May 6 2015 - Maine Legislature: Fill & Download for Free

'Is there any relationship between the opioid addiction epidemic among working/middle class Americans, and the uneven gains from the economic recovery following the 2008-09 financial crisis?'.If the 2008-2009 financial crisis and its continuing fallout triggered and/or exacerbated the ongoing US opioid addiction crisis, a striking increase in opioid overdose deaths post-2008 would be expected. However, epidemiological data does not support such a premise. This answers summarizesData showing steady year-on-year increase in opioid overdose deaths from 1999 till date, overdose death rates varying widely from state to state, disproportionately affecting whites, and increasing in tandem as opioid prescribing rates rose from 1999-2010, deaths that the CDC already noted with alarm in 2006-07.How starting in the 1990s aggressive opioid marketing and lobbying gestated the roots of the ongoing opioid epidemic by changing how the US medical system treats pain.Steady Year-on-Year Increase In Opioid Overdose Deaths From 1999 Till DateOpioids prescribed in the US peaked in 2010, decreasing steadily since then (see below from 1) though they're still much higher than in the rest of the world.'CDC analyzed retail prescription data from QuintilesIMS to assess opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015. ..The amount of opioids prescribed in the United States peaked at 782 morphine milligram equivalents (MME) per capita in 2010 and then decreased to 640 MME per capita in 2015.’Drug overdose deaths have steadily increased since 1999, doubling already by 2006 in 45 to 54 year olds (see second figure below from 2).Drug overdose deaths vary widely from state to state, with states with rather different economic profiles such as West Virginia, New Hampshire, Ohio, Rhode Island, Pennsylvania, Massachusetts, Connecticut, Maine and Maryland experiencing substantial increases from 2010 to 2015 (see below from 3).Overdose deaths disproportionately affect whites (see below from 2) though overall, black males continue to have the lowest life expectancy (see below from 4).Opioid prescribing rates steadily increased 1999-2010 with overdose deaths rising in tandem (see below from 5).Already in 2006-7, CDC reported alarming increases in opioid-induced overdose deaths (see below from 6).Aggressive Opioid Marketing in the 1990s Changed How The US Medical System Treats PainA little known drugmaker best known in the 1980s for the painkiller MS Contin, Purdue Pharma morphed into a multi-billion dollar behemoth on the back of OxyContin, its 1990s upgrade, whose unprecedented marketing vaulted the Sackler family, owners of Purdue Pharma, into the ranks of the wealthiest Americans today.Well worth the reading, Mike Mariani at the Pacific Standard (7) and Patrick Radden Keefe at the New Yorker (8) methodically and comprehensively unravel the process Purdue Pharma used to relentlessly lobby all manner of doctors from general practitioners to pain physicians alike to expand opioid prescription to those with all manner of chronic pain. US doctors in the incalculably innocent pre-OxyContin era tended to view opioids as 'dangerously addictive', limiting their use to those terminally ill, usually terminal cancer patients.Mariani and Keefe recount how sheer money muscle was used to overturn this restriction in use of prescription opioids to instead render them acceptable to treat an expanding list of pain-related conditions.In practical terms, this meant serious boots on the ground in the form of intense lobbying by the likes of the now-defunct American Pain Foundation (9), and thousands of highly paid and hence extremely motivated sales reps to relentlessly push all manner of doctors to start applying the fifth Vital signs - Wikipedia during their routine examination of patients to elicit information about their pain levels and then palliatively treat them with powerful prescription opioids (10, 11), all while repeatedly assuring them opioids weren't addictive (see below from 12, emphasis mine).'Abbott’s relationship with Purdue and its part in building the OxyContin brand are detailed in previously secret court filings unsealed by a Welch, http://W.Va., state court judge at the request of STAT. The records were part of a case brought by the state of West Virginia against Purdue and Abbott that alleged they inappropriately marketed the drug, causing users to become addicted to the opioid. The case was settled in 2004 when