Paying The Doctor

Should one pay a doctor for health or for sickness? In the western model of society based on exploitation, a doctor rejoices on sickness. Is it possible to build a different system of society where all forms of property including of the intellectual kind are held by owners as trustees for the whole society and not for individual benefits?

In ancient China, one did not pay the doctor when one fell sick. One paid the doctor on the days when one was healthy. It was considered inhuman and devilish to take fees / benefit from a sick person who was suffering and could not earn even his livelihood. A doctor was supposed to benefit from a person’s health and not from his disease.

The Chinese system appears strange. But, even in ancient India, the system was more or less the same. Recently, when I was reading a book on ayurveda, I discovered a Sanskrit verse, which said – it is better for a doctor to drink molten lead than to take any gift / money / benefit from a patient or his relatives / friends. In other words, it was an unpardonable sin for a doctor to profit from someone’s sickness.

The traditional Indian system provided that a farmer had to give a share from his crop to a number of persons – doctor, teacher, blacksmith, carpenter, sweeper, and even the king. Key underlying concept was that a crop is result of efforts of many people. There will be no crop if the king and his soldiers did not protect the country from attacks, if the blacksmith did not make agricultural implements, if the carpenter did not make the carts and other wooden tools, if the teacher did not teach proper values to farmer’s family and if the doctor did not keep the farmer’s family healthy.

A central principle of traditional Indian social ethos is that a person’s income is not his alone but is a collective result of many. All those who contribute directly or indirectly to one’s income have rights on it. Rights on income accrue also to others who may not have contributed in any way towards generation of income. Such rights are prescribed by social norms and contribute to the well-being of the society. For example, one-year old son of a farmer has rights on the farmer’s income even though the kid has not contributed in any way.

If income is shared by all those who have rights on it, property, irrespective of ownership, is naturally a shared asset. Mahatma Gandhi said that owners of business should consider themselves as trustees of national wealth. This idea of ownership as trusteeship has been a part of Indian psyche for centuries. It is not unusual for an Indian to consider himself as a caretaker of wealth for the next generation. It is an anathema for traditional Indian mind to think that one’s wealth is exclusively for one’s own personal pleasures and not for one’s family or one’s descendants.

This is in stark contrast to the Western / American mindset, where individual’s right of property is fundamental and inalienable. An American lives for himself and his income / wealth / property is exclusively his own (not even of his immediate family). He gives away money only as a matter of exchange or under compulsions imposed by law, which is supposedly a result of the social contract. It is ludicrous to tell a rich American that he is only a trustee of wealth for society / for next generation. A typical American will never accept rights on his income / property of others.

This difference in the western / American attitude and the Indian / Chinese culture has to be understood and kept in view before there is any discussion on intellectual property rights. In a culture where it is a sinful for a doctor to take money from his patient, profiting from so-called intellectual property is surely a sin.

The traditional system no longer exists in India as well as China. Both the countries are moving fast towards westernization. There are pressures on both to globalize and adopt legal systems that promote western concepts of individual property rights over collective rights and social trusteeship.

China has thrown communism into dustbin and Indians have done the same to Gandhi. Confucius, Buddha and Ram have become deities to be worshipped in the closed walls of temples. They are no longer seen as ones who propounded ideal lifestyles. My doctor friends celebrate with glasses of whisky when patients queue up outside their clinics / hospitals and mourn when the season is healthy. AIDS / HIV is a great opportunity for pharmaceutical companies to make obscene amounts of profits. There are international treaties and agreements to ensure that the profits from patented molecules are not adversely affected even while millions die of curable diseases.

The model of western / American civilization is less than a couple of centuries old. It is based on “survival of the fittest” and using all intellectual / financial/ physical / natural / human resources to profit from all those who can be exploited in whatever manner possible. Traditional Indian & Chinese models are drastically different.

Unfortunately, whether in India or in China, in our blind rush to emulate the western model, we forget that the western success story is less than two centuries old, while our civilizations have survived and grown for more than five thousand years. We have adopted patent laws and value systems of those who fought, about a century ago, for the right to sell opium and narcotics in China.

No wonder, the doctor, who lives on my left, celebrates when the neighbour, who lives on my right, is afflicted with cancer. Let me go and quickly convey sympathies to my neighbour on the right before I move on to the doctor’s party. Cheers!

ANIL CHAWLA is an engineer (and now a lawyer too) by qualification but a philosopher by vocation and a management consultant by profession.

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