The question, always, is whether one is a human or a
resource. A resource is a thing but a person is not. Dealing with a
person is more expensive than dealing with a thing. In the interest
of controlling costs, therefore, organizations are always tempted to
treat most members as things rather than persons. This principle
applies to the public sector just as much as to the private sector.
Take for example the medical professionals of Cuba who
are sent overseas. The official explanation is that they are doing
humanitarian work and at the same time, they earn hard currency or
goods for their country. Yes, they do humanitarian work, but are they
themselves being treated humanely?
Credible reports say that they are
not. Take for example the Being Latino
article Cuban
Doctors. Is this Cuban practice equivalent to "modern-day
slavery?" Decide for yourself. The medical professionals have no
choice in the matter. They are not allowed to travel except by
government order. They are overseen by Cuban "minders," the
local police, or the local military, who use force to keep them in
their roles. They are paid ten percent or less of the money they earn
for their country. Regarding a recent deal with Venezuela, the
article says
"Effectively, Cuban people were exchanged for
oil."
Is a person just a fingernail on the body of society?
To be cut off and thrown away as needed? That seems to be the
attitude of Cuba toward its doctors and nurses.
Tosoc.org believes that persons should never be treated
as chattel. We believe that any economic "efficiencies"
gained by slavery would be more than offset by the inefficiency of
the "slave" attitude, or even the "serf"
attititude. Since slaves and serfs have no voice and no choice, they
will do the minimum necessary to avoid punishment. They can never
develop fully as inspired and energetic individuals. To tosoc.org,
setting up a system of stunted individuals is a gross failure of
leadership.
However, the example of Cuba simply illustrates the
common problem of universal healthcare systems. The basic problem is
how to set up a competitive healthcare marketplace in which resources
are available to all and affordable for all. The highly-tempting
alternative is to use force (like Cuba) to make healthcare workers
obey.
Tosoc.org has already touched on this issue in
The
Other Side of Healthcare, but we think the reason for the skewed
distribution of healthcare "resources" in the US is more
similar to the problem discussed in
Take
from the Poor. That is, in reality, resources tend to move from
poor areas to rich areas in our current system. That includes
healthcare professionals.
Basically, only a fraction of doctors are willing to
give up the income, lifestyle, and professional opportunities
available in the "big city" to practice in rural areas. The
rural lifestyle has to appeal very strongly to them and their
families to overcome all the other considerations. The actual
behavior of doctors in our system demonstrates that the advantages of
the rural lifestyle are not enough to attract an adequate supply of
physicians to rural areas.
Another issue is that physician training generally
takes place in an urban center with access to the best equipment and
support. Expecting physicians trained in this way to want to adjust
to rural medical limitations after finishing their training is not
reasonable.
Third, physicians as they are selected and trained
today are highly motivated and highly competitive. They are not
inclined to settle for positions they consider appropriate for
second- or third-rate physicians if they can avoid them. That is,
rural healthcare is for second-raters. Prison healthcare is for
third-raters.
Finally, each state enforces a single uniform
marketplace for healthcare education and licensing despite the fact
that the healthcare markets in any state are numerous and different
from one another. We are suspicious of any attempt to enforce extreme
uniformity, so we believe this is a problem for the healthcare
market.
This is where tosoc.org's advocacy of multiple markets
comes in. Training and and licensing of healthcare professionals
could be different for the different markets. For example, an
apprenticeship system might be more suitable for remote rural areas
than sending trainees to study for years in big cities. Forcing
trainees to adapt to the big city may ruin them for work "back
home." The big city has become their home.
Multiple exclusive currencies and markets would allow
healthcare professionals to do what they want to do, which is to make
as much money as they can with their efforts, rather than attempting
to make them do what they do not want to do via law and regulation.
Rather than trying to restrict their rates, let them compete in
separate markets that are suitable for each individual. It is dumping
them all in the same market with a single currency that causes the
problem. No amount of law and regulation can truly fix that.
That is why laws and regulations often fail. Laws and
regulations that fight human nature are as unrealistic as ordering
water to flow uphill. There will be limited success and ultimate
failure. It is better to go with the downhill flow, redirecting it
where possible.
Instead of hobbling the lives of healthcare
professionals by telling them where to go and how much they can
charge, let us set them free within a market that is suitable for
them. Let us tell them that they can earn as much as they are able
and that if they prove themselves, they can move "up" to a
more-competitive market with a different currency. If they cannot do
that, then they can only look to themselves for the reason. They will
not resent the government for its interference. In the tosoc.org
system, individuals will be encouraged to grow rather than
deliberately stunted like the slave doctors of Cuba. Support
tosoc.org.
The way capitalism
should be.
Socialism for the
socialists and capitalism for the capitalists.
TheOtherSideOfCapitalism
(admin@tosoc.org)
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© 2013 TheOtherSideOfCapitalism