Quality of Life: India vs. China Amartya Sen 1



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Quality of Life: India vs. China

Amartya Sen

1.

The steadily rising rate of economic growth (increase in the value of goods and services) in India has recently been around 8 percent per year (it is expected to be 9 percent this year), and there is much speculation about whether and when India may catch up with and surpass China’s over 10 percent growth rate. This means that the prices of goods and services have risen about 8 percent per year. When the prices of goods and services rise, people are spending more money, which means that the country overall has more money to spend. Right now India’s economic growth rate is less than China, but they are catching up.

Despite the evident excitement that this subject seems to cause in India and abroad, it is surely rather silly to be obsessed about India’s overtaking China in the rate of growth of GNP (gross national product – value of all products and services produced in one year by the people and materials in the country), while not comparing India with China in other respects, like education, basic health, or life expectancy (how long a person will live). Economic growth can, of course, be enormously helpful in advancing living standards (availability of wealth, comfort and material goods in an area) and in battling poverty (state of being extremely poor).

Some statistics about China and India, drawn mainly from the World Bank (gives loans to developing countries) and the United Nations (promotes international peace and security), are relevant here. Life expectancy at birth in China is 73.5 years; in India it is 64.4 years. The infant mortality rate (death rate during the first year of life) is fifty per thousand in India, compared with just seventeen per thousand in China; the mortality rate for children under five is sixty-six per thousand for Indians and nineteen per thousand for the Chinese; and the maternal mortality rate (death of a women during or immediately after pregnancy) is 230 per 100,000 live births in India and thirty-eight per 100,000 live births in China. The average years of schooling in India were estimated to be 4.4 years, compared with 7.5 years in China. China’s adult literacy rate (ability to read and write) is 94 percent, compared with India’s 74 percent.

As a result of India’s effort to improve the schooling of girls, its literacy rate for women between the ages of fifteen and twenty-four has clearly risen; but that rate is still not much above 80 percent, whereas in China it is 99 percent. One of the serious failures of India is that a very substantial proportion of Indian children are, to varying degrees, undernourished (not having enough food for good health) (depending on the criteria used, the proportion can come close to half of all children), compared with a very small part in China. Only 66 percent of Indian children are immunized with triple vaccine (diphtheria/pertussis/tetanus), as opposed to 97 percent in China.

2.

One of the positive things about economic growth is that it generates public resources that the government can devote to its priorities.

Spending on the “social sector”—health, education, nutrition, etc.—has certainly gone up in India. And yet India is still well behind China in many of these fields. For example, government spending on health care in China is nearly five times that in India. China does, of course, have a larger population and a higher per capita income than India, but even in relative terms, while the Chinese government spends nearly 2 percent of GDP (1.9 percent) on health care, the proportion is only a little above one percent (1.1 percent) in India.

One result of the relatively low portion of funds to public health care in India is that large numbers of poor people across the country rely on private doctors, many of whom have little medical training. Also, the patients know very little about the doctors and health care, allowing the doctors to scam patients into paying more money than they necessary. In a study conducted found cases in which the inexperience of poor patients about their condition was misused so as to make them pay for treatment they didn’t get. This is the result not only of shameful abuse, but ultimately of the sheer unavailability of public health care in many parts of India.



3.

When we consider the impact of economic growth on people’s lives, comparisons favor China over India. However, there are many fields in which a comparison between China and India is not related to economic growth in any obvious way. Most Indians are strongly appreciative of the democratic structure of the country, including its many political parties, systematic free elections, uncensored media, and free speech, among other characteristics of a lively democracy.

Not only is access to the Internet and world opinion uncensored and unrestricted in India, a large number of media present widely different points of view, often very critical of the government in office. India has a larger circulation of newspapers each day than any other country in the world. And the newspapers reflect contrasting political perspectives (different political viewpoints). Economic growth has helped to expand the availability of radios and televisions across the country, including in rural areas, which very often are shared among many users. There are at least 360 independent television stations and their broadcasts reflect a remarkable variety of points of view. More than two hundred of these TV stations concentrate substantially or mainly on news, many of them around the clock. There is a sharp contrast here with the uniform system of news casting permitted by the state in China, with little change of political points of view on different channels.

Freedom of expression has its own value as a potentially important instrument for democratic politics, but also as something that people enjoy and treasure. Even the poorest parts of the population want to participate in social and political life, and in India they can do so. There is a contrast as well in the use of trial and punishment, including capital punishment (execution of prisoners). China often executes more people in a week than India has executed since independence in 1947.



4.

In China, by contrast, the process of decision-making depends largely on decisions made by the people who are in charge. The Chinese leaders, are strongly committed to eliminating poverty, undernourishment, illiteracy, and lack of health care; and this has greatly helped in China’s advancement. There is, however, a serious fragility in any authoritarian (enforcing strict obedience to authority) system of governance, since there is little alternative or remedy when the government leaders change their goals or hide their failures.



The reality of that danger revealed itself in a disastrous form in the Chinese famine of 1959–1962, which killed more than 30 million people, when there was no public pressure against the government’s policies, as would have arisen in a functioning democracy. Mistakes in policy continued for three years while tens of millions died. To take another example, the economic reforms of 1979 greatly improved the working and efficiency of Chinese agriculture and industry; but the Chinese government also eliminated, at the same time, the entitlement of all to public medical care. Most people were then required to buy their own health insurance, drastically reducing the proportion of the population with guaranteed health care.

In a functioning democracy an established right to social assistance could not have been so easily—and so swiftly—dropped. This change caused the mortality rate to drop as people were dying at younger ages than before.


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