Worlddesk

June 26, 2009
Cuba provides free health care without the worry

A hospital in Varadero, Cuba.

Apropos of the current health care debate in the United States: What happens when a government you happen not to approve of does some good things? The case in point is Cuba, where the level of health care is startling.

Medicine has long been held up as one of the success stories of Fidel Castro’s half-century tenure.

During a Worldfocus reporting trip several months ago (February 2009), I had the chance to check out the reality of the claim at various points along the health care track. At one end of the spectrum, I spoke to a retired woman who lives with her daughter, son-in-law and grandchildren in a small apartment in downtown Havana. The family’s basic income is about $40 a month. They could use more money, but not for health care.

The woman, in her 70s, was considering the merits of having a foot operation. It was a standard problem to straighten out some toes. I did hear some complaints from people who complained about a shortage of doctors and waiting times. Not in this case, which I chose at random. The decision was based on the timing; she was confident in her doctor’s skill, was not worried about a delay in treatment and didn’t even consider the cost. It was free.

There was an 80-year-old writer who had a quadruple bypass several years ago. He was taken to the provincial hospital with the best reputation for the surgery, recovered at the hospital and at a facility where his family joined him, and now has regular checkups with a doctor who reminds him to keep exercising. No bill for him or his family. It was free.

I spoke to an African-American woman from New York who attends the Latin American School of Medicine in Cuba. The students there are Cubans and foreigners from two dozen countries; the young woman told me the program was life-changing; she would never have had the means to study medicine in the United States. It’s free — but wait; there’s a catch. Americans who attend must promise the Cuban school that they will practice medicine in poor or under-served communities in the United States.

Finally, I interviewed Dr. Gerardo Guillen, the research director of the Cuban Center for Genetic Engineering and Biotechnology, who described pioneering pharmaceutical research. The center is experimenting with drugs to treat and cure prostate cancer and hepatitis C. The center already produces and distributes a drug that treats and cures deep wounds characteristically suffered by diabetes patients. Guillen estimates that tens of thousands of people in the United States could be saved from amputations if they had access to this particular drug. It’s not licensed in the United States.

Cuban Americans, among others, sometimes come to Cuba for treatment or for other medical intervention they could not afford back in the United States. The cost for visitors? Not free — but a fraction of what it would cost at home.

- Peter Eisner

Photo courtesy of Flickr user scaturchio under a Creative Commons license.

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33 comments

#33

following up on previous comments:
Monday, March 08, 2010
That Fabulous Cuban Healthcare (Part II)
by Humberto Fontova
http://townhall.com/columnists/HumbertoFontova/2010/03/08/that_fabulous_cuban_healthcare_part_ii

#32

following up on previous comments:

Source: nationalreview.com by JAY NORDLINGER
SEPARATE AND UNEQUAL
To be sure, there is excellent health care on Cuba — just not for ordinary Cubans. Dr. Jaime Suchlicki of the University of Miami’s Institute for Cuban and Cuban-American Studies explains that there is not just one system, or even two: There are three. The first is for foreigners who come to Cuba specifically for medical care. This is known as “medical tourism.” The tourists pay in hard currency, which provides oxygen to the regime. And the facilities in which they are treated are First World: clean, well supplied, state-of-the-art.
The foreigners-only facilities do a big business in what you might call vanity treatments: Botox, liposuction, and breast implants. Remember, too, that there are many separate, or segregated, facilities on Cuba. People speak of “tourism apartheid.” For example, there are separate hotels, separate beaches, separate restaurants — separate everything. As you can well imagine, this causes widespread resentment in the general population.
The second health-care system is for Cuban elites — the Party, the military, official artists and writers, and so on. In the Soviet Union, these people were called the “nomenklatura.” And their system, like the one for medical tourists, is top-notch.
Then there is the real Cuban system, the one that ordinary people must use — and it is wretched. Testimony and documentation on the subject are vast. Hospitals and clinics are crumbling. Conditions are so unsanitary, patients may be better off at home, whatever home is. If they do have to go to the hospital, they must bring their own bedsheets, soap, towels, food, light bulbs — even toilet paper. And basic medications are scarce. In Sicko, even sophisticated medications are plentiful and cheap. In the real Cuba, finding an aspirin can be a chore. And an antibiotic will fetch a fortune on the black market.
>>read this article in its entirety at http://nrd.nationalreview.com/article/?q=NjE5NWFkNWU0ZGJhMzdlNjRkMGUzYWMzNGI2NDI5MzI=<<