Purdue agreed to pay $10 million to the state. Neither company admitted any wrongdoing.The documents include internal Abbott and Purdue memos, as well as sales documents and marketing materials. They show that Abbott sales reps were instructed to downplay the threat of addiction with OxyContin and make other claims to doctors that had no scientific basis. The sales reps from the two companies closely coordinated their efforts, met regularly to strategize, and shared marketing materials.'Opioid prescribing inducements included direct payments to doctors as well. One 2017 study estimated as many as 1 in 12 US physicians and ~1 in 5 family doctors accepted payments related to opioids during the course of the 29-month study (August 2013-December 2015) (13).Such change in prescribing was based not on carefully conducted scientific studies but one mediated by relentless lobbying and marketing, and came into place within the span of a decade from the mid-1990s to the mid-2000s so much so that in 2012, 13 states had more opioid prescriptions than even people (see below from 14, 15). Clearly, change in prescribing (demand) went hand in glove with carpeting of the entire country with a surfeit of opioids (supply).Investigative reporting suggests regulator-opioid maker revolving door also helped grease the wheels.A Los Angeles Times report by Harriet Ryan, Lisa Girion, Scott Glover (16) uncovers how Dr. Curtis Wright, the FDA bureaucrat who led its medical review of Purdue Pharma's OxyContin application in 1995 left the FDA shortly after it approved it and within 2 years began working for Purdue.A piece in the Milwaukee Journal Sentinel by John Fauber suggests (see below from 17, emphasis mine) beefing up pain advisory councils with opioid maker-friendly voices also helped smooth the way in expanding usage of opioids in pain treatment,'Federal health industry regulators and executives of companies that make pain drugs have held private meetings at expensive hotels at least once a year since 2002 through an organization funded by the drug companies, according to emails obtained through public records requests and provided to the Journal Sentinel/MedPage Today.Each year a handful of drug companies have paid up to $35,000 each to send a representative to meetings of IMMPACT, where they could discuss clinical trial testing procedures with officials from the U.S. Food and Drug Administration and other government agencies. IMMPACT's stated goal is to improve the design of clinical trials conducted to develop new pain treatments.’Such meetings appear to have favored opioid makers even as recently as 2013 (see below from 18, emphasis mine).'The Food and Drug Administration is under enormous pressure to change its mind about a powerful new prescription painkiller. Forty-two public health groups are urging the FDA to withdraw its support of Zohydro. The drug is similar to Oxycontin, except it comes in significantly higher doses. The FDA approved Zohydro last year, despite its own advisory panel voting against it. And critics are, among other things, raising questions about that approval process.’As late in the US opioid crisis as January 2016, a federal government pain advisory panel of 18 had at least 5 with financial ties to opioid makers, connections that came to light (see below from 19),'...after the committee last month bashed a federal plan to recommend doctors scale back on prescribing painkillers for chronic pain. The guidelines by the Centers for Disease Control and Prevention are intended to curb deadly overdoses tied to powerful but highly-addictive opioid drugs, including Percocet and Vicodin.'The Center for Public Integrity - Wikipedia also uncovered evidence of opioid maker lobbying of Congress and state legislatures (20), efforts estimated by Mother Jones to be 8X that of the gun lobby and 200X that of those advocating stricter opioid prescription rules (21).Raw numbers reflect the spectacular success of such unprecedented marketing and lobbying. In 1996, annual OxyContin sales were $48 million. For OxyContin's inaugural marketing alone, Purdue doubled its sales force to 600 and spent $207 million, so much so that already by 2000, OxyContin sales grew 23-fold to ~$1.1 billion (22).Already by 2001, OxyContin had become the most frequently prescribed brand name opioid for treating moderate to severe pain in the US, with so much overprescribing that the US GAO issued a 58-page report warning about it all the way back in December 2003 (23).In recent years, other