A ‘Little Extra’

13 May 2021

By Charoo Piplani, MBBS

On a Sunday afternoon, while caring for my COVID 19 positive father at home in India, I decided to give him his favorite yet effective substitute for fluids – coconut water. The nearby seller who has served us for years claimed that a single coconut that normally costs ₹40 (Indian rupees; approx. $0.54 US dollars) was priced at ₹80 (approx. $1.09 US dollars). A doubling of the price in a day? To both of our dismay, he wasn’t getting an adequate supply of coconuts from his previous sellers. He also went on to narrate a story about his sons having to travel across three cities to procure the gem in question. It was a plight for everyone. It was, however, a necessity for me. I decided to stop my quarrel or any attempt at logical understanding since time for me meant my father’s health. It wasn’t long after this incident that I noticed a wave traveling through India, where we paid ‘extra’ to live through each minute of our lives. 

A friend’s father needed an oxygen cylinder that was transported across two states only to be available at fifteen times the original price, classically known to us as a ‘little extra.’ A childhood friend needed to rush to the hospital to find a bed for her mother, who had a declining spO2 of 79%, likely requiring ventilation. These were two ‘little extras’ – an ambulance or a public transport vehicle and a ventilator-enabled bed in the hospital with the hope that they don’t run out of oxygen just yet. Given the state of the city flooded with cases and overcapacity, she scrambled her way through several contacts and paid a ‘little extra’ to be able to transport her mother to another town and hospital. The following day progressed as we expected (given the situation), as opposed to how we would normally hope. Her mother did not survive, for which she ended up paying a ‘little extra’ to be able to bury her with dignity. There are a million stories of people in India paying ‘extra’ to survive. They pay ‘extra’ to be prepared and to maintain their sanity, often with no real hope in sight. More than half their stories do not have a happy ending, for which they end up paying a ‘little extra’ for cremation, burial, and other rituals. Our loved ones, who sadly succumbed to the greatest virus – our system of governance, are merely numbers in data reported in papers. Their lives mattered! 

Why was there an imbalance between the desired and required resources you ask? Not everything in the market, ranging from travel modalities to trivial needs in the household, was a necessity. In economics, supply and demand are the quantity of a commodity that producers wish to sell at various prices and the quantity consumers wish to buy, respectively. They are the chief drivers of price determination in economic theory. The price of a commodity is further determined by its interaction in the market. The price at which it is set with an agreement between the producer and consumers is known as equilibrium price – this means the quantity produced by the producer matches the demand of a consumer. In any given scenario, if the demand of a commodity increases, the price in that same period invariably increases as well, given that its supply remains constant or is only slightly increased because of storage capacity. This theory, however, exempts all necessities to sustain life. The commodity in question today is the oxygen we breathe packed in cylinders, several life-saving medications, hospital beds in reserved units, and goods and services needed to enable a patient to receive medical care, including but not limited to, transportation, food, and water to name but a few. 

Why the common man is suffering is the question of the hour. Who exactly is at fault here? Is it the way our healthcare system is formulated or the system at large? Can we collectively not take advantage of the sensitive situation and limit profiting and hoarding? Is it impossible to have tax exemptions on necessities and preparedness of the 13-month-old global pandemic? In my understanding of everyone’s apparent need to charge more than things are worth, I wonder why I was able to get a free consultation from my cardiologist and physician in my prime time of need. I wonder why most healthcare workers, charitable trusts, and non-governmental organizations (NGOs) are charging next to nothing for their services. I wonder! Perhaps, these are questions the answers to which we will never know.

Charoo Piplani, MBBS, is an international medical graduate (2019) from India, currently pursuing a dual degree – diploma in Medico-Legal Systems and Clinical Research, at Symbiosis International University, India. She is also working as a junior doctor in general surgery and is excited to be applying for this year’s general surgery match. Her future interests are in Plastics and Reconstructive Surgery. She is passionate about promoting diversity and equity in medicine and sustainable living. She has spent most of her life in the hills, and, at present, she enjoys her free time with a cup of tea, painting, and in her dog’s company. You can find her on Twitter @charoo_piplani.

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