ROLLING HILLS ESTATES, Calif. (AP) — ROLLING HILLS ESTATES, Calif. (AP) — Natural Health Trends Corp. (NHTC) on Wednesday reported earnings of $172,000 in its third quarter. On a per-share basis, the Rolling Hills Estates, California-based company said ...

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Fintel reports that on October 31, 2023, Mizuho maintained coverage of Tenet Healthcare (NYSE:THC) with a Buy recommendation.  Analyst Price Forecast Suggests 67.25% Upside  As of October 31, 2023, the average one-year price target for Tenet Healthcare is 89.

Mizuho Maintains Tenet Healthcare (THC) Buy Recommendation

Fintel reports that on October 31, 2023, RBC Capital maintained coverage of Tenet Healthcare (NYSE:THC) with a Outperform recommendation. Analyst Price Forecast Suggests 79.72% Upside As of October 5,

RBC Capital Maintains Tenet Healthcare (THC) Outperform Recommendation

Tenet was also the latest for-profit operator to call out the impact of rising physician fees from the implementation of the No Surprises Act.

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Tenet Healthcare CEO Saum Sutaria, MD, expresses concern about the increasing rates of claims denial activity from health plans.

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Tenet Healthcare Corporation beats earnings expectations ... These factors, in addition to an ongoing post-pandemic recovery for health care services provide tailwinds into next year. Our starting point also assumes some rather obvious points in this ...

Tenet Healthcare Corporation (NYSE:THC) Q3 2023 Earnings Call Transcript

The closure of three labor and delivery departments in less than a month has some asking questions about what comes next for expectant mothers in Alabama.

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Get the most recent info and news about Tenet Healthcare on HackerNoon, where 10k+ technologists publish stories for 4M+ monthly readers.

Tenet Healthcare Corporation operates as a diversified healthcare services company. The company operates in three segments: Hospital Operations and Other, Ambulatory Care, and Conifer. Its general hospitals offer acute care services, operating and recovery rooms, radiology and respiratory therapy services, clinical laboratories, and pharmacies. The company also provides intensive and critical care, and coronary care units; cardiovascular, digestive disease, neurosciences, musculoskeletal, and obstetrics services; outpatient services, including physical therapy; cardiothoracic surgery, complex spinal surgery, neonatal intensive care, and neurosurgery services; quaternary care services in heart and kidney transplants; and limb-salvaging vascular procedure, acute level 1 trauma, intravascular stroke care, minimally invasive cardiac valve replacement, imaging, and telemedicine access services. In addition, it operates ambulatory surgery and urgent care centers, imaging centers, surgical hospitals, off-campus emergency departments, and micro-hospitals; and offers healthcare business process services in the areas of hospital and physician revenue cycle management, patient communications and engagement support, and value-based care solutions to hospitals, health systems, physician practices, employers, and other customers. As of February 09, 2022, the company operated 60 hospitals; and approximately 550 other healthcare facilities, including surgical hospitals, ambulatory surgery centers, urgent care and imaging centers, and other care sites and clinics. Tenet Healthcare Corporation was incorporated in 1975 and is headquartered in Dallas, Texas.