#31

following up on my previous comment. This is a post from a Cuban Blogger Yoani Sanchez. SHE LIVES IN CUBA. THIS POSTING WAS FROM OCT 2009-
Generation Y-On Health
October 8th, 2009
I search, without success, for a bottle of detergent to wash the glasses smeared with grease and fingerprints, which don’t yield to water and the dishcloth. Looking for the soapy liquid, I have walked part of Havana today, as the television announcers call on us to strengthen our hygiene before the advance of H1N1. The alert occasioned by the epidemic, however, has not caused the shops to lower the price of cleaning products, not even the cost of simple soap which is the equivalent of the wages for a full day’s work. Instead, the opposite has happened. The collapse in imports has been most notable in those that are used to bathe and disinfect.
The voice of the announcer calls on us to wash our hands often, use handkerchiefs when we sneeze and maintain good personal hygiene, but the reality forces us into filth. We lack face masks, running water in many houses, the simple possession of vitamin C to strengthen the organism, and cleanliness in public places. Thus, the so-called “swine flu” has fertile ground to reproduce. While it advances through our neighborhoods, the official media maintain their reserve and don’t mention the closed schools, the quarantined sites and the full hospitals.
This illusion of paradise is killing us. This wanting it to appear that we live better and that our statistics put us at the world average, cannot manage to hide the fragility of our society in the face of an epidemic that requires material resources in the hands of citizens. If soaping the body and having a bit of alcohol to sterilize the hands become luxuries, how can we stop the pandemic that is already upon us? If the September ration of soap never even reached the rationed market, how is it possible that on TV they call for hygiene without referring to the material resources to accomplish it. Is it that they haven’t noticed before that we are sinking into the dirt? They have to face the ravages of conjunctivitis, diarrhea, and the viruses to figure out that sanitation is not only a white coat and a stethoscope, but starts in the streets, with collecting the garbage, with showers in the houses and with a mother who cannot wash the plate her child will eat off.
—-Sir Winston Churchill - ‘The inherent vice of Capitalism is the unequal distribution of blessings; the inherent vice of Socialism is the equal distribution of misery.’—-

#30

I LIVED IN VARADERO BACK IN THE 70′S. THIS HOSPITAL IS ONLY FOR THE ELITE AND THE TOURISTS…..THE ‘POLICLINICS’ ARE FOR THE OTHER (CUBAN PEOPLE) AND THIS IS WHAT THEY LOOK LIKE: http://wp.me/pFj7B-8z
STOP BEING SO ENAMORED WITH SOCIALISM!!!
Sir Winston Churchill - ‘The inherent vice of Capitalism is the unequal distribution of blessings; the inherent vice of Socialism is the equal distribution of misery.’

#29

So many ‘experts’ here on Cuba … but we all know that the loudest critics here are the ones who have never even visited that country.

#28

Healthcare is NOT a right!!!!!!!!!!!!!! While we don’t deny it because it would not be humanitarian, it is still not a right. It’s a service for which we must pay like any else.

CUBA should fall into the ocean… they are not beating us on anything by any means.

#27

What baloney!!!!!!!!!! Where are the photos of them rotting in the filthy hospitals… uncared for? This is a myth that liberals love to push… and it’s just that a myth. THERE IS NO FREE LUNCH.

#26

Most seem to focus on whether Cuban health care is better than the US health care or not. Probably not, but keep in mind, Cuba spends $200 - $300 per person, per year on health care and the US spends $7,000 to $8,000 per person per year.