opioid makers such as Insys Therapeutics Inc. (24) and Mallinckrodt Pharmaceuticals (25) have also come under the public spotlight for their aggressive sales practices, tactics that also applied to antidote makers such as Reckitt Benckiser (26).Like a burst dam, such intense marketing and lobbying ended up transforming how US doctors treat pain, replacing wholesale old true and tried methods that erred on the side of caution to an approach where it suddenly became acceptable to treat any and all pain with extremely powerful opioids (1, 5, 27, 28), a change that a 2016 study (29) suggests had US family doctors and general practitioners at the forefront.Could one seriously argue that from the years 1996 onwards, physical pain and/or existential angst increased so much among the US population as to justify such an increase in opioid sales and consumption? Obviously not. Instead, the US opioid epidemic is inextricably linked to an unprecedented medical culture change in how US doctors were carefully and relentlessly persuaded by opioid makers, their lobbyists and sales reps to treat all manner of pain, not just terminal, late stage cancer pain, with highly powerful opioids.Problem is so far opioid makers haven't been held accountable for their willful recklessness (slaps on the wrist in the form of relatively piddling monetary fines obviously don't count) even as they've saturated the US market. Rather, a report in the Los Angeles Times by by Harriet Ryan, Lisa Girion, Scott Glover suggests that as their profits in the US market start to dry up, their ongoing intense lobbying around the world may end up replicating the US opioid crisis in other countries as well (30). For governments, policy makers and regulators the world over, how to avoid 'globalization of the prescription opioid epidemic' (31) thus becomes a matter of urgency.Bibliography1. Guy, Gery P. "Vital signs: changes in opioid prescribing in the United States, 2006–2015." MMWR. Morbidity and mortality weekly report 66 (2017). https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6626a4.pdf2. Hedegaard, Holly, Margaret Warner, and Arialdi M. Miniño. "Drug overdose deaths in the United States, 1999-2015." NCHS data brief 273 (2017): 1-8. Welcome to CDC stacks3. Rudd, Rose A. "Increases in drug and opioid-involved overdose deaths—United States, 2010–2015." MMWR. Morbidity and mortality weekly report 65 (2016). https://www.cdc.gov/mmwr/volumes/65/wr/pdfs/mm655051e1.pdf4. https://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf5. Centers for Disease Control and Prevention (CDC. "Vital signs: overdoses of prescription opioid pain relievers---United States, 1999--2008." MMWR. Morbidity and mortality weekly report 60.43 (2011): 1487. https://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf6. CDC Publications7. Mike Mariani, February 23, 2015. Poison Pill8. New Yorker, Patrick Radden Keefe, October 30, 2017. The Family That Built an Empire of Pain9. Propublica, Charles Ornstein, Tracy Weber, December 23, 2011. The Champion of Painkillers — ProPublica10. Tompkins, D. Andrew, J. Greg Hobelmann, and Peggy Compton. "Providing chronic pain management in the “Fifth Vital Sign” Era: Historical and treatment perspectives on a modern-day medical dilemma." Drug and Alcohol Dependence 173 (2017): S11-S21. http://www.sciencedirect.com/science/article/pii/S0376871617300030/pdfft?md5=3f2ef3c4ddb2c940d6f48f623ef4cc45&pid=1-s2.0-S0376871617300030-main.pdf11. Harris, Matthew C., et al. "Prescription Opioids and Labor Market Pains." (2017). http://cber.haslam.utk.edu/staff/harris/Opioids_HKMG.pdf12. Stat News, David Armstrong, September 22, 2016. Secret trove reveals Abbott's bold 'crusade' to sell OxyContin13. Hadland, Scott E., Maxwell S. Krieger, and Brandon DL Marshall. "Industry Payments to Physicians for Opioid Products, 2013–2015." American journal of public health 107.9 (2017): 1493-1495. https://www.researchgate.net/profile/Brandon_Marshall/publication/319203662_Industry_Payments_to_Physicians_for_Opioid_Products_2013-2015/links/599acf44aca272e41d4089fa/Industry-Payments-to-Physicians-for-Opioid-Products-2013-2015.pdf14. Prescribing Data15. Protect patients from opioid overdose16. The Los Angeles Times, Harriet Ryan, Lisa Girion, Scott Glover, May 5, 2016. http://www.latimes.com/projects/oxycontin-part1/17. Milwaukee Journal Sentinel, John Fauber, October 6, 2013. Emails point to relationship between drug firms, regulators18. Critics Question FDA's Approval Of Zohydro19. Associated Press, Matthew Perrone, January 27, 2016. Federal pain panel rife with links to pharma companies20. Public Integrity, Liz Essley Whyte, Geoff Mulvhill, Ben Wieder, September 18, 2016. Politics of pain: Drugmakers fought state opioid limits amid crisis21. Mother Jones, Julia Lurie, September 21, 2016. Opioids are ravaging the country. These lobbyists want to keep the drugs flowing.22. Van Zee, Art. "The promotion and marketing of oxycontin: commercial triumph, public health tragedy." American Journal of Public Health 99.2 (2009): 221-227. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/pdf/221.pdf23. https://www.gao.gov/new.items/d04110.pdf24. Founder and Owner of Pharmaceutical Company Insys Arrested and Charged with Racketeering25. This company’s drugs helped fuel Florida’s opioid crisis. But the government struggled to hold them accountable.26. Reckitt Benckiser sued by 35 US states for 'profiteering' from opioid treatment27. Boudreau, Denise, et al. "Trends in long‐term opioid therapy for chronic non‐cancer pain." Pharmacoepidemiology and drug safety 18.12 (2009): 1166-1175. 6 (2017). https://www.cdc.gov/mmwr/volumes/66/wr/pdfs/mm6626a4.pdf28. Schuchat, Anne, Debra Houry, and Gery P. Guy. "New data on opioid use and prescribing in the United States." Jama 318.5 (2017): 425-426. https://www.issup.net/files/2017-07/New%20Data%20on%20Opioid%20Use%20and%20Prescribing%20in%20the%20United%20States.pdf29. Chen, Jonathan H., et al. "Distribution of opioids by different types of medicare prescribers." JAMA internal medicine 176.2 (2016): 259-261. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2474400?version=meter%20at%20null&module=meter-Links&pgtype=article&contentId=&mediaId=&referrer=&priority=true&action=click&contentCollection=meter-links-click30. Los Angeles Times, Harriet Ryan, Lisa Girion, Scott Glover, December 16, 2016. http://www.latimes.com/projects/la-me-oxycontin-part3/31. Humphreys, Keith. "Avoiding globalisation of the prescription opioid epidemic." The Lancet 390.10093 (2017): 437-439.

NEW ELIGIBILITY CRITERIA:The government intends to raise the upper age limit and number of attempts of applicants of the UPSC Civil Service Examination with effect from 2015.According to information published on the website of the Department of Administrative Reforms and Public Grievances, the upper age limit will be 37 years for SC/ST candidates with unlimited number of attempts; 35 years for OBC with 9 attempts; and 32 for the unreserved (general) category with 6 attempts.For physically handicapped candidates age limit is 42, 45 and 47 years for General, OBC and SC/ST category respectively while the number of attempts is 9 for General and OBC and unlimited for SC/SC category.Eligibility Table:Category/Maximum age limit/Number of attempts:General/32/06OBC/35/09SC/ST/37/no barPhysically disabled(Blind, Deaf-mute, Orthopedic)/42/if general then 9 OBC then 9 SC/ST- then upto age limt.J&K domicile/gen 37,obc 40,sc/st 42,PH 50/Disabled serviceman discharged from duty/gen 35,obc 38,sc/st 40Ex-serviceman with five years duty* specific condition on page2 of notification/gen 37,obc 40,sc/st 42Academic Eligibility:The candidate must hold a degree of any of Universities incorporated by an Act of the Central or State Legislature in India or other educational institutions established by an Act of Parliament or declared to be deemed as a University Under Section-3 of the University Grants Commission Act, 1956, or possess an equivalent qualificationCandidates who have appeared or intend to appear for the qualifying examination and are awaiting results are also eligible to appear for the Preliminary Examination. All such candidates who qualify to appear for the Civil Services Main Examination must produce proof of having passed the said examination along with their application for the Main Examination.The UPSC may in exceptional cases treat a candidate without the foregoing requisite qualification as an eligible candidate if he / she has passed an examination conducted by other institutions, the standard of which justifies his / her admission in the opinion of the Commission.Candidates with professional and technical qualifications recognised by the Government as equivalent to professional and technical degrees.Candidates who have passed the final year of MBBS or any Medical Examination but are yet to complete the internship can also appear for the Main Examination. However they must submit along with their Main Examination application, a certificate from the