Tenet Healthcare

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“A man can have as many diseases as he damn well pleases” — Hickam’s Dictum Every profession has oral traditions you can’t find in textbooks. I was a doctor before I became an entrepreneur, and like every medic I have been steeped in the maxims and mantras of the craft. These memorable sayings are passed down through the generations, getting rather than studied, for example: absorbed “Common things are common.” “Put your finger in it, or you’ll put your foot in it.” (don’t skip the rectal exam) “Don’t f**k with the pancreas.” “ All bleeding stops eventually.” To anyone on the outside they can seem tautological or abstruse, but with context and experience you appreciate their wisdom and they become indispensable. Craft Wisdom As a founder I’ve often reflected on the parallels between the craft of medicine and business leadership. And over the years I’ve found myself collecting new sayings. For example: Optimise for alignment, not control. What’s the path to green? Great leaders serve. Some are quotes from wise colleagues, others are my attempt to capture lessons learned. As I've curated my collection they've started to feel less like a mélange of founder tips, and more like that signpost the way to deeper truth. They have become a cornerstone of my practice. mantras Below I’ll share 7 mantras for startups, accompanied by short commentaries. Mantra Health Warnings
(i) Your milage may vary: items might seem trite or irrelevant depending on your context; 
(ii) They are mantras not commandments, you're meant to reflect on them; 
(iii) No mantra is an authoritative ‘last word’ on any theme or subject; 
(iv) For best results it’s a good idea to create and curate your own list — it is a craft after all. My Startup Mantras 1-7 1. Ideas are easy, execution is hard. The world is overflowing with good ideas. We come across them every day: in our work, with our friends, in the news. But there's a reason why humanity hasn't cured cancer, solved climate or colonised space - execution is what matters. Successful companies understand this. They put their effort into the hard thing - building. Above all else, this requires focus. Our responsibility isn't to dream up big ideas, it's to realise them. 2. Great companies are defined by incredible teams, not heroic individuals. Optimise for your team. "Not finance. Not strategy. Not technology. It is teamwork that remains the ultimate Competitive advantage, both because it is so powerful and so rare." – Patrick Lencioni, The Five Dysfunctions of a Team. The team is the basic unit of computation in a company, it gets the work done. A single developer might be able to code an app, but success and scale nearly always depends on the collaboration and contribution of many others: product managers, researchers, designers, marketing, finance, etc. Great companies optimise for teams at every level. They hire and promote people who are collaborative, they create cultures that are open and enabling, and when making decisions they consider the team. Great teams embrace responsibility, take ownership, and continuously push themselves to get better. 3. Great Leaders Serve . Steve Jobs and Elon Musk are extraordinary, but they are too often venerated in a way that shows no understanding of their actual gifts, and total ignorance of their weaknesses. The archetype of the all-seeing, all-powerful executive is bullsh*t The role of a leader isn't to wield power, but to distribute it. Effective leaders scale their time and impact by setting direction, empowering others, and making sure decisions are made at the right level - by the people with the right skills and context. 4. "What's the path to Green?" Complex problems create uncertainty and inertia. Instead of struggling for the elusive grand solution, you should consider: "what is the path towards a better outcome"? i.e. from red through amber to green. This framing can help you get moving in the right direction by inviting near-term pragmatic action rather than wistful big ideas. Once you identify the path you can start walking in the right direction. You won't know its exact route, and you may find new obstacles along the way, but you will move forward, step by step. 5. Your budget is your strategy expressed in numbers This mantra paraphrases James O. McKinsey, who understood that an organisation's accounts are a powerful source of truth. Understanding how much money you make, how much capital you spend, and where you spend it, will tell you what kind of business you have, and where it's going. To understand your business, get a grip of your budget. 6. A company is a -  not the sum of its parts, but the product of how those parts interact. system If Apple announces a new iPhone with a 10% faster CPU and a 20% better battery life, it doesn't follow that the new phone is better than the old model. In fact, if these changes increase the device's size, weight, charging time or price, the new phone may well be worse. An iPhone's appeal stems from the way in which its many parts work together to create a great experience - not in the performance of any one component. This is the central tenet of systems thinking. Improving individual components / teams / departments in isolation rarely improves the system itself. If you want to strengthen your company, then you need to tune the entire system to the outcomes you want. Make your goals clear, focus on interface points and handoffs, and ensure all incentives are pointing in the same direction. 7. Optimise for alignment, not control As teams scale communication becomes harder, coordination degrades and departments can slip into silos. A common response is for executives to create more processes, rules and meetings… but this causes even more damage. The way out of this swamp is to accept that scale has tradeoffs, and focus on . alignment https://www.youtube.com/watch?v=OqEeIG8aPPk?embedable=true Featured image is Prompt of ‘What's the path to Green?’ HackerNoon Stable Diffusion

Optimize for Alignment, Not Control. Great Leaders Serve. And More Startup Mantras :-) 

Optimice para la alineación, no para el control. Los grandes líderes sirven. Y más mantras de inicio :-)

Optimisez pour l'alignement, pas pour le contrôle. Les grands leaders servent. Et plus de mantras de démarrage :-)

