Human Resources

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.

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