Health Care Professionals in Communist Countries: Happy or Not?

A young caring doctor

Meghan Harshaw, Period 3, Honorbound

If someone broke an arm, should he go to the doctor or to the president to seek help? Every person asked this question will automatically say that the doctor is the obvious answer. What most people do not know, however, is that the health care systems in communist countries are actually directly controlled by their governments. Doctors are not actually free to individually decide how to treat each patient. So then the new question is: is it really possible for medical professionals in communist countries to be truly happy?

Before investigating this question, it is necessary to define happiness. Aristotle defines happiness as the purpose of life, stating that “the good is the final end, and happiness is this [1].” Therefore, assuming Aristotle’s statement to be true and correct, each action a human takes should be furthering his closeness to happiness. In order to achieve this happiness, it then becomes necessary that humans fulfill their function. Aristotle also states that “the function of man is [to] exercise of his faculties with the best and most complete virtue [2].” Putting these two statements in the context of a medical professional, a doctor should then be allowed to be the best doctor he is able to be if he wants to be truly happy. In order to do this, he must have not only the proper training and experience, but also the freedom to make decisions for and about his patients. This aspect of freedom is the differing factor between health care systems in communist countries and free countries such as the United States.

Using the evidence provided by a capitalist philosopher, it is apparent that freedom in communist countries cannot exist at all. In Ludwig Von Mises’ Liberty and Property, Von Mises claims that “freedom is to be found only in the sphere in which the government does not interfere [3].” Applying this statement to various forms of government, a communist country such as Cuba would not be considered free in any aspect, while the United States would be considered free in terms of the exchange of goods and services. People in the United States are free to choose which products they would like to purchase, offered to them at various prices and brands. Contrastingly, people in Cuba are offered a single product for one set price. Because the government interferes with buying and selling of any product in Cuba, it would ultimately, according to Von Mises, lack freedom. So, again, is true happiness possible for someone who lives in a society which prevents them from fulfilling their ultimate function?

I am going to use the example of Cuba to continue answering the previous question. Cuba’s health care system, based on preventative medicine, is actually one of the most successful health care systems in the world. The country has a life expectancy of eighty-one years and a child mortality rate of 4.70 deaths per 1,000 births [4]. Medical professionals are highly trained, as the government also runs all educational institutions. However, the health care system is also fully operated by the government, meaning that each person can receive treatment in any hospital. There are no private hospitals and no private clinics, so doctors are hired and employed by the government directly [5].

Unlike Cuba, the United States health care system is not fully run by the government. Rather, it is operated by a large array of private businesses: some hospitals are non-profit, some are government run, and some are for profit.  Known for innovation, the United States focuses on curative medicinal practices as opposed to Cuba’s preventative practices [6]. Despite the United States’ wealth and success in general, the health care system is one of the worst in comparison to the rest of the world. The life expectancy is seventy-eight years and there is a child mortality rate of 6.17 deaths per 1,000 births [7]. These statistics are significantly lower than other first world countries, and especially Cuba. However, the freedom of decision making for medical professionals is much broader. Medical professionals are able to treat each patient differently according to his situation, and the decision is solely up to the patient and doctor. In Cuba, the decision would be up to the patient, the doctor, and the government—meaning it is not free.

I use the example of Cuba compared to the United States because of an experience that I know very well. My grandfather and his family, a long lineage of medical professionals, lived in Cuba for hundreds of years. When Fidel Castro took over the country and began to implement communism, my grandfather knew his freedom as a medical professional was threatened. As a doctor of internal medicine, he was working directly for the government. He had first hand experience with being told what procedures he could not perform, even if it meant not being able to save someone’s life. Unable to freely practice medicine for its ultimate purpose of helping people, he became unsatisfied with his monotonous job of simply taking orders from and obeying the government. For this reason, he took his family (including my mother) and escaped the communist country to reside in Illinois. Once in the United States, he pursued his medical degree and opened up his own private practice—something he never would have been able to do in Cuba.

I often wonder if my grandfather could have achieved his same level of happiness in Cuba as he did in the United States. He attributes part of his happiness to his family and to his faith, but most of his happiness comes from the success he has as a doctor saving people’s lives and fulfilling his duties as a medical professional. Using Aristotle’s words to discuss my grandfather’s happiness, he would be happy because he is living out his function and life purpose, exercising his abilities to the best of his ability. Ludwig Von Mises would add on that my grandfather’s freedom to do his job the way he believes he should is extremely important and is what pushes him to ultimate happiness. This leads me to believe that my grandfather is indeed happier here in the United States than he would have been back in Cuba.

The question still remains however, if this happiness resulting from freedom rings true for all medical professionals living in communist countries. Is it correct to assume that everyone in Cuba is less happy than people in the United States simply because they are denied the freedom of exchanging goods and services? The statistics show that the health care system in Cuba is actually stronger than the health care system in the United States, so it is also likely that Cuban doctors acclaim their happiness to the success of their system in general as opposed to their success as an individual. This is even more likely when considering Cuba as a collective culture rather than an individualistic society.

Yet, Ludwig Von Mises also states that “the standard of living [is] incomparably higher in the free countries of the West than in the communist East [8].” Through this statement, it is reasonable to assume that the freedom of living increases if the standard of living increases, due to the availability of more resources to encourage exploration of one’s purpose and ultimately achieve happiness. This would also then assume that people have more opportunities to be happy in free countries against communist countries.

In conclusion, if viewing the question through the eyes of Ludwig Von Mises, even if medical professionals in communist countries are unaware of what they could have in a free country, they cannot truly be happy because they do not have the freedom necessary to live out their proper function.  However, if viewing the question through the eyes of Aristotle, medical professionals in communist countries do have the ability to be happy because they are living according to their purpose, since it is to the best of their personal ability. Even if the definition of happiness and freedom remain constant, the answer to the question can have differing views.

____________________________________________

Works Cited

[1] Aristotle, “Book 1: Chapter 2.”  In The Nicomachean Ethics.  Bernardo Aparicio, 2015.

[2] Aristotle, “Book 1: Chapter 7.”  In The Nicomachean Ethics.  Bernardo Aparicio, 2015.

[3] Mises, Ludwig von, Liberty and Property. Bernardo Aparicio, 2015.

[4] “Life Expectancy and Infant Mortality Rate.” Central Intelligence Agency. 2014. Accessed May 3, 2015. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html.

[5] Lamrani, Salim. “Cuba’s Health Care System: A Model for the World.” The Huffington Post. August 8, 2014. Accessed May 2, 2015. http://www.huffingtonpost.com/salim-lamrani/cubas-health-care-system-_b_5649968.html.

[6] Davis, Karen, Kristof Stremikis, David Squires, and Cathy Schoen. “How the U.S. Health Care System Compares Internationally.” The Commonwealth Fund. June 16, 2014. Accessed May 2, 2015. http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror.

[7] “Life Expectancy and Infant Mortality Rate.” Central Intelligence Agency. 2014. Accessed May 3, 2015. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html.

[8] Mises, Ludwig von, Liberty and Property. Bernardo Aparicio, 2015.

Image:

“Health Care Industry.” Verdeja De Armas. January 22, 2014. Accessed May 1, 2015. http://www.v-dcpa.com/industries/healthcare-industry/.

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