Cuba's Healthcare System In Practice

[Robo]

Cuba's Health Care System in Practice

Says Canada's National Post, which assessed Cuba and its health system in a three-part series:

Even the most commonly available pharmaceutical items in the U.S., such as Aspirin and rubbing alcohol, are conspicuously absent [in Cuba]... Antibiotics... are in extremely short supply and available only on the black market. Aspirin can be purchased only at government-run dollar stores, which carry common medications at a huge markup in U.S. dollars... This puts them out of reach of most Cubans, who are paid little and in pesos.11

The same National Post story continues, quoting Jasmin, a nurse from Moron, Cuba, "We have nothing. I haven't seen aspirin in a Cuban store here for more than a year. If you have any pills in your purse, I'll take them. Even if they have passed their expiry date."12

Cuban defector Dr. Leonel Cordova told the New York Times about his experience practicing in Cuba, "[E]ven if I diagnosed something simple like bronchitis... I couldn't write a prescription for antibiotics because there were none."13

Along these lines, Patricia Grogg of the Inter Press Service writes:

[A] survey carried out in pharmacies late last year [in 2000] by the local [Cuban] magazine Bohemia failed to find 211 of the medicines included on the official list of products produced to attend to the health of this Caribbean island nation's population of 11 million... 'They say scarcity of medicine is no longer such a serious problem, but I've been trying for days to buy aspirin in this pharmacy, and they always tell me there isn't any,' complained Mara Dolores Pea, a 60-year-old pensioner, outside her neighborhood pharmacy.14

In addition to a limited supply of medicine, according to a 2005 report in the Boston Globe, Cuban health care workers are in short supply:

A 45-year-old nurse in Camaguey Province said she has worked without a doctor in her primary-care clinic for more than two years since the physician was transferred to another clinic to replace a doctor sent to Venezuela. 'My patients complain every day. They want me to act as a doctor, but I can't,' she said. 'The level of attention isn't the same as before.'15

The nurse is alluding to a program in which one-fifth of Cuba's health care labor supply - some 14,000 doctors and 6,000 health workers - has been contracted out to work in Venezuela. Under a special "oil-for-doctors" exchange between Venezuela's Hugo Chavez and Cuba's Fidel Castro, Venezuelans receive free eye surgery in Cuba. In return for these medical services, Cuba receives 90,000 barrels of discounted oil per day.16

Ordinary Cubans have suffered as a result. "Blackouts, shortages of consumer goods and other problems persist," wrote Gary Marx of the Chicago Tribune.17

Indira A.R. Lakshmanan of the Boston Globe wrote:

The system has suffered setbacks... since the cutoff of Soviet aid some 15 years ago, with hospitals and clinics in need of renovation and equipment, pharmaceutical costs soaring, and patients saying they must bring bedclothes, food and fans to hospitals. But complaints about a lack of medical personnel are new, dating to the cooperation with Venezuela that some observers disparagingly call the oil-for-doctors program.18

Lourdes Garcia-Navarro of National Public Radio reported:

peaking privately... some Cuban patients and doctors say the system has been feeling the strain of treating the Venezuelans in their home country and on the island. Doctors say that there's a shortage of trained specialists. Most Cuban doctors now they say become general physicians and forego specialized training because what is needed in Venezuela are community doctors. Patients in Cuba complain that their hospitals are stretched and they're not getting the same standard of care they're used to.19

Finally, the Chicago Tribute reported in 2005:

At least one nurse involved in the eye operations said Cuban physicians are sacrificing quality for quantity as they hurry to complete as many operations as possible. The nurse said the number of eye operations at her hospital has soared from about 15 to more than 120 daily, and many patients fail to receive important preoperative tests, she said. The surgeries are performed round-the-clock... 'Nobody is in agreement with this, but they say that you have to do it without discussion,' the nurse said. 'The patients are being mistreated.'20

Despite shortages of medicine and care, especially since the exchange agreement with Venezuela, not all Cubans suffer. "In Cuba there exists TWO health care systems,"21 explains U.S. Rep. Ileana Ros-Lehtinen (R-FL), who fled Cuba with her family to the United States when she was seven years old.22 "[O]ne [care system is] for tourists, as well as Communist Party officials, and another for Cubans, who are forced to take with them even the most basic necessities when visiting a Cuban hospital; even aspirins are scarce."23

Reports on therealcuba.com, a privately-run website that contains anecdotes, including ghastly images, of suffering anonymous Cubans cut off from the rich foreign-only facilities. As explained on the website,24 the horrors of socialized medicine are not, in fact, evenly or universally experienced:

