The ethics of medical marketing

Is it ethical to sell medicines in the same way as you sell soap ? A trivially put , but troubling question. Consider the arguments for and against.

The problem in the medical industry is that the consumer, in most cases, is absolutely ignorant and is completely reliant on a doctor's opinion. But it is not the doctor who is paying - it is the consumer. At the time of consumption, the consumer is usually also not in a frame of mind to make rational , sensible choices. He is at his most vulnerable and therefore it can be argued that freedom of choice, a basic underpinning of capitalisim is, by definition, a contradiction in terms when it comes to a medical product

The basics of the medical industry is predicated on a few facts

• New discoveries are extremely costly - be it a drug or a medical device.
• Most nations grant a patent for a new discovery which enables the inventor to enjoy a monopoly for a fairly long time
• Once the patent expires, the product is subject to the same pressures of competition, demand and supply as any other product in any other industry. 
• There is very little product differentiation that is possible - formulations being legally regulated. Consequently, distribution and selling become the primary marketing tool for companies.

The industry is also peculiar in that the consumer is forced to consume - if it were possible, the consumer would prefer not to consume any medical product at all.  Given that it is the doctor who "forces" the consumer to consume, the backlash of customer dissatisfaction is also on the doctor - at the very least a virulent negative opinion against the doctor and more likely in the US for example, a lawsuit.

If that is so, is it correct for aggressive sales practices, usually found in most industries, to flourish in the medical industry as well ?  Most of the aggression on sales is towards doctors which raises even more ethical questions - should the doctors be influenced so heavily in their decision making. Every major drug company has been caught in questionable sales practices.  GlaxoSmithKline has been accused of bribery of medical professionals in China. Eli Lilly was charged with the same thing in Brazil. Pfizer sponsored incentive trips for Bulgarian doctors - euphemism for holidaying in Greece. Glaxo again took US medical professionals for "conferences" in Hawaii. Amgen offered discounts to  doctors to shift from competing products but allowed them a way to claim full price from health insurers.  Johnson & Johnson has been fined a colossal $2.2 billion for marketing practices stretching over 10 years in the US. Is anybody still left  who hasn't been fined ?

Almost every patient who sees a doctor in India complains of over testing and over prescription. Aggressive sales practices of medical companies and hospitals have certainly contributed to this "disease". One doctor I know, quit a hospital, because he was given a target for generating revenues through tests and prescriptions, regardless of whether the patient needed it or not.

While it would be easy to condemn all sales practices, these are a fundamental and essential part of the capitalist system. We would not bat an eyelid on any of them in other industries like telecom or clothing, or whatever. Its because the industry is the medical industry that there is unease. Although die hard loony leftists will argue against this, it is undeniable that capitalism and free markets have made incredible medical advances possible. If you simply ban all selling , and therefore dampen the means of achieving the profit motive, the industry would inevitably stagnate and then decline.

So where should the line be drawn. What is the difference between educating a doctor on a new drug or the effectiveness of an existing drug  and pushing him to prescribe it. We would, of course,  encourage a "soft sell" but would frown on a "hard sell" - the difficulty is to determine what is "soft" and what is "hard". These are extremely tough issues on which there isn't an easy answer. Doesn't mean that we shouldn't grapple with, or debate about, them.

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When two arrogant heavyweights meet

In the blue corner - the gigantic gorllia, sometimes the most valuable company in the world. The inventor of the smartphone and the giant who believes that you can have any colour you want as long as it is black or white. Yes it makes a great product, but then behaves like a monopolist - sets prices , forces you and carriers, charges an absolute bomb and snubs India, launching its product whenever it likes, a few million years after launching in the US.  Meet Apple Inc.

In the red corner, the largest telecom carrier in the world. Has a mere 750 million subscribers. Cares two hoots about anybody anywhere, so much so that it has a proprietary system for 3G which nobody else in the world uses. Tells every body in the telecom ecosystem to grovel on bended knees before even coming to visit. Has the almighty Chinese government at its back; so it can basically do whatever it wants. Meet China Mobile.

In the middle is the Chinese consumer who is absolutely nuts. He and she own a zillion mobile phones. They are constantly at it; so much so that Homo Sapiens Chinesensis has evolved a neck at a 15% angle to the rest of the body so that the being can see the phone better. Loves the iPhone, loves every other company phone, has a million ripoffs as choice and spends  89.4% of waking hours fiddling with the phone - the rest 10.6% spent in the Karoake bar, popularly called KTV ! It also helps that the aforesaid species has tons of cash in the pocket.