US citizens can legally visit North Vietnam, but we can’t legally visit Cuba - why is this? Why can’t we see for ourselves?

When US citizens are allowed to visit Cuba, they may start a booming medical tourism business.

For a collection of articles about Cuba, please visit:
http://www.hctalk.com/viewforum.php?f=62

#25

So many people are for this but few are willing to do the research. Cuba pays about 50% of their earnings as personal income tax. So for this ‘free health care system’, it’s funded from some where. I ask you where do you think it comes from? Right now the highest taxes for the lower brackets in the US are 28% for a single person and it goes down for having dependents. Can each and every one of you afford to lose 22% (or more) of your monthly income for the rest of your lives for this ‘free’ health care? What most Americans need to learn is control. Seriously. Stop leasing new cars every couple years, getting the 46 inch big screen TVs, drinking, partying and start planning on the future. Planning now will help most people in the long run. There will be select few who it won’t. And that is what our current system is designed to help. Additionally, why are Mexicans getting free healthcare in California? They don’t pay taxes here but come over and get all kinds of bennies that legal tax paying citizens can’t even partake in? Granted, California government has been completely insane for the last 10 years or so… and as such they may be the first state to file for federal bankruptcy in the near future.

#24

i agree with “cubaverdad ” indeed ,the real hospitals(for the population) in cuba are filthy and the care substandard . bribery is a must if one wants to actually have something done. some but not nearly all medicine is available.equipment is hopelessly out of date .Try to visit for example “hospital lenin” in a (southern city)if they would let you in (which i doubt) your eyes would be opened.

#23

[...] Government Health Care? By Michael Eden Liberals have oft exalted communist Cuba’s “free” health care system.  Isn’t it wonderful?  Why can’t we do [...]

#22

It’s people like this socialist radical Peter Eisner who spreads lies like this that I am praying everyday that Obama gets all his wishes fulfilled. I can’t wait for the day when that happens and all the radicals like him wonder what the heck happened. The only way this country is going to wake up is for it to be torn down.

#21

Cuba has 627 doctors per 100,000 people while the
U.S. has 225 doctors per 100,000 people. Part of
the problem in Cuba is the 1962 embargo against Cuba and the Trading with the Enemy Act which is due for renewal on September 14. These have a devastating impact on the health care system in Cuba despite the abundant supply of well trained
doctors.

#20

Funny, but an American that recently immigrated here said he was in a car accident, taken to the “best hospital” in Havana, and they didn’t even have bandages to cover his wounds. I guess he was just lying. We idiot Americans are easily led.

#19

This is not a comment but rather a question, if Michael Moore was able to bring in a couple of US Americans to Cuba for treatment and they were cured. Now on the other hand Peter Eisner mentions that healthcare in cuba is not free, it really cost a fraction of what we may pay in USA. Keep in mind that those that do have insurance also pay a fraction of the cost. The million dollar question would be, how realistic is Cuba adavanced in medicine vs USA. I’ve also heard Cubans that are heading or live in the US that they will like to send their loved ones medications from US so if the medication are so inexpenensive in Cuba. Then why are Cubans from USA wanting to take or send medication to their family in Cuba?
Thank you for your ear,
Best regards,
Frances

#18

[...] I know it might shock some people, but many Americans do go to Canada for health care. Even Cuba. Cuba provides free health care without the worry | Worldfocus Much as it might pain people, that’s a real phenomenon. Yes, many Canadians go to the US for [...]

#17

I am curious who would like to live on Cuban doctor’s salary, not counting all other thigns that previous commentators mentioned.

#16

[...] Here is one recent account that backs the former view; the benefit of a free health care system to Cubans is great. Citizens do not have to consider the cost of a serious surgery, and do not have to worry about a staggering bill for follow-up appointments and rehabilitation. And foreigners, even U.S. citizens, can study medicine in Cuba instead of trying to foot the enormous tuition expenses in this country. [...]