concerned authority of the University / Institution that they have passed the final professional medical examination. At the Interview stage they must then produce a certificate from a competent authority that they have completed (including internship) all the requirements for the award of the Medical DegreeRESTRICTION FOR APPLYING FOR THE EXAMINATION:A candidate who is appointed to the Indian Administrative Service or the Indian Foreign Service on the results of an earlier examination and continues to be a member of that service will not be eligible to compete at this examination. In case such a candidate is appointed to the IAS/IFS after the Preliminary Examination of Civil Services Examination, 2015 is over and he/she continues to be a member of that service, he/she shall not be eligible to appear in the Civil Services (Main) Examination, 2015 notwithstanding his/her having qualified in the Preliminary Examination, 2015. Also provided that if such a candidate is appointed to IAS/IFS after the commencement of the Civil Services (Main) Examination, 2015 but before the result thereof and continues to be a member of that service, he/she shall not be considered for appointment to any service/post on the basis of the result of this examination viz. Civil Services Examination, 2015.Only for IAS and IPS a candidate should be citizen of India.thank you.

I often don’t understand why BJP is too much obsessed with this ONE NATION concept.They are yet to understand, India is a FEDERAL Country and Union of States. It's not a UNITARY NATION.Well, I am not against the basic reason for One-Nation, One Election. The basic highlighted reason is cost savings. Its a fact, elections became a very costly affair. As per estimates, the last elections cost approx 50K crore, which is almost half of the estimated cost for a Bullet train covering around 500 Kms. Which means, for that amount, we could construct a Bullet train for 250 Kms (Chennai-Bangalore) or around 50 Kms of underground Metro rail in a densely populated city. But again we need to understand, this amount is for preserving DEMOCRACY and there are many areas where the government can make savings. For example, Modi govt just in 5 years spent more than 5000 crores for Prime Minister’s personality publicity. Perhaps controlling these costs would be more appropriate than celebrating democracy.Apart from the cost, multiple impositions of the Moral Code of conduct across various states in various periods of time, factors in for such suggestion.While these two Pros are often highlighted by the majority of Right Wingers in Quora, they fail to address issues specific at the state level.The Indian Republic may be a nation, but India is too diverse for ONE NATION concept. We cannot work like the UK or France or Japan. We need to work in Federal Fashion, not unitary fashion. After all, India cannot be controlled just from New Delhi alone…Just to understand the perspective, the very first elections to the newly formed Republic of India started on 25 October 1951 to 21 February 1952. Elections were simultaneously held for Lok Sabha and State legislatures.So on Feb 1952, Congress won a brute majority in both Lok Sabha and almost all states and they formed a govt.In Kerala (that time, it was known as State of Travancore-Cochin or Thirukochi as in Malayalam) had a strange situation. Congress was short of 11 seats to reach majority mark and thus India’s first coalition govt formed with a post-poll alliance with Tamilnad Congress (8 MLAs), KSP (1 MLA) and 1 Independent. Then Congress managed to form a govt and using the support of a nominated member, they managed to reach the majority mark.1952 Travancore-Cochin Legislative Assembly election - WikipediaAnd the coalition issues started from day 1 and within 2 years, KSP broke into two and 4 MLAs resigned, thus the government became a minority and collapsed.Remember, I am talking about 1952–1957 period which was the most stable period across India as Congress had a brute majority in almost all the states and centre. But in one single state, Election Commission of India had to call a second election as early as 1954.Again another election came up in 1954 and this time again Congress fell short of seats in Travancore-Cochin Assembly. To avoid any issue of collapse, Congress which had 45 seats out of 117 seats (short of 13 seats) offered Chief Ministership to PSP party which had 19 MLAs, a predecessor model of today’s Karnataka Model. Again within a year, issues popped out in Kerala