संरेखण के लिए अनुकूलित करें, नियंत्रण नहीं। महान नेता सेवा करते हैं। और अधिक स्टार्टअप मंत्र :-)

コントロールではなく、アライメントを最適化します。優れたリーダーは奉仕します。その他のスタートアップ マントラ :-)

Otimize para alinhamento, não controle. Grandes Líderes Servem. E mais mantras de inicialização :-)

Tối ưu hóa để căn chỉnh, không kiểm soát. Các nhà lãnh đạo vĩ đại phục vụ. Và nhiều câu thần chú khởi động hơn :-)

优化对齐，而不是控制。伟大的领袖服务。还有更多的创业咒语:-)

What is Modern Monetary Theory (MMT)?

The telemedicine is expected to create a more than $5.4 Bn market opportunity by 2025.  While the growth has been slow in the past years, the demands for medical advice and the restrictions on movement during the outbreak of COVID-19 have renewed the need for, and interest in, applications that enable healthcare at home. industry With realtime technologies and cost-saving approaches made possible by the new economy and machine learning and artificial intelligence, we can surmise that the focus on logistics and operations will only intensify to leverage these new opportunities and improve both patient care coordination and profit margins. How Realtime Communication is transforming telemedicine Telemedicine will become a global reality, patients and caregivers can get medical help from experts halfway around the world. PubNub’s telehealth solution has spurred on healthcare providers to create effective ways to communicate with their patients and deliver care in a way that makes it easy for everyone involved. We are working with leading healthcare providers like Apollo Healthcare and others, to ensure their patients don’t have to drive to clinics, hospitals, and are able to leverage telehealth apps for routine check-ups, prescription refills, and mental health services. The adoption of realtime communications in the healthcare industry has led to a growing world of innovative approaches to telemedicine. These applications enable the remote communication of medical information, , and treatment. Implementations can range widely: remote patient monitoring technologies might allow patients with diabetes to monitor their blood glucose through mobile apps. Or, they might facilitate virtual doctor consultations through video conferencing, voice calls, and synchronous 1:1 chat. technology advice Realtime Benefits of Telemedicine Enhance engagement with patients: Often, doctor’s appointments are either booked in advance, or are routine check-ups set at regular intervals. But, this can create an uncomfortable limbo for those with non-emergency symptoms, chronic problems, or ongoing mental health challenges. Rather than leave patients caught in a binary between seeing a doctor and being on their own, telemedicine allows access to medical advice, even while on the waiting list. When used as a supplement to office visits, , especially when it comes to mental health. Even while waiting in the system, patients can access advice, care, and treatment using telemedicine. This encourages  patients to adopt a preventative care regime, which has an impact on the outcomes of patient health while also offering huge savings on overall treatment costs. Allows patients to practice preventative care, and helps lower overall treatment costs: chat-based consultations can serve as effective treatment One of the major benefits of telemedicine is that it gives healthcare providers multiple opportunities to reduce costs. By nature, they take a load off of brick-and-mortar clinics, and can offload traffic from nurse call-lines. Consultations taken via chat apps actually improve patient engagement and satisfaction, letting healthcare providers lower operational costs without negatively impacting patient outcomes. The core tenet here is efficiency. Using doctor-patient chat, healthcare providers can refer patients to relevant departments before they walk in the door. Similarly, prescriptions can be filled, and some symptoms can be checked or monitored remotely. With responsive chat, healthcare providers can expand service while saving on costs. Reduce operational costs without sacrificing quality: Ensure better patient outcomes: In addition to augmenting check-ups and consultations, telemedicine apps can With app-assisted treatment, patients can access knowledge, monitor their own symptoms in conjunction with their doctor, and contact healthcare professionals when questions arise. Some telemedicine apps with patients, and this leads to care that sticks. play an important role in long-term, at-home care regimens. actively check in As augmentations to established medical methods, these approaches allow doctors to serve as coaches and supervisors, teaching patients to take an active, ongoing role in their own treatment. Together, this results in better patient experiences and health outcomes, with the added benefit that educated patients are more capable of preventative care, and therefore stand to draw on fewer healthcare resources in the future. Improve doctor-patient communication with HIPAA-compliant chat: Whether between physicians or physician-patient, HIPAA-compliant chat can help drive faster and more complete communication for better patient outcomes. As has become apparent this year with the restrictions born of COVID-19, . But, even when movement at large is unrestricted, mundane things can be substantial barriers to care. Finding time during the work week to make an appointment, distance from facilities, or a simple lack of transportation For clinics, no-shows waste resources, time to coordinate office staff, and time slots that could have been allocated to other patients instead. Overcome barriers to care: physical barriers have driven the rapid growth of telemedicine prevents many from accessing care. By its very nature, telemedicine offers a way to overcome these . Text chat, voice, and video lets doctors and nurses reach patients where they are. As vehicles for higher-touch interactions between medical offices and patients, these apps also make it easy for patients to notify staff of scheduling issues. Then, it's easy to set new appointments or move to a remote check-in. This benefit may seem like an intuitive feature of doctor-patient chat apps, but it is well-worth calling out. barriers to care

