Published on
the Portland Press Herald (Maine)

America's Health-Care System Could Learn from Cuba

The difference between average lifespans and methods of delivering care is worth study.

Leigh Donaldson

At a local polling place during the recent election, I signed a petition in support of universal health care.

But I did so in a perfunctory way, fully aware that I was going against the grain of countless Americans who don't want to see our health-care system handled by government, preferring it to be privatized.

The arguments pro and con are boundless, but they don't seem to address the reality that the United States has among the worst health care in the world. More and more of us simply can't afford to be sick.

In his documentary "Sicko," director Michael Moore portrays Cuba as a model for us to aspire toward. A socialist state that our administration shuns, this Caribbean island manages to implement progressive health ethics despite its otherwise impoverished conditions.

According to a Guardian Weekly article by Rory Carroll, "Whether it's a consultation, dentures or open-heart surgery, (Cuban) citizens are entitled to free treatment."

Thus, Cuba has better health indicators than its more prosperous neighbors. What does this say about the so-called wealthiest nation on the globe?

In a Time Magazine interview, Moore asserted, "There's a reason Cubans live on average longer than we do. I'm not trumpeting (Fidel) Castro and his regime. I just want to say to fellow Americans, 'C'mon, we're the United States. If they can do this, we can do it.'"

Cuba's health-care system has been lauded by notables such as Kofi Annan, the former U.N. secretary general, and many nongovernmental organizations, as well as several U.S. officials, according to Carroll.

The World Health Organization states that a Cuban man has a life expectancy of about 75 years, and a woman, 79. The probability of a child dying under age 5 is 0.5 percent. That is patently better than what this country can boast.

But how does this communist regime do this with such limited resources? Cuba's annual per capita health expenditure is around $280, compared to America's $6,543.

For one thing, it seems that health and education are part of the moral authority of the government. Of course, their government is far from transparent and their statistics are open to question. Complaints would likely land the complainer in jail as a political dissident.

But how they go about dealing with health issues is worth noting. First of all, Cuba places a great emphasis on prevention. They promote exercise, hygiene and regular check-ups to head off illness and treat it in its early stages. Sounds sensible, doesn't it?

Among other variables related to good health among Cubans is that millions are actually forced to exercise because of the scarcity of cars and public transportation.

In Cuba, there is extensive advertising that promotes self-examination for signs of cancer and ulcers, as well as tips on fighting mosquitoes that can spread dengue fever. Radio and television dramas sponsored by the health ministry urge safer sex. Additionally, the state advocates alternative medicine, such as Chinese herbal remedies, that are less expensive than many western drugs.

Now here's something you hardly hear of in this country: free access to doctors. According to Carroll, there are an estimated 14,000 family doctors for the 11.2 million population, a ratio of about one per 785 people. Everyone is expected to be visited (get this) at home at least once a year, often without warning, so doctors are in a unique position to monitor patient lifestyles.

With an average monthly salary of $20, Cuban doctors are still known for their dedication. They certainly couldn't be accused of gouging the system like many American medical practitioners.

Patients, however, do sometimes offer doctors what are called "regalito," a small present such as cash or a scarce consumer good.

No doubt this system is far from perfect. For example, some pharmacies lack basic items such as aspirin, but that appears to be improving.

Paradoxically, foreign patients who pay in hard cash, including Europeans and Americans, are the ones who receive red carpet treatment. Carroll describes the Camilo-Clenfuegos as a 200-room hospital/hotel for foreigners that includes cable television, air-conditioning, mini-bars and gourmet chefs.

Many Cubans see this as an example of the humane principles of Cuban society, which offers medical care to anyone. They also believe that the money spent usually goes back to ordinary Cuban citizens.

Cuba is not widely considered a utopia and remains off limits to most U.S. citizens. But because of a health-care system that is proactive and universally accessible, people in a tough region manage to have healthier and longer lives than many in the land of the free.

Whatever route our country takes in treating the health of its citizens, it should include a more thorough examination of the successes in other lands.

We've got a lot to learn.

Leigh Donaldson is a Portland writer. He can be contacted at:

Copyright © 2007 Blethen Maine Newspapers

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