Until now the two beasts circled each other warily, but never really wanted to get into the wrestling ring together. Apple was basically selling whatever it was producing and didn't care about China Mobile. China Mobile was busy recruiting the entire Chinese population and didn't care about any phone manufacturer. End result was that iPhones couldn't be used on the China Mobile network, atleast on 3G and no self respecting Chinese would be seen dead on 2G.

Things have however changed for both the giants. Apple has seen Samsung overtake it as the largest smartphone maker. Apple increasingly can't sit back after launching an iPhone model and simply count the cash . So much so that  it had to descend from its lofty heights and condescend to launch the iPhone 5S in India, a mere two months after launching it elsewhere (fly a kite Apple; I am not buying your product anymore). The hope for salvation  is the largest market in the world, China - where Apple has a miserable 6% market share.

China Mobile has two "tiny" competitors - China Telecom and China Unicom who adopt the global standard for 3G and have been offering iPhones for years. These pygmy upstarts have "only" 450m subscribers.  China Mobile's profits are falling and it is absolutely pissed off that Chinese kiddos, besotted with iPhones are ditching it despite getting Mao Zedong to order them not to from his grave !

Now the two giants have shed a bit of their arrogance and have  done a deal. Tim Cook actually flew to Beijing instead of the usual practice of asking every telecom company chief to stand outside his door and recite Gayatri Mantra 1008 times before coming in. China Mobile have actually welcomed him into their sanctum sanctorum, thus far reserved for only Xi Jinping and Li Keqiang. Terms of the deal have not been disclosed but it appears that China Mobile's 4G standards will be something that iPhones will be compatible with and hence China Mobile will now offer iPhones to its customers.

We'll have to wait for full details of the deal to judge which of the two heavyweights had to shed their arrogance more.  But is nice to see two beasts eating a little bit of humble pie. Especially since I can sit on the sidelines and hoot derisively having no truck with either. It's three and a half years since I escaped from the clutches of China Mobile. And yes, I know I said this in a  long ago post in Preeti's blog, but I am hoping that readers have short memories and will not hold this against me !

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Oh Yes, Wait a minute Mr Postman

There are some endangered species in  the business world. One is the Secretary - gone are the good old days when an Amazon or a pretty young thing (you had a choice) would guard the entrance to your cabin, get you tea, organise your wife's kitty party, bring a shorthand notebook and take dictation (remember that ?), and do such other extremely important activities. It was invariably a woman - gender equality activists please note - and the choice of an Amazon or the pretty young thing depended on whether your need was mothering , or ....... you get the drift !

But this post is not about secretaries ! It is about another , what I though was an endangered species,  the mail room kid.

In the good old days, all offices had a big mailroom. Usually in the basement, this was a fairly large room into which all the incoming mail would come.  There was a massive pigeon hole contraption and the boys would expertly flick the mail into the relevant pigeon hole. This done they would collect all the sorted stuff and make their way to each part of the office, delivering the mail. 

Now, it must be understood that the mail room boy was the lowest on the corporate totem pole and it was the entry job for a young boy (always boys) who was , well, not qualified for greater things. There have been examples of those who started in the mail room and made their way to the corner office, but let us say, this was the exception. Being young, and in his opinion incredibly handsome, he was rather looking forward to that portion of his job that involved  delivering and collecting mail. His time and demeanor when delivering however depended on whether he was encountering the above mentioned Amazon or pretty young thing. A hopelessly big smile, lots of chit chat, a sing song voice, a general slowness of speed, etc etc all characterised the journey to those stations where the Amazon was not the resident species.

This of course, must be long gone. surely. Whoever has heard of a mail room still in existence - surely no dinosaur still writes a paper letter anymore.  Right ? Imagine my surprise when I read the news item that corporate mail rooms in the UK are straining under the weight of incoming stuff and they have had to take extra staff !!! What on earth is happening ? Have the Brits , with their well known fondness for ancient customs, gone back to snail mail ?

Well, it appears that the culprit is Christmas shopping. Staff are doing all their shopping on line and getting it delivered to their offices. So the mail room kid is making a comeback - instead of delivering a mountain of paper, he is now deluged with everything from frilly knickers to iphones ! He still does the rounds of the offices, whistling to himself, but alas, there is no Amazon to avoid or pretty young thing to chat up. Instead there are only dull boring spectacled oafs all hunched up over their keyboard.

