Even Healthcare Sector Succumbs to the Capitalists
Capitalists never failed to impress us by the cruelty it possesses, for the long working hours with low returns to the labor, for much of the labor produced, the poorer they get.
In the end, capitalism produced nothing but merely miseries. While much of the idea of capitalism stems from the industry, it is undeniable that its ubiquitous influence has become something normal–something forgiven for how much laborers spend their time in the industry and how little salary they receive. The world is big on secrets–but the fact that capitalism had no longer practiced under secrecy explained a lot of how rotten this world has gotten. Capitalism consumes the entire aspect of day-to-day practice. It’s sickening, but one has to succumb to capitalism once they are out of college and start seeking a job–or even long before.
On the other hand, one aspect that the capitalist has successfully conquered is the health sector. It definitely sounds mortifying and terrifying, much or less terrorizing regarding the consequences of monetizing health workers and patients trying to battle their own death.
While capitalism affects both patients and health workers, this article will talk about the latter and further talks of the first will not be discussed in this paper.
Capitalism in Health Sectors
While health is everyone’s need; capitalist turns it into necessary commodities; of which slowly began to fall out of its humanities phase. COVID-19 pandemic highlighted this situation and eventually exacerbated it, of which they put health workers on duty 24/7 til they rest due to exhaustion working on pandemic stuff–consequently affecting their own health while receiving little to none incentives for much productivity they produced.
Much to the writer’s knowledge, the previous thoughts of capitalism in the health sector have long been explained by Engels, who was Marx’s co-writer. However, both Marx and Engels actively rewrote several things about capitalism and health. It is advised to read more regarding that in this paper
Capitalism comes with features of low wages below the value of the labor (health worker), uncertain status in social class (which may be attributed from low incomes, excessive working hours to the point that labor spends their nights at the working place due to inability to go back to home for the deadlines and work urgency, and such features that make it easy to distinguish in current practice in the industry. To no one’s surprise, its features indeed sound familiar.
Job Expectation for Health Worker
In Indonesia, the term health worker acts like a shelter for several professional jobs, namely medical workers (doctors and dentists), clinical psychologists, nurses, pharmacists, public health workers, etc. As the professions suggest, health workers are expected to conduct medical or non-medical (but related to health) jobs, in order to establish and maintain healthy communities in the society, be it physically, mentally, or any other forms of health through professional procedure.
It’s known that in the current healthcare industry works in a shift system; of which health workers work from a specific time to time. While the afore-mentioned specific time sometimes is explicitly written in the contract, sometimes (or most of the times), the shift is non-existent. COVID-19 has stressed this and marked it as the precedent. Even for other occasions, health workers are expected to work during the holiday, of which the hospital and health community center are open 24/7. With its long working hours, it is a miracle that they are able to have breakfast in the middle of their shift.
Underpaid Value
In a populous country, little is known about the actual health worker wages in Indonesia. Several salary surveys by HR companies such as PersolKelly, JobStreet, etc. left out health workers as their respondents, causing lack of the data. However, one survey from HRDBacot included health workers as their respondents. This article will then use the data from that for further references.
To no one’s disappointment, health workers sit in the bottom ten of low pay jobs hierarchy, along with other jobs such as customer service and training service. One thing that is intriguing is that even among health workers, such a gap exists among medical teams and non-medical teams.
Another report also stated that a doctor’s salary is deemed to be lower than unskilled labor (street sweeper or tukang sapu jalan). Much more ridiculous than it seems, they receive 300 IDR or 20.44 USD per month! (it’s clear that the HRDBacot survey does not have good coverage). For comparison, the average of minimum wage in Indonesia in 2022 was 2.720.000 IDR or 185.35 USD.
Given the salary, it is unreasonable with their current workload. It does not resonate given how much energy they exerted for their jobs with such a low income. IDI (Indonesian Doctor Association or Ikatan Dokter Indonesia) has once warned about this issue in their 2019 symposium. While the notice went unnoticed, the issue re-emerged when COVID-19 hit the country. The high mortality number of health workers once again showed how important the issue is.
On the other hand, it was the management of the hospital that received a huge amount of commission. While the income of hospital managers remains unclear and unknown as the data is not publicly disseminated, one report says that they make more than what they contributed. This suggests that much of their commissions are uncredited. Moreover, it implies an irony of wealth distribution discrepancy among health workers and hospital directors in the same working setting.
While the issue is huge in Indonesia, this particular problem also occurs in many countries, especially in the United States and European countries where this issue is on the rise. In Polandia, health workers complained about the long working hours with little income. The similar situation was also replicated in Spain. It indeed is ironic and frustrating to fathom how little capitalist sees values in health workers, how normalized capitalism is in the health sectors. While this article will not further elaborate about the length of study health workers have to do throughout their entire careers, when we take that into consideration, the salary will be a mere joke.
Inevitable Impacts
Under the current circumstances, it is clear that healthcare quality is at stake. Several studies have established the relationship between those factors and healthcare quality, one states that they are correlated significantly, implying that workload and compensation statistically affect the service quality health workers provide to the public. On the other hand, motivation seemed to influence the quality of healthcare service by health workers, of which motivation is suggested to be derived from working salary. This is an endless cycle; a systemic problem that needs to be addressed comprehensively as a whole instead of investigating it as a piece of unrelated problem to each own.
It is highly suggested to increase the health worker numbers in order to eliminate the staff shortage problem; thus, they can exert more focus on their job. While this is a condition up to no bargain, other things that should be taken into consideration is to understand that wages are one of the variables that should be fixed, adjusting to the current workloads, as proposed by the WHO. Low income is supposed to be an old-fashioned thing that goes irrelevant in 2023, yet capitalism failed this. COVID-19 was a wake up call no one seemed to be woken up to, and the longer this happens, the worse we can achieve a good healthcare system according to the WHO.