#15

He who chooses to not educate his children, and those children who choose not to educate themselves, give the gold to those who do. Sucks for them who choose to not educate themselves.

#14

[...] Outline of Cuba’s healthcare system. [...]

#13

wow Americans sure get riled when you mention the great enemy having good healthcare.
thanks for atleast going to see yourself!
one thing that must be mentioned is that trying to compare Cuban healthcare to first world healthcare is ridiculous, it should be compared to similar nations like their neighbours in the Dominican.
and let me tell you, it is disgustingly better.
i’ am also disgusted by Americans who talk of “freedom” and “chioce”. how many poor Americans have a chioce? did they choose to be poor? illiterate? unqualified? or unemployed?

in American there is only one golden rule; he who has the gold makes the rules.

#12

It is your choice to let go of your 401K. In Cuba, a bueaucrat makes that decision for you. Often he decides grandma must die.

#11

Yes, Cuba is ahead of us on healthcare. We have to say goodbye to our 401k life savings when Mom gets cancer.

#10

Heathcare is one of the 5 basic human rights. It looks like Cuba has the USA beat on this one.

#9

Someone wrote: “Here is one recent account that backs the former view; the benefit of a free health care system to Cubans is great. Citizens do not have to consider the cost of a serious surgery, and do not have to worry about a staggering bill for follow-up appointments and rehabilitation. And foreigners, even U.S. citizens, can study medicine in Cuba instead of trying to foot the enormous tuition expenses in this country. [...]”

First; be serious, there is not such a thing as “free health care.” Someone has to pay and the cost of research and development in health care are considerable. Resources most be allocated somehow, and not paying in one way, only means you are paying in another way. Cuba uses a centralized system where a few make the decision for everyone else, according to what the few consider is fair and necessary. As we can see here people often differ in their opinions, decisions, and choices. In Cuba, choices, decisions, and opinions are often made for you and there is no redress or appeal.

Staggering costs in terms of dollars is a relative term when you are deprived of choice, of the right to challenge the decisions of the government and of the right to appeal. Cubans have none. A comon Cuban cannot make a case for being flown to Europe as the son of Juan Almeida Bosque could, someone at the MINSAP makes the decision for them. A bureaucrat decides that you are not sufficiently valuable, and so you may be left to die: end of story; no petition, no redress, no appeal.

I do not know of even one MD graduate in the US who had trouble paying their student’s loans. Our President Barack Obama and his wife Michelle both attended school with borrowed money and look were they are today.

Anyone who values human dignity would have serious questions about the Cuban system. It is impossible to cover sunlight with just one finger.

#8

[...] Here is one recent account that backs the former view; the benefit of a free health care system to Cubans is great. Citizens do not have to consider the cost of a serious surgery, and do not have to worry about a staggering bill for follow-up appointments and rehabilitation. And foreigners, even U.S. citizens, can study medicine in Cuba instead of trying to foot the enormous tuition expenses in this country. [...]

#7

(3rd generation antibiotics are reserved for hospital use, not available at pharmacies, but free for hospitalized patients. Patients needing insulin, thyroid replacement therapy, or other chronic disease management drugs have a special card at their local pharmacy guaranteeing them the meds–I know, I am one of them.)

Thank you for making my point about government rationing. Also for making my point that “bartering,” free unregulated exchange, solves many problems that governments seem unable to cut through.

I would like to add that “health” is not the same as access to a physician.
Cuban working conditions, stress level, and nutrition are some of the worst in the hemisphere.
And that has nothing to do with the “embargo.”

During colonial times, just like today, Spain forbid Cubans from conducting commerce with the United States. Yet, in the absence of a police state, like Cuba has today, three thirds of the trade from New Orleans was destined to Cuba and six thousand people in New Orleans worked for Cuban commerce.

Government should get out of the way. Both governments not just the United States. Is time for Cubans to reconcile, the Cuban government obssesion with controlling the Cuban people is in reality the biggest hurdle to friendship among our nations.

