La Alborada: OPINIONES Whats a doctor worth in Brazil? La Alborada - Feb 6 A Cuban doctor, Ramona Rodriguez, 51, has left her assignment in Brazil to the Mais Médicos program created by president Dilma Rouseff. The program aims to provide medical care in very-underserved communities, mostly rural, by importing professionals from other country. It responds to the lack of physicians in Brazil and the unwillingness of those who are there to serve in the hinterlands. The doctors defection has become, of course, major news on various mainstream media. Rodriguez said that she was being exploited because her salary was less than that received by doctors in other countries, so, with the assistance of a local right-wing party, she filed for refugee status in Brazil. In reality, she is comparing her gross salary, of which the Cuban government takes a part, to the pre-tax salary of doctors from elsewhere. The doctors sent abroad by Cuba are not forced to go. They volunteer, and they know under what kind of circumstances they will work. They receive far higher salaries than their counterparts at home, and are able to purchase and repatriate consumer goods not available in Cuba. In Brazil, the Cubans have been praised for their dedication to patients in impoverished areas with a minimum of access to health care. When areas of Brazil flooded not long ago, the Cuban doctors were affected too, but remained at their posts. The patients, according to reports, are very grateful to them. Rodriguez arrived in October. Given that the nature of the contract was known to her, it is not unreasonable to think that she had made her plans before departing. According to the original source, Reuters, she is the first (and only) doctor among the 5,378 who began serving in Brazil last year to have left except to return to Cuba. As reported by Reuters, Justice Minister Jose Eduardo Cardozo said that Cuban doctors lose their visas to stay in Brazil when they abandon the program, meaning that Rodriguez would have to leave the country if her request is denied. Where would she go? Perhaps to the US, or to Europe, where physician salaries are much higher even than those in Brazil. Practice Link (The Career Advancement Resource for Physicians) reported in 2009 its findings based on figures derived from the US Congressional Research Service (CRS) and the Organization for Economic Co-operation and Development (OECD) in 2006. The general relationship probably holds true today. According to the chart published by the mentioned site, there is a wide variation in salaries among the countries listed. For example, at that time, the highest compensation for specialists was found in the Netherlands ($253,000); Australia ($247,000); and the US ($230,000). At the bottom of those listed were Hungary, Mexico, and Poland, where compensation was, respectively, $27,000, $25,000, and $20,000, or lower by roughly a factor of ten. For General Practitioners, the US led the list at $161,000, followed by UK ($118,000) and Netherlands ($117,000). At the bottom end, the figure for Hungary was $26,000 and for Mexico $21,000. Polands was not available, but it would likely have been below $20,000. The wide variation in remuneration must be understood –following Rodriguez logic– as plain exploitation, and should suffice to support a petition for refugee status in countries where more is paid to physicians. Her best choice appears to be among the US, UK, and Netherlands. Even the Czech Republic offers way less than those countries, with $32,000 for a GP. Thats one-fifth of what the US offers. Of course, if the principle is accepted, it should be available to doctors from all lower-income countries. For example, doctors from Latin America, the Caribbean, Africa, and most, if not all, of Asia would qualify. But thats not likely to happen. In most cases, doctors leave less-developed countries for more-developed countries because there is more money to be made in the latter. Its called brain drain, and refugee status does not apply. The case of Dr. Rodriguez seems newsworthy only because it involves Cuba. The real news is that the number of Cuban doctors in Brazil rose by another 2,000 recently. They, and the governments of the host nation and of Cuba, have agreed to keep the program going. The Brazilians who are now finally receiving attention are very happy with it. How much is that worth?
Posted on: Thu, 06 Feb 2014 23:21:36 +0000
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