8 Transformational Benefits To Telemedicine Because Of Realtime Communication 

How Quantum Computing Can Make Contact Tracing Safe from Prying Eyes

The novel coronavirus might not be the world’s first pandemic or even the deadliest. But the virus has set the stage for a truly unprecedented time of global harmony. For the first time in history, the nations of the world are cooperating to issue a joint response to a global crisis. While millions huddle indoors with their Tiger King, yoga videos, and killer recipes, governments across the globe have ceased preparing for military interventions and trade wars. Today we all face a common enemy: a deadly virus that threatens us all, no matter our race, religion, sex, or nationality. As the world bands together to prevent the spread of the virus, it must also grapple with the impending economic disaster COVID-19 brings with it. That trouble began on March 12, when news of coronavirus-induced lockdowns across the globe sent the . Interestingly enough, crypto markets, led by bitcoin, followed suit, an event later referred to as “Black Thursday.” stock market in a downward spiral The event called into question bitcoin’s ability to serve as a hedge against inflation, as well as its reputation as an asset ungoverned and uncorrelated with the broader markets of the world. It was bitcoin’s first great crisis, and while many declared the digital currency dead immediately after the March crash, others see a financial market in ruin, ripe for the cryptocurrency’s taking. Since the so-called Black Thursday, named after the 1929 stock-market plunge that set off the Great Depression, markets have rebounded, as have cryptocurrencies. Bitcoin rose to $7,800 early on April 27 to hit its highest level since March 12, when prices fell from $7,950 to $4,700. The largest cryptocurrency by market capitalization on the low of $3,867 registered on March 13. Other digital coins bounced back as well. traded at around $7,700, representing a 100 percent gain Why? Some attribute the rally to a general upward trend in global markets. Those who follow cryptocurrencies understand that it’s much deeper than that. Bitcoin fundamentals dictate that the cryptocurrency is recession-proof—not crash-proof. When a global pandemic puts millions out of work, shuttering the global economy, and quite literally quarantining entire populations, it’s understandable and expected that peoples’ first instinct will be to sell off their assets for cold, hard cash. Survival comes first, and bitcoin isn’t going to buy you toilet paper or hand sanitizer. As the global economy deteriorates, though, and central banks begin to print money (which can lead to inflation), investors are likely to look to tangible assets such as gold and real estate, as well as bitcoin, the . best-performing asset of the past ten years All this is taking place right now, just weeks before the third bitcoin halving event, which cuts the reward of mining the coin in half every four years. Based on bitcoin’s short history, the event is expected to cut supply in half, meaning that even if demand remains constant its price should rise after the event. Current economic trends, coupled with the halving hype, point to higher demand as well. The point here, though, isn’t to make the case for bitcoin or any other cryptocurrency. The point is it’s time for our governments and financial institutions, along with our healthcare systems, to adapt to the 21st century. It’s time to incorporate blockchain technology and digital currency into the global economy. Just as the Great Depression gave way to Franklin D. Roosevelt’s New Deal that gave short-term relief and long-term economic stability back to the people, this coronavirus-induced economic struggle can bring with it a Digital New Deal suited for 2020. With 33 million unemployed in the United States alone—a real unemployment rate of 20.6 percent—there aren’t any