is the art that can be mastered only with practice. Carrying on the threat is a loss-loss scenario which both parties avoid because of the fallout & chaos that it results in. Blackmailers also need to calculate risks before taking any action/counter-action.

Why was Hitler successful in his initial days?

There was nothing remarkable about Hitler in his early days. He was a bastard son of Alois Hitler Sr and was never adopted/legitimized. Hitler was not a German but an Austrian, who was stateless for seven years before being granted German citizenship in 1932. He was an aspiring architect & a painter. Yet there are no notable buildings or paintings credited to his name.

His military credentials are also doubtful. On 5th February 1914, he was deemed unfit for military service by Austro-Hungarian Army, hence he volunteered to be enlisted in the Bavarian Army. (even though his citizenship prevented him from legally doing so). He served away from the front-lines as a dispatch runner and never rose above the rank of Gefreiter (a very junior position). His much acclaimed Iron Cross was due to the recommendation of his Jewish commanding officer Lieutenant Hugo Gutmann, who championed his cause. His antisemitism views are famous, yet his first love was rumored to be with a Jewish girl, Stefanie Rabatsch.

Politically he was a failure throughout his career. He joined DAP (German worker’s Party) in September 2019 as an undercover intelligence agent responsible to spy on the party and influence its opinions. In 1923, his infamous “Beer Hall Putsch” was a failed coup and a poor imitation of Mussolini’s “March to Rome” a year earlier. He was charged with high treason and sentenced to five years of prison, at Landsberg. Where he was doomed, but achieved his resurgence through his book “Mein Kampf” and was released early.
There were seven elections between 1924 and 1933 and his party was never able to achieve majority. This is in spite of the global depression, high unemployment, hyperinflation and all other socio-economic factors that are contributed to rise of Fascism in Germany. Nazi party never won the elections. Hitler was nominated as the Chancellor in 1933 and later grabbed Dictatorship to form Nazi Germany.

So why was Hitler so successful in his initial days as head of Nazi?
Nothing sums up the rise of Hitler then the famous poem “First they Came… “  by Martin Niemöller. The world at that time had become too self-centered to act against the atrocities against mankind. It became an easy prey to the divisive ideology & propaganda promoted by fascism.

In 1931, The League of Nations chose not to act when Japan attacked China in Manchuria. Japan’s indiscriminate rape, plunder and massacre of Manchuria, China continued for three years without any intervention.

It failed to mobilize when Mussolini attacked Somalia (Abyssinia) in 1935.The League of Nations gave a tacit approval to Nazi annexation of Saarland in 1935 and Rhineland in 1936. The nationalist caused a 3 year long civil war in Spain overthrowing a elected democracy there but the world did not care. In fact, it was encouraged to expand east closer to Russia. In 1938, Hitler invaded Austria on the eve of plebiscite (referendum to decide on joining with Nazi) and the world did nothing.

in 1939, Czechoslovakia had a well-equipped modern army of 1.2mn soldiers with a home advantage ready for onslaught of 1.5mn German soldiers. (total strength invading Poland). They had prepared a series of fortifications of 264 small forts and over 10,000 light pillboxes designed to provide a stiff resistance. On the other hand hand in 1939, the German tanks were yet not a fighting force. As demonstrated in the march of Austria, over 30% of the armored vehicles developed mechanical failures even though no shots were fired.  The Czech’s LT-35 was much more reliable and mobile, unlike Panzer I and II. In fact, German continued to produce 1,400 of them till 1942 under the new name Panzer 38(t). Nazis were fully aware of their positions and hence relied on posturing rather than military.

The policy of appeasement by Chamberlain (then British Prime Minister) fanned the dreams of world domination rather than nipping the fascist menace at its bud. Annexation of foreign reserves, material stock piles, industries, natural resources & technology from these conquests further strengthened the Nazi military at the cost of its inhabitants. For example, Germany gained 2,175 field cannons, 469 tanks, 500 anti-aircraft artillery pieces, 43,000 machine guns, 1,090,000 military rifles, 114,000 pistols, about a billion rounds of ammunition and three millions of anti-aircraft grenades from Czechoslovakia. This amount of weaponry would be sufficient to arm about half of the then Wehrmacht and enabled them to expand to Poland.

The invasion of Poland was also the same story. Except for a token declaration of war against Germany, France & Britain did nothing for 8 long months, till it invaded France. Germany army bloated from 100,000 men in 1935 to over 2mn (1.5 participated in invasion) by 1st Sept 1939. This new green, untested army had unproven tactics, command structure, training & discipline which could easily be bogged down if the Western front was opened. Furthermore, in this first battle fought by Nazi Germany, the bulk of the tanks, weaponry used were Czech and acquired forcefully only a few months ago without adequate time to train/familiarize.

Hitler, aware of his weak position, signed a pact with his arch-rival Stalin & handed him over more than half of the Polish territory in return of Russian support in the invasion to surround the Poles. This war and the lull that followed helped Hitler to revolutionize his green recruits into the most formidable wrath that the world has ever seen.

In short, “The only thing necessary for the triumph of evil is for good men to do nothing.” – Edmund Burke

Sarahah: Curing one’s blind spot

Every person has a blind spot. Traits, attributes, biases, habits or even filler words/speeches or stories which others notice but we fail to give adequate attention to. An anonymous messenger like Sarahah really helps us identifying them. After-all defining the problem correctly is the first step to any transformation & correction on ones behavior.

Will you please help me identify my blind spot. Please use this Sarahah link to help me identify & cure the faults in my thoughts, actions & presentation.