What It’s Like to Be a Doctor in Cuba
By Repatriado*
HAVANA TIMES — Exporting services is one of the Castro government’s most profitable businesses. When I say exporting services I’m saying leasing out specialized Cuban personnel to other countries, international organizations or even private companies.
Cuban specialists, thereby converted into the world’s most profitable high-quality labor at a low cost, are commercialized and exploited. Marx would have liked nothing less than what the Cuban “Marxist” leadership are doing.
By comparatively analyzing the most commercialized sector, i.e. doctors, I believe we can conclude that here in Cuba they are closer to being slaves or feudal serfs than their counterparts in the first world, or any world for that matter. They of course are different in the kind of ties they have or punishment they receive, but they are both susceptible to being punished and tied fastly.
In any case, when you draw your own conclusions, don’t lose sight of the fact that this is a theoretical exaggeration that seeks to spark critical thought. What happened to slaves and serfs is too awful and there’s no comparison, but also bear in mind that what has happened to Cuban workers, exemplified here by our doctors, is also terrible in human terms.
Freedom of movement:
Slave: Nonexistent, they didn’t have the right to leave the area outlined by their owners.
Serf: Extremely limited, you were already born into serving a man and his estate.
Cuban doctor: Extremely limited, graduating as a doctor means equates as having a never-ending debt with the State. You are “regulated” and outside of Cuba, you can only go on the government’s conditions that are imposed on you or you will be punished.
Non-Cuban doctor: Total freedom, once you graduate as a doctor, you can do whatever you please.
Freedom to choose how you practice/work
Slave: Nonexistent, your owner chooses for you.
Serf: Relative, depends on the feudal lord’s needs.
Cuban doctor: Relative, once you graduate, your priorities are secondary to those of the State.
Non-Cuban doctor: Total freedom, once you graduate as a doctor, you can work wherever you are accepted and go wherever you choose to.
Pay
Slave: Non-existent.
Serf: Enough for you to still be poor and not have any choice. Very low.
Cuban doctor: Enough for you to still be poor and hope you can be converted into exportable material. Very low.
Non-Cuban doctor: Excluding extremely poor areas, it’s a reasonably well-paid job.
Freedom of association to negotiate with those in power
Slave: Non-existent and punished.
Serf: Non-existent and punished.
Cuban doctor: Non-existent, unions are just another of the State’s control apparatus and medical associations only work on academic issues.
Non-Cuban doctor: Absolute freedom, trade union rights are protected by medical schools or unions, even the right to strike.
Determining value of their work
Slave: Balance between owner and market. They don’t have any say.
Serf: Balance between feudal lord and market. They don’t have any say.
Cuban doctor: Balance between State and foreign market. They don’t have any say.
Non-Cuban doctor: Balance between union and market. Mediated influence.
Surplus value
Slave: A huge percentage is given to the owner. Non-negotiable distribution.
Serf: The feudal lord takes such a significant cut that it stops them from accumulating capital and having the opportunity to be financially independent. Non-negotiable distribution.
Cuban doctor: The State takes a greater cut than what is given to the worker. Non-negotiable distribution.
Non-Cuban doctor: The professional takes an important cut of the surplus value. Distribution subject to individual or union negotiation.
Negotiating power with whoever is paying.
Slave: None.
Serf: Limited, disproportionate power to the feudal law who imposes the law.
Cuban doctor: None, doctors don’t participate in discussing their wages or in negotiating their contracts, which the State directly negotiates with the foreign contractor.
Non-Cuban doctor: High, contracts are directly negotiated between both parties and they both have various options.
Level of defenselessness
Slave: High, without being able to appeal to a higher power.
Serf: High, extremely limited opportunities to make an appeal.
Cuban doctor: High, the authorities you can turn to are a part of the same apparatus that impose sanctions; the government is the judge and acts on every level.
Non-Cuban doctor: Low, there are impartial authorizations who can mediate and these are available to them when there are disagreements.
Two tier medical system where the real Cuban people are treated by incompetent physicians who have been trained by the Russians?
Now is this about physicians who have trained by the Russians, you know those incompetent ones who treat the Cuban people or the excellent Cuban physicians who are appointed to treat the political chiefs and tourists?
Repatriado’s footnote is revealing, reflecting that justified fear of repercussion. Such is the position of a medical doctor, a relatively privileged profession. Imagine that of a normal worker earning $21 per month.
Thank you for your insightful perspective. Very interesting. Hoping that all your dreams come to fruition.