quick fixes here. There are, however, innovative solutions to novel problems. Those solutions should be explored. The short term fix doesn’t even require blockchain. In order to prevent a complete financial collapse due to hyperinflation, the U.S. Federal Reserve, European Central Bank, and other central banks should put money directly in our (including companies’) pockets by lowering interest rates below zero, a he “could get used to.” policy President Donald Trump has said Indeed, interest rates on short-term Treasury bills have already on March 25. turned negative While they have inched back up, rates remain close to zero and negative rates, previously uncharted territory, could become a reality very soon in the U.S. Such a reality would mean borrowers would actually be paid for borrowing money. It’s a policy with the potential to jolt Main Street back onto its feet and pump money back into our economies, without continuing to print more. It’s a true “bottom-up” approach that promotes spending and economic growth while limiting inflation. With trust being based on fiduciary money and the economy that it holds, wouldn’t we trust borrowing money more if we knew that at the end of the month we would have money, not from a salary, since much of the population lost theirs, but from institutions paying us to borrow money? It sounds like a contradiction, yes. Why would anyone pay you for letting you borrow money? The alternative, though—central banks continuing to print money and keeping interest rates above zero—is a sentence of death by inflation. Negative interest rates, on the other hand, would have the desired effect of putting cash in people’s pockets without printing additional money, because financial institutions would be paying individuals to borrow. Such innovative thinking in monetary policy that flips the current system on its head is exactly what global economies need right now, serving as a short-term solution to fill people’s pockets with cash and enable them to spend. The long-term solution is where the “digital” aspect of a Digital New Deal would come in. The widespread, institutional adoption of digital currencies and digital assets must be a central tenet of any kind of financial reform shaping the 21st century. While many call into question Bitcoin’s price potential, technical superiority, or even the ability to survive in the coming years, no one can dispute that blockchain technology is the financial way of the future. Governments globally must work to develop systems that utilize blockchain and digitization, decentralizing finance, and empowering individuals. Tangible assets reign supreme during financial crises, but access to such assets for the average person is limited. Tokenization offers a secure and efficient means of breaking ownership of such assets into much smaller fractions that average people can afford, as well as transferring ownership of those fractions seamlessly over the blockchain. The logistics of such a reform would vary by region, country, and even province—decentralization is key. Coronavirus or no coronavirus, institutions, and individuals alike will soon realize that digitization can cut fees, generate efficiency, and distribute wealth more equally across the board. Governments globally must stay ahead of the trend as they focus on flattening the curve. Financial reform is inevitable, the coronavirus pandemic merely hastened it. Let’s make sure the next New Deal serves as a digital revolution of finance. About the author: Salvador Casquero is the Founder and Chairman of , the fair crypto trading app. Casquero has more than 25 years of experience in the banking sector and has worked for several banks, including JP Morgan, BBVA, LaCaixa, and Banco Sabadell. He holds an Industrial Engineering degree from Universidad Pontiﬁcia de Comillas (ICAI), and since 2010 has been researching and building concepts on the blockchain. 2gether