The problem of a deluge of Christmas shopping deliveries has apparently reached epic proportions. Sir Humphrey Appleby (Ramamritham's guru and mentor) has issued a decree banning government department staff from ordering online stuff to be delivered to the office. He has invoked the principle that office was office and staff are not supposed to use the office facilities for personal stuff. The staff are protesting saying that since they have to be in the office all day, where else could they accept the deliveries. They are threatening Sir Humphrey that denying  Christmas shopping opportunities and making staff work instead, tantamounts to human slavery and denial of basic human rights (Mr Preet Bharara, please note !)  The matter had not been satisfactorily resolved at the time of publishing this post, and its only 5 days to Christmas.

Even endangered species make comebacks ! And this blogger has taken to posting utterly trivial and inane stuff as the holiday season approaches !!

PS : Regular readers with the exception of those old enough to know (Sriram and Ravi !!) might want to learn of the significance of the title of the post from here :)

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United States beware - you have twisted Ramamritham's tail

The recent diplomatic spat between India and the US, should normally not be the subject matter of this blog - it having nothing to do with economics or business. However, since the nuclear weapon of Ramamritham has been invoked by India, it now falls into the realm of comment here, considering rhe world beating expertise this blog has on that venerable gentleman.

In case you have not been following the events, the US arrested the deputy consul of India in New York on the grounds that she had underpaid her domestic maid (imported from India) and consequently committed "visa fraud". I don't wish to discuss the merits of the case here, although this pertained to an event in the past, is subjudice in an Indian court, and very likely debatable hinging on the obscure valuation of accommodation and food. But in true American government fashion, this was handled with extreme insensitivity - the lady was arrested as she was dropping her children to school , handcuffed in public, searched (allegedly strip searched) and taken to jail before being released on bail.  This blogger has long been a critic of how America handles such matters even when it comes to its own citizens - there is hardly a need to handcuff people , make them do the perp walk, hold them along with those accused of criminal charges etc, for alleged civil crimes. No civilised country does this  but that is the prerogative of American voters to decide if it is right or wrong.

India, or at least, the Indian government is mightily pissed and has retaliated. It has done such things as summoning the US ambassador in India and giving her a dressing down, refusing to meet a US delegation currently in India and such other diplomatic rebuffs.  But the real deadly move has been to let Ramamritham loose on the US embassy in India ! Ramamritham has now sought details of the activities of every diplomat and his or her spouse, asked them to furnish details of salaries paid to Indian staff, including maids, they employ here, etc etc. He has asked them to turn in their ID cards and has withdrawn their special privileges that breezes them through the every day bureaucracy that anybody in India faces. He has also hinted that gays in the US embassy could equally be arrested under the current laws of India !!

America does not know what it is risking by attracting the attention of Ramamritham. If he puts his mind into it, he will discover innumerable violations of the law that American diplomats have done, albeit in ignorance or involuntarily.  Such is the nature of India's laws and pedantry that it is impossible for any human to exist in India without having violated the letter of  one law or the other. The violation may be purely procedural in nature - for example not filing some form or intimating some trifling detail, but that is enough. Ramamritham will go after you with gusto. There is no power on earth who can stop him. For example if the diplomat and his family have stayed in a hotel somewhere and not taken great care to fill their nationality as US citizen on the hotel form (whoever looks at that form's fine print when checking in at 11 PM after a delayed flight) - he has committed a crime. Years ago, Ramamritham arrested Nusli Wadia precisely for this ! If the embassy has not displayed the Provident Fund rules on its notice board for the benefit of Indian staff (and there are rules on where the notice board has to be situated in relation to the office) , it has broken the law.  There are potentially 1,453, 678 violations he can look into. I have great pity for the American embassy staff and their families - they have no idea what they have gotten into - and all because of the actions of some insensitive pig headed Ramamritham equivalent in New York.

If the United States knows what is good for it, it will promptly meet with Ramamritham, beg his pardon, fall at his feet ,  do shashtang namaskar, recite Abhivadiye three times and beseech him to turn his kind attention back on the hapless Indian citizens who he has been torturing from time immemorial.

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I love Samoa Air

I am likely to vote for Samoa Air as the best airline in the world. I have never flown the airline, nor have I been to Samoa. So why this sudden fancy ? Its because I just discovered that they charge passengers based on their weight !

