The shortage of general practitioners is not a uniquely Canadian problem. Another country experiencing the same problem is Italy who, like Canada, is a member of the G7, the group of the world’s most advanced economies.
Italy has adopted a sobering solution to its shortage of medical doctors: Calabria, Italy’s southernmost region has negotiated a multi-year contract with Cuba to supply the region with hundreds of doctors – hundreds!
That a founding member of the European Union could be driven to negotiate a multi-year contract with Cuba, a country whose per capita GDP is less than 15 percent of Canada’s, a country having been subjected to severe, vindictive, and punitive economic sanctions by the US for over half a century, for the services of hundreds of medical doctors sounds absurd.
Cuba was colonized for centuries by Spain before becoming a protectorate of the US after the Spanish-American War. Cuba gained independence in 1902, but independence did not mean freedom and prosperity for Cubans. The country struggled through periods of violence and turmoil. The revolution of 1959 installed the Communist Party as the island’s governing power.
Cuba today, still under communist rule, is not a wealthy country. Economic hardships notwithstanding, Cuba has managed to educate an army of medical doctors in numbers far in excess of its own needs. Thousands of Cuban doctors have provided, and continue to provide medical care to impoverished communities in Africa, South America, and other underdeveloped regions of the world.
That a country as economically weak as Cuba should be able to “produce” an abundance of medical doctors, professional personnel qualified to be licensed to work in the EU, in a G7 country, did not come about by accident.
There is nothing unique about Cubans; nature did not gift them with a unique talent for medicine. It was a deliberate policy of the Cuban government to treat health care as a priority.
The Italy-Cuba agreement highlights a classic economic dilemma. As Prof. Donald B. Calne noted in ‘Within Reason: Rationality and Human Behavior’, “[t]he experience of two centuries suggests that socialism without capitalism leads to inefficiency, and capitalism without socialism leads to exploitation. When socialism and capitalism are brought together, they support each other – the term “mixed economy” reflects this interdependence.”
Should British Columbia look to Calabria for a way to fill the many family doctor vacancies in our communities?
Maybe Cuba can spare a few hundred more doctors to help us out. To solve our problem over the longer term, however, we need to re-examine our economic policies.
For the past 40 years we have paid homage to capitalism’s Golden Calf by embracing neoliberalism, a more extreme form of capitalism introduced to the world by Margaret Thatcher and Ronald Reagan.
Doctors, nurses, and health care professionals are not produced by the market’s supply and demand pressures.
The shortages of personnel we now experience across the medical care field did not come about by accident, these shortages evolved as a direct consequence of democratic political decisions to abandon Prof. Calne’s “mixed economy” in the pursuit of profit and capital gains.
Easing our economic pendulum back, somewhat closer to a “mixed economy”, would take time and it would not be easy. But we could do it if we really wanted to. A long-term solution to our shortage of medical doctors calls for political decisions, not for economic decisions.