Bitcoin’s First Great Crisis Is Setting The Stage For A Digital-First New Normal

Ever since I quit the corporate world, the story I have been telling myself is that I want to work on uplifting the poorest. It sounds romantic at the onset but like most things, is a lot more complicated when you get down into the weeds. I am data-man, or so I would like to think. So, it is essential for me to understand the size and depth of this problem of poverty. And how do you even define poverty? Let alone quantify it. Over the past three years, I believe I have earned a decent understanding of it. This is an attempt at formalizing that understanding. First, what is poverty? Believe it or not, this isn’t straightforward. There are four different ways to look at it: : This draws an income line across the world and everyone under it is poor and everyone above it is not poor. There are different lines; the most popular being the “extreme poverty” line which is $1.90 / day adjusted for purchasing power parity. Which basically means let’s keep things apples to apples, not apples to moons. Pros and cons here and you can think about that all day. Absolute Poverty : This arranges people within a certain population according to income, and those that fall in the bottom tranche are considered poor. A good way of understanding this is that while there is no absolute extreme poverty in the U.S., there’s a ton of relative poverty. Relative poverty will almost always exist. Absolute poverty doesn’t need to. Relative Poverty : This is my preferred definition. It is based on the tenet that poverty is more than just a lack of money — it is a lack of access to healthcare, education and a decent standard of living. It just falls short of including dignity, but dignity is something even the Gods won’t be able to quantify. Intuitively, this increases the total number of poor because it increases that base standard we aspire to for humanity. Multidimensional Poverty : If you’re poor, you’re probably hungry. So, sometimes, looking at the hunger index is also a good way of gauging pain. Sounds morbid, but it is easier to quantify. Hunger absolutely And these definitions are just skimming the surface of the ocean that is measuring injustice. There are also recall methods, survey nuances, time-sensitivity issues, and other permutations that give data-abusers enough ammo to craft any story that fits their narrative. I’m going to avoid doing that. Okay enough jargon, so how many people in India are poor then? You guessed right; there are many different estimates for this as well. But I promise I’ll end this section with somewhat of a reasonable number for us to anchor to. Meanwhile, here is a bunch of poverty estimates for India that you’ll see flying around in the public: Image by Author, Sources: , , 2012 Extreme Poverty 2020 Extreme Poverty Multidimensional Poverty It’s important to consider what the numbers were during the survey year because that’s when the data is the cleanest. Estimates based off that add more assumptions to an assumption-laden world, which only contaminates the truth. For instance, I don’t fully believe ’s assumption that India has only 40 million extremely poor people right now. Either way, I don’t think looking at extreme poverty is the best way of looking at specific country's poverty — it’s singular, and poverty is not singular. So, let’s drop that and progress. World Poverty Clock on the other hand, is hands-down the best way to look at poverty based on what’s out there. It was developed by Oxford University in 2010 so there’s some credibility for you. This metric is hard to calculate but not impossible. Enter UNDP. They have been nice enough to calculate and aggregate this for us. Multidimensional poverty Ahh, I’m finally getting to the point. In India, in 2017, 28% or 374 million were multidimensionally poor. I did my own math from an incredible from 2012 using a similar thought process, and my estimate was ~34% for back then. human development dataset So, taking all that into consideration, and the fact that India has been growing economically (at least pre-COVID), I think it is fair to assume that today, India has a multidimensional poverty rate of 20%-25%. Extrapolating that to current population estimates (2020), that’s somewhere between 274 million and 342 million people. To make it a little easier, let’s settle for a number somewhere in the middle which conveniently comes to 300 million people that makes up ~22% of India’s population. There, as I promised, a reasonable number we can anchor ourselves to. Fine, so who are the poor? It’s now time to get to the meat of things. If you’re familiar with the social impact space, none of the above should have been bombastically revealing. The following though? Maybe. The question that was grappling my mind (and my heart) is who exactly are the poor? And not just from a meta, philosophical perspective, but from an actionable, data-driven perspective. Farmers, construction workers, waste-pickers, — that’s what comes to mind right off the bat, but how many of them? By how much? Who else? From what perspective are they poor — health, education, income? And what about security guards and and ? Are they poor? Not all of them, obviously, but how many? Dalits dhobis coolies So yes, if work is the center of sustenance of life, I was curious what type of workers comprised the landscape of the poor in India. I happened upon an incredible human development