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BEHIND THE SCENES

- The untold story of the Indian-American lobby

One of the best kept secrets of how the controversial nuclear deal between India and the United States of America was passed in the US Congress is the role played by Indian doctors and accountants in America. When Ronen Sen, then India’s ambassador in Washington, met nearly half of the US senators in their home states to persuade them to swing their support for the nuclear deal, he relied considerably on these sections of the Indian-American community.

The average age of the US Senate during the years of the nuclear-deal negotiations and the health condition of average Americans past middle age have made a large number of the senators very dependent on their doctors. This columnist has heard gossip — which may well be true — on Capitol Hill of some senators being closer to their doctors than to their wives.

Many of these doctors happen to be Americans who emigrated from India after getting their medical degrees back home. But this is not to suggest in any way that these doctors have misused their influential political connections across the US.

The high cost of fighting elections, political corruption, American ethics laws and fear of scandals involving financial impropriety have made public officials in the US at all levels — from the smallest counties to the Senate and the House of Representatives — critically dependant on chartered accountants, many of whom happen to be Indian as well. These accountants are often next to doctors in their influence on senators.

It was all done very quietly in the three years from 2005 after the nuclear deal was announced by President George W. Bush and Prime Minister Manmohan Singh, but New Delhi tapped heavily into this valuable human capital of influential Indian Americans to operationalize the nuclear deal before Bush went out of office.

In the months after Bush and Singh announced their landmark deal, informal polling of senators by the Indian embassy and their lobbyists revealed a depressing lack of enthusiasm on Capitol Hill for ending India’s nuclear winter. Between those senators who were actively opposed to the deal and those who were unenthusiastic about it or did not care — these included very prominent members of the Senate India Caucus — the Bush-Singh initiative was acutely short of majority support in the Senate.

All the stops were then pulled out in an effort to create a majority: the Bush administration put its best foot forward, important Democrats joined them but Indian doctors and accountants played a critical backroom role in that effort.

There were hints throughout the process of getting the deal done that Indian-American doctors were an important part of the process. For instance, when the deal was stalled for an extended period because of a veto by the Left parties in the United Progressive Alliance, Sen went to the annual convention of the American Association of Physicians of Indian Origin in Las Vegas in July 2008 to assure these doctors that the deal will be consummated.

“I would like to assure you that we will do our best to see that all the time, all the effort that you have put into this endeavour will not be in vain,” Sen told the AAPI convention, which is a celebration of Indian-American professional presence in the US year after year. But the real story of AAPI’s lobbying for India could only be read in those days between the lines such as the ones Sen delivered. It remained untold and unacknowledged for reasons of discretion.

Indeed, AAPI’s role in elevating Indian-American presence and influence in the US is itself a story that has not been narrated in its entirety. It is still the most influential organization of Indians in North America even though others, such as the Asian American Hotel Owners Association formed in 1994, much after AAPI, have caught up. Next month, AAPI will have an opportunity to showcase its work in India when it holds a global healthcare summit in Kochi.

Indian physicians in the US have been holding an annual Indo-US healthcare summit for several years now since cooperation in health matters became a part of the bilateral agenda between Washington and New Delhi. But last year, the minister for overseas Indian affairs, Vayalar Ravi, suggested to AAPI that it should expand the scope of this summit and make it a global event in 2013. Ravi’s ministry promised its full backing for the endeavour if it was held on the margins of the Pravasi Bharatiya Divas, the flagship annual gathering organized by his ministry.

AAPI accepted the challenge: the most significant outcome of the global healthcare summit from New Year’s Day to January 3, 2013 is likely to be a recommendation and an outline for creating an independent institution in healthcare quality and safety for accrediting hospitals in India. The outline for the proposed institution will be modelled on America’s Joint Commission on the Accreditation of Healthcare Organizations, which is acknowledged worldwide as a symbol of quality that reflects its standards for certifying healthcare organizations and programmes in the US.

The Kochi summit’s recommendation will be notwithstanding the Union government's decision 15 years ago to set up the Quality Council of India to create a national accreditation structure and promote quality in major areas of national activity. Girdhar Gyani, who did pioneering work in making this council a credible organization as its secretary-general, will be travelling to Kerala at the time of the summit, whose organizers will work with him in making their recommendations.

Narendra Kumar, AAPI’s chairman, believes that creating a strong, dedicated body in India like America’s JCAHO could act as an insurance against incidents such as the fire last year at the AMRI Hospital in Calcutta. Kumar said that inspections of hospitals in the US by the JCAHO keep medical personnel on their toes and healthcare systems up-to-date.

Some attention will be focused on medical education at the summit because T.P. Sreenivasan, executive vice-chairman of Kerala’s newly-created higher education council, will be leading one session of the programme. Kerala has recently set up a University of Health Sciences, which is mandated to affiliate institutions offering professional education in healthcare. For a state that sends out its doctors and nurses to far corners of the world, medical education is of great importance.

As part of a commitment by Indian-American physicians to “give what we can give back to our motherland,” the first ever healthcare CEO’s forum will be held as part of the summit with the aim of “advancing accessibility, affordability and the quality of world-class healthcare to Indians.” The CEO’s forum will bring together policymakers, hospital industry leaders and pharmaceutical companies on a common platform.

Kumar is a rare breed in the Indian-American community: because he got his basic medical degree from Kerala University and his post-graduate degree from Banaras Hindu University, he has tried to bridge the North-South divide that is a bane of non-resident Indian organizations worldwide. Yet, infighting reared its head last year even in AAPI, somewhat undercutting its leadership role as the most influential Indian-American organization in the US.

That role was underscored when Bill Clinton spoke at the annual convention of AAPI in Chicago in June 1995: Clinton became the first US president to attend a convention of an Indian-American organization.

AAPI hit the headlines when Clinton was introduced to America’s youngest doctor, an Indian-American, at the convention. “I was certainly humbled when young Dr (Balamurali) Ambati was introduced at 17 years old. Then it was whispered in my ear that his brother became a doctor at the ripe old age of 19...When I was elected Governor at 32, they said I was too young…When I was elected the third youngest President at the age of 46, they said I was too young. Where were you guys when I needed you?” Clinton asked young American doctors of Indian origin like Ambati.

Clinton discovered the potential influence of Indian-American money in US politics at that AAPI conclave. A few hours before the president’s arrival in Chicago, word of a fundraising hope was circulated by Clinton’s re-election team. Doctors at the convention immediately raised $125,000 and gave it to Clinton. But that is another story.