I have traveled many a long mile on planes and can be considered a fair expert on the matter of air travel. But even I have failed to understand how airlines fix their fares. Nor can I be sure that I won't have to cough up more on reaching the airport, for check in bag fees (horrible American airlines) , place in the queue to board fee (Southwest), going to the loo fee (Ryan Air), quench thirst fee (Indian carriers)  whatever, whatever. If there is a logic to air fares, it has thus far escaped my comprehension.

But I do have  a pet peeve when it comes to airfare. You see, the cost of flying an airplane is all down to weight - airlines will do anything to reduce the weight of the aircraft.  You would therefore expect that airlines would have some linkage of their fares to weight That is indeed the case with checked in baggage. But when it come to the more substantial issue of the weight of the passenger itself,  it seems to have been forgotten. Now, I must confess that I have a serious weight problem  - I weigh literally nothing !!! Therefore my pet peeve has always been that I have to pay the same fare as  Rajalakshmi sitting beside me - she of the gargantuan proportions ! And I always seem to attract Rajalakshmis as my neighbour - so I occupy one tenth of the seat and the good lady spills over from hers and occupies the balance nine tenths !

I have railed often against the injustice of it all, but to no avail. And then I came across Samoa Air's policy on fares. Fares are simply based on your and your baggage's weight. They quote a per kg price. You and your baggage stand on the weighing machine. Weight multiplied by the per kg fare and that's your bill !!! If you don't believe this, visit their website.

Wow - I can now fly almost for free.  Wouldn't that be the most spectacular thing to happen. I , a jaded traveler, who can't stand the sight of a plane anymore, is now all perked up and energised to travel - thanks to the wonderful policy of Samoa Air.

The airline was forced to take this practical step because Samoans are the most obese people in the world. Any airline that flew Samoans and did not have a weight policy would not take off - pun intended. So this was virtually forced on them, but then who cares what is the motive for a brilliant pricing strategy.

I love Samoa Air.  Samoa - Oute alofa ia te oe !!

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How about a WTO deal inside India

If you can get 159 people to agree to anything, you must be a magician. Well, Roberto Azevêdo, did just that. The Brazilian is the Director General of the World Trade Organisation and today 159 countries agreed to a treaty. For years and years, nothing but bickering has the been the result - in Geneva, in Seattle, in Cancun, in Doha.  But at last in Bali today, something has been signed. Modest it may be, that will set common customs standards and ease the flow of goods through borders around the world. But to get all 159 countries to sign up (even one could scuttle any deal), is a major achievement.

They almost didn't. The chief spoiler was India - at the end of the negotiations, virtually every country was pissed off with India. India was threatening to veto the deal on the issue of its programme to feed 75% of its population at subsidised rates (the unfortunate Right to Food Programme).  India's stand in most multilateral forums is to shout loudly, be a spoiler, pontificate, and in general be a nuisance. Such a position was usually the role of the United States, which remains very good in pontificating. But in the last decade, the developing countries have been big noise makers - none more so than India. At the end of the Bali round, Anand Sharma, India's Commerce Minister is not going to be very welcome in most parts of the world. But finally he did relent and India signed too.

A global free trade agreement is in everybody's interests, although the loony left usually rail against any form of globalisation. Most countries have come to realise the value of free trade, except for the problem that they want it to be free when it suits them and want to shamelessly protect when they encounter some lobby or the other. One of the chief culprits is the self appointed bastion of free trade , the United States. It champions free trade to other countries, but has horrible market distorting subsidies in a wide range of industries - chiefly farming. So does the EU. Both of them want free trade, but do everything in their power to stop free movement of services - the draconian visa restrictions is as trade blocking a move as any customs barrier. India wants the US and everybody else to let it freely export IT services (the one thing it is good at), but refuses to import say wheat or onions . China wants to export to the world, but will not allow foreigners anywhere near banking, insurance, etc. Everybody is protecting special lobbies and screwing the consumers in the bargain - the consumer has a right to the best and cheapest product, wherever it may originate from and yet governments do their best to block this, citing the need to protect some powerful lobby, usually of the rich.