from 2012 that had data at an individual and a household level for over 40,000 households and over 200,000 individuals. It was representative and has been used by many impact strongholds including the International Labour Organization as recently as . Credibility. survey 2018 I isolated the 50,000 individuals who were mostly working, cleaned up some of the occupation data, mapped it, calculated a reasonable version of multidimensional poverty based on the data that was available, and voila! Here is how I answered those grappling questions of the head (and the heart). Image by Author, Based on 2012 (IHDS) India Human Development Survey No surprises here. Low skilled factory workers come third at 3%, which is substantially lower. The rest are 2% or less. The small revelation for me was the tobacco product makers ( -makers) at 2.2% or almost 2 million. ~79% of all poor workers in India (62 million) work either in agriculture or construction. beedi They earn the lowest on average and almost a third of all of them are multidimensionally poor. Interesting cognitive dissonance here: tobacco is bad for you but what happens to the millions of people who make a (poor) living out of making tobacco products? Image by Author, Based on 2012 (IHDS) India Human Development Survey We now know that most of the poor are farmers and construction workers. But they also constitute the largest proportion of all workers in general. So what percentage of farmers, and construction workers and drivers are poor? Image by Author, Based on 2012 (IHDS) India Human Development Survey And remember, these folks are not just poor from an economic perspective, they are also less educated and much more at risk with their health. Almost a third of all agricultural workers are poor. Construction workers are also above the average, and so are tobacco product makers, household help and stone cutters. One final bit before I get all personal with you. Inspired by UNDP’s (HDI), I created a morphed / modified version of it for the various types of workers of India. Why ? Well because I was limited by the information available by worker in the data set I was using. Enough excuses, enough disclaimers, it is still helpful, albeit not telling us anything spectacularly new. Human Development Index morphed Image by Author, Based on 2012 (IHDS) India Human Development Survey Similar story — farmers, tobacco makers, construction workers, maids and stone cutters live a disdainful life. One of the morphs I sizzled into this modified HDI was the inclusion of a social status index. This is a tad bit controversial and it’s pretty sad that I even have to include something like this, but in India, it’s just not advantageous being born into a lower caste or a marginalized minority. Adding that dimension into the mix pulls the occupation group of sweepers lower down. Most sweepers and sanitation workers (~60%) are (low caste folks). Most stone cutters are also and many are (protected tribes). This shouldn’t make a difference, but it does, and not for the right reasons. dalits dalits adivasis Where I’m coming from around all this I have been on a nervy adventure of starting a social enterprise focused on multidimensional poverty here in India. And I have been fortunate to have the resources to really understand the space and be as research-driven as I can. Hence this poor little post. To be honest, I have written this more for myself than for anyone else. There is this crystallization of thought that occurs when you formally pen something down. So if I was to follow my own research, it’s pretty clear. Focus on farmers. And if I want an urban life, focus on construction workers. Those are the biggest pieces of the poverty pie and they need the most amount of attention. But that’s not what has been on my mind. I have been drawn to the waste management space (specifically solid waste) in India for a couple of reasons. One because it employs some of the poorest— waste pickers, scavengers, rag pickers. And two because there is value in waste than can not only fuel financial sustainability, but also make mother earth better. With regards to the first reason, there isn’t a whole lot of data available that isolates the poorest in the waste management space. Case in point: the data set I am using in this analysis. Out of the 50,000+ entries, I found maybe ten or twelve entries that had their job description as “waste picker” or a Hindi-equivalent. Some were grouped under agriculture, some under construction, some under coolies, some under sweepers, but to cut a long story short, this is not a category that’s looked at closely from a macro research perspective. There is probably some overlap with the “sweepers” category and there might be some noise is the “sanitation workers” category, but it is not explicit. And that matters because being a municipal sanitation worker versus a rag picker is significantly different. Here’s an excerpt from Assa Doran and Robin Jeffrey’s excellent book, that throws light on this darkness Waste Of A Nation : On the frontline of rubbish recovery are the people who collect waste. Scavengers, waste-pickers, ragpickers — by whatever name they are called, they carry a burden of poverty and prejudice. They are commonly regarded as dirty people, dislocated migrants, indifferent to basic hygiene. Their scavenging of open dumps is taken as an affront to social order and urban sanitation. And the fact that they work in