unit of INC due to problems with PSP, but High Command of INC effectively managed it, though the assembly had to be terminated in 1956 due to the formation of Kerala State and fresh elections were called in 1957.1954 Travancore-Cochin Legislative Assembly election - WikipediaSo just in the first term of India’s first Lok Sabha (1952–1957), 3 state elections were conducted just for Kerala state alone.I am talking just about one single state of India which historically didn’t have much of Aya Ram-Gaya Ram concept (deflections) due to stronger ideological politics in play. States like Haryana saw its government collapsing in the first year of its state formation and elections calling in gap of one and two years. In first one decade of Haryana state, 4 elections happened (primarily due to the deflections from which the Aya Ram Gaya Ram expression got generated)Then how we managed to keep ONE NATION-ONE ELECTION for an entire country like India?We don’t need to travel way back in the 1950s or 60s to understand the gravity of the problem. In the last 5 years (2013–2018), the national capital of Delhi saw 2 elections, 2013 and 2015. Why did that happen?Indian democracy is fully based on WESTMINISTER MODEL where the executive is linked with the parliamentary majority. Its so hard to maintain a fixed term for parliament/legislature, especially when it celebrates diversity. And for a nation like India, diversity is the KEY.There are more 2416 parties in India who contest elections for various levels of governance apart from Independents.So its too hard to decide the priorities and aspirations of political representatives of such huge diverse political background in parliament/legislature.Any moment, a coalition government could happen and it can come down.Saying so, the primary suggestion of the government is to FIX a term for parliament.Well, this same method, the UK has done in 2010. Like India, the United Kingdom was too concerned with regular collapse/early demise of parliament and frequent elections. So they brought new legislation- Fixed Terms of the Parliament Act 2011 which restricted the power of HM The Queen to dissolve the parliament and call for new elections before the natural termFixed-term Parliaments Act 2011And the current Parliamentary Mess in the UK due to Brexit can be defined as the first major manifestation of the problems caused by this act. It has created a situation in the UK, where no in the ruling party knows what to do and people of UK denied a chance to express their will in the matter as the next public election is fixed on 2022. If there was no FTP act in the UK, the govt would have fallen down when they lost a Confidence vote in Parliament a few weeks back and the public of the UK will decide what they wish on it by now.Why wait? Why not just suspend parliament permanently now?Brexit Betrayal: The UK in Another Fine Mess - Liberty Nationhttps://www.washingtonpost.com/opinions/at-least-theresa-may-tried-to-fix-britains-mess-how-many-other-politicians-there-can-say-the-same/2019/05/24/99b78642-7e4a-11e9-8ede-f4abf521ef17_story.html?noredirect=on&utm_term=.df0628af384fDo you want INDIA to be in such Parliamentary mess?Infact, the UK which is facing such a huge unprecedented Parliamentary mess just with 2 Major parties and 7 minor parties. Take the Indian Parliament context, we would have to deal with 58+ parties. It won’t be just a mess, rather it would STINK to the core.On top of that, the UK is a unitary nation. There is only ONE PARLIAMENT for the entire UK (with a minor parliament for Scotland) and no concept of regional governments. India, on the other hand, is a federal country with 29 state legislatures, so if FTP act kind of legislation comes to India, it would mess up not just Indian Parliament, but entire states of India.I have seen many solutions and opinions on this topic in Quora. Probably in course of time, more solutions may be raised. But the current solutions don’t work much. The most commonly heard solution as Prime Minister suggested is typical of FTP Act of UK which pushed the UK into such mess. So it won’t work for a country like India.So as other most heard solution is placing Presidential Rule for the remainder of the period if the state legislature falls down. Definitely, its an indirect way for Central Govt to rule a state and against the basic principle of democracy. It may work for States, but what about Center? Will President of India rule directly for the remainder of the term, if central govt falls