Show me the Money

While conducting some research on my topic, which is an examination of the policies which led to health care decisions regarding the treatment of people with HIV and AIDS in Cuba and the USA (this may be tweaked to New York State or New York City), I stumbled upon the BBC article, Cuba to Abandon Salary Equality. The full text can be read at the link below. I plan to write an analysis of the similarities and differences which exist in policy and how they have
http://news.bbc.co.uk/2/hi/americas/7449776.stm
resulted in disparate outcomes in the incidence of HIV AIDS in both societies and also to examine whether long term survival rates are similar, dissimilar and why. This article mentions the fact that Cuba has had salary equality since 1959 but Raul Castro is changing that. Average wages in Cuba for everyone including doctors and laborers is $20 per month. The vice minister of labor Carlos Mateau, is quoted as saying "it is harmful to give a worker less than he deserves, it is also harmful to give him what he doesn't deserve." This is vastly different than "from each according to his ability to each according to his need" popularized by Karl Marx in 1875 and which has been the lynchpin of the communist economic system.

On its face, my topic seems very different from the topic of Carol's blog but reading this BBC article caused me to identify a theme common to both issues. The economic structure in Cuba is an anachronism and Raul Castro appears to be making the first steps towards using monetary incentives for work to increase productivity. Workers will be given a 5% bonus for meeting targets and supervisors would get a 30% bonus if their team increases production. From my perspective, one of the reasons for the failure of communist economies is
that in translating the ideal into reality, policymakers overlook basic human nature and the likely responses of people. If there is no incentive to produce then why should one strive to produce?

Carol's blog discussed the current meltdown of the capitalist economies which seems to happen with predictable regularity every few decades. Here too, policymakers in capitalist societies (read USA) ignored basic human nature. If you offer excessive monetary incentives based on production then the likely response is that some people will abandon common sense, ethics and concern for their fellow man in pursuit of the monetary reward. If the size of a banker's bonus is based on the volume of mortgages he writes and there is no risk because those mortgages are going to be sold anyway, then why not write an obsene amount of suspect mortgages to gullible people?

Carol advocates abandoning the capitalist system because it is fundamentally flawed just as most communist societies have abandoned their system. Some societies such as China, have an amalgam of communist rhetoric combined with state endorsed capitalism. The bottom line is that organizing a stable, just society costs money and health care costs a lot of money . Cuba has made the provisison of health care for all citizens a priority and has used its limited resources to achieve that. The United States on the other hand has the best medical facilities and doctors in the world but there are 25 million people who have no insurance. It addresses the health care issue in fits and starts every few decades.

What does this have to do with HIV/AIDS? The political and economic structure of both societies influence the decisions made by policymakers in addrssing HIV/AIDS. Inevitably there is a question of where and how to allocate scare resources. How does a society
which pays its doctors on average $20 per month compare with a society which pays its doctors on average considerbly more than that? Which society is more efficient in its use of resources?

Tamara