places that were once regarded as no one’s land, or the commons, but now are often claimed by the state or private owners makes them ready targets for police harassment. Little is mentioned about the effects of their work in reducing the amount of rubbish destined for landfills. The most vulnerable scavengers work in grim conditions on mountainous landfills, such as Deonar in Mumbai, Okhla in Delhi, Dhapa in Kolkata, Kodungaiyur in Chennai, and less prominent dumps like Belgachia at Howrah in West Bengal. Estimates put scavengers’ life expectancy at thirty-nine years . In their search for defecation space and salvageable materials, adults and children have learned to tread lightly. At Deonar “there are cracks and crevasses” that can trip, and even swallow, waste-pickers, Doron was told when he visited the smoldering mountain, “and kids inhale the toxic fumes” spewed by the mountain. In 2017, a landslide at another site, East Delhi’s giant Ghazipur dump, killed two people. The usual competition on open dumpsites comes from rats, dogs, pigs, monkeys, and birds — all thriving on mixed rubbish. For ragpickers, sporadic fires generate an acrid haze that makes breathing difficult and presents the greatest health risk. Waste workers register high levels of tuberculosis. Doron, Assa. Waste of a Nation (pp. 211–212). Harvard University Press. Kindle Edition. Also, Kaveri Gill wrote an on poverty and waste-pickers based on her research in Delhi. It’s a little dated (2007–10), but she does have estimates for amounts they earn. When adjusted for inflation, waste-pickers make about 30% than urban construction workers and low-skilled factory workers. entire book less High-level estimates peg the the number of waste pickers in urban India between . Another excerpt from Doran and Jeffrey on how elusive a real number really is: 3 and 5 million “The census does not have an occupational category for ragpickers or waste-pickers. In New Delhi, a common estimate was that between 200,000 and 350,000 people worked as waste-pickers in an urban area of 16 million people in 2011. Rough calculations suggest that India’s 53 cities with populations of more than 1 million support close to 2 million waste-pickers, and its 465 cities with populations between 100,000 and a million sustain a further 1.5 million. At that rate, urban India in 2011 had at least 3.5 million people handling waste every day, and these calculations do not include the manual scavengers who clean the dry latrines described in Chapter 3.” Doron, Assa. Waste of a Nation (p. 189). Harvard University Press. Kindle Edition. For the record, there are about 2.5 million “manual scavengers” who jump into sewers and cesspits, and I am not even looking to focus on them for now. How do you quantify this sort of poverty? Of a group that barely gets isolated from a research perspective. Of a group whose life expectancy seems so absurdly low that it’s hard to believe. Of a group that competes with rats, dogs, pigs, monkeys and birds. Of a group comprising low caste folks and stigmatized minorities that either way get treated like shit. What statistical weight do I put on what factors to spit out an index that quantifies inhumanity? Look, this does not mean that being a poor farmer or a poor construction worker or a poor tobacco product maker isn’t as bad. Those lives need uplifting as well, and in some dimensions, even more than waste-pickers. For instance, urban tobacco product makers earn almost half of what urban waste-pickers earn. And when it comes to poor farmers and poor construction workers, we have already seen that in absolutes, they encompass countries worth of people. But where do waste-pickers lie in a world where even holistic data evades them? Even if there was, it’s not just as simple as what the data says. There are other philosophical factors at play here that are almost impossible to program in while contemplating starting a social enterprise. Such as the importance of a viable starting point, the future of work, the probability of success (where the metric is the # of people lifted out of multidimensional poverty) and the scalability potential of a model with high, untapped intrinsic value. Each of these factors could probably do with a novel worth of explanations, but I’ll spare you the additional dramatic justifications, at least for now. Or maybe I am overthinking it. Rationalizing my gut in true Haidt-ian fashion. Maybe it is as simple as what the data says and I just focus on farmers and construction workers and tobacco product makers? This back and forth isn’t startlingly novel, so it’s not like Jesus has returned and I need to reevaluate everything. It has all been hovering around for a while. The only difference now is that it is time to make a decision. A note on the sources for this post: The base for the majority of this analysis is the micro-data of the I ndia Human Development Survey : Desai, Sonalde, Reeve Vanneman and National Council of Applied Economic Research, New Delhi. India Human Development Survey-II (IHDS-II), 2011–12. ICPSR36151-v2. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2015–07–31. http://doi.org/10.3886/ICPSR36151.v2 I created and cleaned some of the data to make it more sensible. I have cited sources for all one-off data where I have used them. Any questions / concerns, please do not hesitate to reach out. Am a believer in full transparency.

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