down?BJP is making this proposal primarily because they wish for a Presidential style election in the country and instead of making India into a presidential republic, they are trying for a slow tuning.I personally don’t object PRESIDENTIAL REPUBLIC CONCEPT and I believe for a country like India, the Presidential Republic is better than current Parliamentary governance. Parliamentary governance works in more unitary nations like the UK etc, too hard for a diverse nation like India. The reason why we had so much horse trading in past, was only because of such huge diversity.But I definitely don’t support injecting Presidential System methods into Parliamentary Methods. It's like dropping Oil into Water. Won’t mix at all. The current proposal is one such act.I find this sort of mechanism as a danger because it would jeopardize all the checks and balances in both Parliamentary and Presidential methods.In Parliamentary method, if the govt can’t move ahead, then the people get a right to make a choice thro’ fresh elections by dissolving the house. That's the classic method of a Check and Balance.In the Presidential system, the president is not all powerful. His executive orders can be vetoed by the parliament which may or may not fully linked to President’s political affiliations. So as in countries like the US, they placed their Parliamentary elections exactly in the mid-term of the Presidential Tenure, so as the public gets a chance to vote for the opposite party of the president if they dislike/disapprove President’s policies. It has happened in the US now as in 2018 Congressional elections, Democrats won the majority which now acts as a perfect check and balance to Republican’s President- Donald Trump. Due to this arrangement, the President would require to compromise a lot for consensus in Parliament which is a case of Check and Balance.What Modi is pushing is a method WITHOUT any check and balance. He cherry picks some elements of the Presidential system and place in Parliamentary system thereby losing the checks and balances in both the systems. It would only allow more authoritative governments. Even a minority govt or a coalition govt can become so powerful as they need not fear the public for five years. It also makes Govt of India too authoritative, as they too don’t require to fear public for 5 years.Just understand, the powerful BJP which had a majority in the National house and regularly winning most of the states in 2014 and 2015 election, suddenly got a speed breaker in form of Delhi Elections and later Bihar elections. It forced them to alter their strategy a bit. So as in 2018, they got more shock when they lost 3 major states, so as they drew a lot of new plans and schemes in the 2019 Budget to woo the voter's back. If such fear or in-between shock treatments doesn’t exist, things would be too radical for any govt in power.My suggestionsMake India fully into Presidential Republic similar to US style. In such a case, there will be more stable as Legislatures / Parliaments are NOT LINKED with Governments directly. Still, there will be mid-term elections and multiple state elections as we see in the US. But one can fix permanent dates for Presidential /Governor elections as well as legislative elections due to the stability.Adopt Bangladesh Model, if continuing with Parliamentary form. In the event, a Legislature or Parliament fails and the govt collapses, let the remainder of the term be governed by a Care-taker govt (CTG) drawn from members of all the political parties in the state/country. Bangladesh has a form of it but restricted to be Non-Political in nature and has no formal authority over policymaking. But what I suggest is a form of political Care-taker government. India has experience in this format as we had a CTG in power from 1947–1951. Despite having the absolutely mammoth majority in elections of 1946, Congress didn’t form a Congress only govt after 1947. Rather they asked every single party to send a representative to be part of a caretaker government untill the first election will happen. So there was Nehru as Prime Minister, Baldev Singh from Pathan Party as Defence Minister, Shyama Prasad Mukherjee from RSS/BJS (predecessor of BJP) as Industries Minister, BR Ambedkar from Republican Party as Law Minister etc and few members to represent communities without parties. In such cases, there will be stability and can conduct elections in pre-fixed dates. But definitely, there will be issues in the cabinet due to people from