It is not this blog's intention to make the case for free trade - it has been well made by far more illustrious men and women.  In any case, no rational argument is going to convince the loony left and the rabid right - so why even try ? This post instead is going to plead for a "National Trade Organisation" inside India itself. If you thought there is free trade inside India, you are grossly mistaken. Each state draws it boundaries, and the sight of the long queue of trucks on the state border is enough to tell you that every possible block is made on the free movement of goods. The honourable lady in charge of one of our Eastern states went even to the extent of banning the movement of potatoes from her state to the North East recently, ostensibly to reduce potato prices in her state. She was literally playing with a nuclear bomb - first of all her act was grossly unconstitutional and secondly if every state decided to copy her, what will become of India.

For years, India has been trying to implement the Goods and Services Tax - a common indirect tax regime across the country.  Nobody can get the States to agree (although I am sure none of the honourable finance ministers of any state can cogently argue why he is opposing this ). BJP Chief Ministers are the chief blockers although the idea itself came about when Vajpayee was the Prime Minister and the move was a BJP brain child. Freeing up the state borders will do wonders to India's economy. The only person it will hurt is Ramamritham - and he along with his political masters are doing their best to block this.

Mr Anand Sharma is not going to be very welcome outside India. Maybe he may want to sit in Delhi and try and get a national treaty signed by all states. After all, there are only 35 states and union territories. And if 159 countries can agree to a treaty, surely 35 states  can. Oh I forgot. In the WTO, there is only 1 India - Inside,  there are 35 India types, each worse than the other. Fat chance of a deal.

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Blimey ; what a spectacular trade deal

The sight of David Cameron, prostrating himself flat at the feet of the Chinese "emperors" is a beautiful reminder of the state of affairs of the British Empire. To understand the context, about a year or so ago, David Cameron had the temerity to meet with the Dalai Lama. Now anybody who even smiles at the Dalai Lama is a pariah  as far as the Chinese government is concerned. David Cameron committed the unpardonable sin of actually shaking His Holiness's hand. China promptly condemned UK to the doghouse - no meetings, no trade deals, no investments, etc etc. For one year, the naughty schoolboy was made to stand outside the class.  After a year of punishment, he has been allowed inside again.

Promptly the Rt Hon'ble Prime Minister has taken a big delegation and gone straight to Beijing, to do Shashtang Namaskar (Indian way of prostrating at one's feet). It is as yet unclear as to whether he did "Abhivadiye" as well :) No less than 130 other luminaries accompanied the Prime Minister , no doubt to clinch innumerable trade deals (rumours to the effect that they have gone there to sample Peking Duck are strictly untrue).

I have been scouring the newspapers as to what sort of trade deals these worthy leaders of the British Empire have struck. Only one real deal has been reported so far. Britain will now be able to export pig semen to China.

Until now, Britain was unable to export pig semen to China, because apparently Chinese sows had concluded that their would be British  suitors, er, rather smelled. China did not want its dainty damsel sows, "polluted" by laowais.. The British Prime Minister and his 130 strong entourage succeeded, after marathon negotiations, to convince the Chinese that British pigs did not smell. The clincher was achieved when it was pointed out that suitors would not travel to China, but instead, er, only the manifestation of their manhood, would .

Animal Rights activists perhaps protested that it was unfair that Romeos and Juliets were not allowed to coo sweet nothings personally, before being asked to maximise "production". Such protests were firmly quelched - on the Chinese side, by rounding up the entire lot and sending them to the 114th People's Prison in Hohhot, Inner Mongolia, and on the British side by Sir Humphrey Appleby proclaiming that for services to country and Her Majesty, the aforesaid love deprived pigs would be awarded the Order of the Thistle and Garter (2nd grade).

It is  well known in knowledgeable circles the the male species amongst China's various living organisms are rather less well endowed than their counterparts from the West. Now it has been expertly opined that British pigs were capable of producing 30 piglets a year, whereas the Chinese cousin could only manage 16. Pork is the staple food of the Chinese, and the fact that the Chinese were prepared to overlook the insult to their manhood to satisfy their bellies, is proof that the stomach is mightier than the organs further south.

The British are crowing about this trade deal saying that it will generate some £45m. It is unclear as to whether the great and mighty British empire has fallen to such levels where the aforementioned sum is considered "big". I suspect it is the affirmation of the superiority of British manhood , albeit of the porcine variety, that has made the British crow about the deal. Well, it wouldn't be cricket to boast about the size of the matter in question (deal I mean), but in the pubs across Westminster, after a few pints, that is precisely the boast being made !