#6

Having been a patient–in a regular Cuban hospital, community clinic and family doctor’s office–for many years, I can say that of course Cuban health care facilities suffered from tough economic times in the 90s, with the socialist bloc collapsing and the US embargo tightened. Many hospitals need repair, true, and some meds are not readily availabe. That said, however, I know nobody in Cuba goes without health care–and that the health professionals are first class. (You might want to read Paul Farmer on Cuban healthcare.)

On Havana and Miami: It’s interesting to note the barter exchange in meds that goes on between Cuban Americans and their families in Cuba: they bring antacids and some 3rd generation antibiotics to Havana, and they take home to Miami ampicillin tablets, a Cuban-developed medication for reducing cholesterol, and dozens of other meds that are sold for just pennies in Cuba. (3rd generation antibiotics are reserved for hospital use, not available at pharmacies, but free for hospitalized patients. Patients needing insulin, thyroid replacement therapy, or other chronic disease management drugs have a special card at their local pharmacy guaranteeing them the meds–I know, I am one of them.)

#5

Being able to train Doctors is not the same thing as delivering a comprehensive and efficient system of health care. While Cubans may have secured the right to receive a diagnosis; treatment, planing and prevention remain one of the worst in the hemisphere.
In Cuba, there is no access to independent research to test the veracity of the official statistics about health, and the best medicine is reserved for foreigners and the Cuban elite.

Quality of treatment is based on party loyalty. Recently, it was reported that the son of Juan Almeida Bosque (one of the original Comandantes) was receiving treatment for cancer in Brussels. Not only regular Cubans cannot travel abroad for treatment but the news piece explained that Almeida’s permit to travel was cancelled after he criticized the Cuban government.
This is the unavoidable consequence of government hegemony in health care.
You better not get sick if you plan to criticize the government. Political freedom can never be separated from the strength of the private sector.

#4

If Cuban Americans truly loved Cuba they would have fought to lift the embargo. “Damn the citizens because I don’t like the leaders” is a pathetic moral argument. The nostalgia of these Cuban Americans is repulsive. The current leaders of Cuba are no better but had the Cuban Americans behaved more responsibly perhaps Cuba could have reached the stature of some of the better East European countries today. So much energy is expended in acrimonious debate that forces Cuba to raise unnatural barriers for self-preservation. Cuban Americans are very enterprising; I would have thought that could have developed better strategies than simply lobby politicians that have not helped (and never will) the vast citizens of their prior homeland.

#3

Appalled is right on target. And let us not forget the food ration books that Cubans receive. Further, how is it that visitors to Cuba are asked to bring medicines, even over the counter meds that we can easily purchase. It is because those meds are not easy to get. Apparently you did not get the whole story, nor the real story.

#2

Cuba’s health care for Cubans is substandrad.
Hospitals lack everything from antibiotics to bedsheets.
Cubans have to bring food to their family members in hospital.
To get an operation bribes have to be paid. A Cuban family I know had to pay 300 CUC to get a a family member considered for a hernia operation.
I have seen lots of Cuban hospitals for Cubans. they stink.
The person that wrote this story went at best on a guided “protocolo” trip and never saw Cuban reality.
This is reality in Cuba;
http://www.cubaverdad.net/apartheid_in_cuba.htm#II._Medical_apartheid.

#1

It is amazing to me how these articles about free healthcare never bother to ask how these benefits compare to the lack of civil liberties that Cubans live with day to day. Does free healthcare justify not being able to leave your own country unless the government gives you permission? Not being able to read what you want learn what you want speak out against the governemnt if you want… I would rather work till I’m 90 to pay for my own health care and not have my civil liberties infringed upon…

Peter Eisner is an editorial consultant with Worldfocus and a 30-year veteran of international news. He has been an editor and foreign correspondent at The Washington Post, Newsday and The Associated Press. He co-authored “The Italian Letter,” which details fraudulent intelligence leading up to the Iraq War. He was founder and president of Newscom, an international online news service, and speaks Spanish and Portuguese.

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