multiple ideologies forming part of the govt.Introduce Proportionate Representation in Parliament/Legislature. One key reason why horse trading and similar happen in Indian Parliament/Legislatures is because of the importance of MP/MLAs. Once elected, they cease to people’s representative, rather more of party representatives. What I suggest is placing half of the strength of assembly in the current method of the first-the-past-the-post method, by fixing the same number of seats for all states. Say let both UP and Kerala will have 15 Parliamentary seats, irrespective of its population (very smaller states, say like Goa or Tripura can be limited to 5 seats). In this way, we can restrict total seats of Lok Sabha less than 400 and have an additional 400 seats allotted to parties based on the total proportionate vote for each party. This means there would be a larger diversity of MPs/MLAs in a house and often it won’t result in any party gaining a huge/absolute majority. What happens when parties don’t get an absolute majority. A sort of permanent alliance system comes up and parties learn to fix permanent partnership which doesn’t simply fall down over-night. Germany is one classic example where permanent coalition systems came up, thus assuring stable governments. Back in India, Kerala has a similar concept, which helped stability for the last 30 years (primarily due to fixed fractured electorate).All the above suggestions are long term in nature and cannot be implemented overnight. They all have their own cons too.In short term basis, what I believe could be done isTry streamlining all elections due for a year together by giving authority to Election Commission to have a right to Plus/Minus the tenure of existing government to a maximum period of 6 months. Imagine, if such authority exists, the 3 state elections held in Dec 2018 could have been shifted along with National elections of April-May 2019. So as this year, few elections are coming up, like Haryana, Jharkhand, J&K, Maharashtra etc in mid and end of 2019 which could have been prepended along with National elections.Make two election seasons just like how universities have two admissions/academic seasons in many countries. August-Sept period and Jan-Feb as Election months per year, so as to put all elections (main, local, state, national and byelections together)Making any sort of deflections, including a mass deflections (2/3rd majority) illegal. If to deflect, one must resign completely. Byelections to be conducted together for all states according to the nearest election season.If after byelections, the govt fails or falls down, an All Party CTG govt must come up and state/national elections must be conducted to nearest upcoming election season.Multiple phase election spanning over 2 months etc MUST GO… State elections must be conducted either in single phase or maximum 2 phase. The election period must be reduced to less than 40 days max.Instead of transporting EVMs and voting machines from one place to others, we should have permanent Election Stations and fixed EVMS. Probably election commission can construct such election stations within police-stations or court complexes or similar higher secured zones along with a permanent cadre of election officials rather drawn from state services.I guess, this can be done within current framework and doesn’t affect the current format in a big way.I personally don’t see much priority for One election. I strongly believe multiple elections help our governments to have a fear factor as their performances would be constantly reviewed.There are many more priorities for India like fixing Healthcare so as to save our future generation from mass deaths or education or literacy or similar more than elections etc.Even within elections, there are more pending issues like the case of electoral bonds or similar which needs more public attention than minor issues like the common election.Perhaps the biggest priority would be overhauling the Election Commission of India from a bureaucratic organization nominated by Govt of India (the incumbent political party) to a more accountable public expertise organization, much on lines of the judiciary etc. I believe, the post of Chief Election Commissioner post must be decided by 2/3rd votes of Indian legislatures and Joint Houses of Indian Parliament.These require more priority more than topic of common elections unless Governments in power is in ELECTION MODE forgetting their primary responsibility of GOVERNANCE MODE.