What a spectacular, almighty, game changing deal that the Prime Minister of the United Kingdom of Great Britain and Northern Ireland has achieved along with 130 illustrious subjects of Her Majesty, the Queen, traveling halfway around the world.

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Send Ramamritham to Mars

Statutory Warning : This piece is not a sober, reasoned, point of view. It is an unadulterated rant. It may be highly biased and devoid of much logical argument. But , what the hell, once in a  while a blogger deserves a good yell. So here goes

I wish the Indian Space Agency had hit upon the idea of sending somebody with a one way ticket in the recently launched Mars expedition. I would have happily sponsored the ticket for Ramamritham. Especially the Ramamritham who sits in the Income Tax Department.

What has prompted this rant is the antics by Ramamritham against Nokia. He has been going against Nokia disallowing their royalty payments as an expense and demanding tax on them. When the company refused, he went to court and has frozen their main factory in Sriperumbudur.  By this act, he is jeopardising the sale of Nokia's telecom business to Microsoft. Succumbing to sheer blackmail, Nokia has offered to pay some Rs 2000 crores just to get Ramamritham off its back - so that it can include the Indian operations in the sale to Microsoft. This is nothing short of extortion. But Ramamritham has refused this amount too to settle the case .

This specimen has a problem with every global company that operates in India. He has a problem with their linkage with overseas operations - maybe transfer pricing., maybe structuring of M&A, maybe whatever. He has gone after Vodafone in the famous case, he is going after IBM, he is going after Nokia and no doubt he will be going against every global company that operates in India.

I am not for one moment saying that global corporations are saints. Far from it. But these sort of tax planning actions are done by all companies in all corners of the world. Remember, tax avoidance is not a crime; only tax evasion is. Every company cannot be a rogue. In true Ramamritham fashion he is going after soft targets and cares two hoots about its fall out effects on the Indian economy. No  global M&A transaction is possible these days without India proving to be a massive headache or else excluded altogether. Every Indian operation now has to staff an oversize tax department to cater to Ramamritham. Only an absolute idiot will invest in India today. India is not some special divine country which is separate from the rest of the world. If Ramamritham has a problem with transfer pricing, he should go to the WTO and negotiate tax treaties with the entire world. He should also remember that the shoe can equally be on the other foot too - other governments can also screw Indian companies in their respective countries. The US equivalent of Ramamritham has to only do a fraction of what he is doing and the Indian IT industry will come to a halt.

The British government and the Finnish government, to name only two, have intervened at government levels and asked the Prime Minister to rein in Ramamritham. But Ramamritham cannot be stopped. Once he has gotten into his silly head that he must do something, not even an asteroid hit will stop him.

If Ramamritham is seriously interested in increasing tax revenues, he should at least be man enough to go after the people who do not pay any tax at all. Only 3% of the Indian population pays income tax. The rest of the 97% don't. If he has the guts, he should go after the blatant tax evaders, who number in the millions. By going against respected companies, who are tax payers,  he is basically saying to the world - come to India at your peril. We would be delighted if you don't come to India at all . In Ramamritham's view of the world, it is best if there is no economic activity at all - for then his tax department will be perfect - there are no taxes to collect and hence nobody to go after.

Deliver us God, from this parasite who infests us. The only route to salvation for India is to send Ramamritham to Mars.

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Hooray Hooray; It was not a holiday !

I never thought that my Nobel Prize winning poetry ( !!) , featured in the previous post,  would so fox my readers. No my dear ladies and gentlemen , No, I was not on a holiday. I did not go trekking in the hills. I was not marooned on Robinson Crusoe island. I was not a trillion miles away from civilization.

I was in the People's Republic of China. And all of the facts mentioned in my "poem" are true.

The country hides behind the jīndùn gōngchéng. The Chinese have their own equivalents of everything - Weibo is actually bigger than Twitter;  TMall and Taobao are bigger than Amazon and E Bay.  Youku may not be as big as YouTube, but its all there and Renren is as big as Facebook. But then only the Chinese use these . CCTV is all in Chinese, except for one appalling English channel and the less said about China Daily, the better.

What a shame, that such a proud, fine, great and strong culture like China wants to retreat into isolationism. Three years after I left China, I go back and the thing that strikes me most is how much more inward looking China has become.

China has every qualification to "conquer" the world - not on horseback, but into the minds and hearts of the people everywhere. But my dear Chinese friends, you can hardly do that if you are gazing intently at your navel !

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