Castro has built excellent health facilities for the use of foreigners, who pay with hard currency for those services. Argentinean soccer star Maradona, for example, has traveled several times to Cuba to receive treatment to combat his drug addiction. But Cubans are not even allowed to visit those facilities. Cubans who require medical attention must go to other hospitals that lack the most minimum requirements needed to take care of their patients.25

Are Cuba's health care woes the result of the longstanding U.S. economic embargo? Not a chance, according to a group of 18 exiled Cuban doctors. The doctors made their personal views clear in a joint letter in 1997:

We remain mystified as to why people of ordinarily good will and faith would seek to find fault with the United States for the disastrous situation inside Cuba, while failing to direct the blame squarely where it belongs - at the feet of Fidel Castro, who continues to rule our country with an iron fist after 38 years in power.26

The exiled doctors continued:

We, who have only recently emerged from the belly of the beast, can categorically and authoritatively state that our people's poor health care situation results from a dysfunctional and inhumane economic and political system, exacerbated by the willingness of the regime to divert scarce health resources to meet the needs of the regime's elite and foreign patients who bring hard currency.27

https://www.nationalcenter.org/NPA557_Cuban_Health_Care.html

 

[Robo]

Chris Sabatini is an adjunct professor at Columbia University’s School of International and Public Affairs and director of Global Americans, a research institute focused on the foreign policy of human rights and social inclusion.

But while Cuba made great gains in primary and preventive care after the revolution, advanced health care is flagging. In the famously closed country, reliable statistics and rigorous studies are impossible to come by, but anecdotally, it appears that the health system used by average Cubans is in crisis. According to a report by the Institute for War & Peace Reporting, hospitals “are generally poorly maintained and short of staff and medicines.” The writer visited facilities in Havana such as the Calixto García, 10 de Octubre and Miguel Enrique hospitals and describes them in an advanced state of neglect and deterioration. In the 10 de Octubre, “the floors are stained and surgeries and wards are not disinfected. Doors do not have locks and their frames are coming off. Some bathrooms have no toilets or sinks, and the water supply is erratic. Bat droppings, cockroaches, mosquitos [sic] and mice are all in evidence.”

One reason Cuba still sends doctors abroad despite findings like that: Its foreign medical program is a huge moneymaker, bringing approximately $2.5 billion per year to the cash-strapped government. With more than 50,000 Cuban health professionals working in 68 countries other than Cuba, the doctor export program has created a shortage of medical practitioners in Cuba.

https://www.washingtonpost.com/opin...647fcce95e0_story.html?utm_term=.bae1400b3755

 

[Robo]

Default NHS Socialized Medicine In Britain: Unmitigated Failure
EDITORIALS
NHS Socialized Medicine In Britain: Unmitigated Failure

7/17/2013
Health Care: A new report on Britain's National Health Service notes that as many as 13,000 needless deaths have occurred in 14 NHS hospital trusts since 2005. This is no fluke. It's the result of socialized medicine, done by experts.


Britain's much vaunted public medical system, accountable for 82% of all health care spending, according to the OECD, is in shambles.


A warning shot was fired a few months ago when one hospital, Mid-Staffordshire, was found to be a veritable death trap of neglect, misspent funds and starved investment. Now a new report on 14 NHS trusts, released by government-appointed Prof. Sir Bruce Keogh this week, finds that neglect and "needless" deaths are pretty much a characteristic of the entire system.


"We hear of A&E departments 'in meltdown', GP services 'on the verge of failure,' the Welsh HNHS being 'on its knees,'" wrote Simon Jenkins in the left-leaning Guardian. "The 111 non-emergency telephone service is reportedly useless. On one evening, Cornwall was said to have just one agency GP to cover the entire county. Last week's Cavendish report on frontline nursing told of wards left in the hands of untrained assistants for hours, indeed whole weekends," Jenkins wrote.

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Then there was the "Liverpool Care Pathway" — an Orwellian death panel operation, where nurses shouted to visitors to not give their dying relatives sips of water for fear it would interfere with the hospital's death target. "No one was doing anything 'wrong' since everything was done by the book," wrote Jenkins.


Keogh found that as many as 13,000 "needless" deaths were the result, about 3 per day in each hospital district.


The U.K. has seen reform after reform of its health care system, but none has made much difference.


The problem is it's a socialized system. Unlike a private one — and in the OECD, only the U.S., Mexico and Chile have them — state priorities trump those of the consumer. That's why the NHS is celebrated as a patriotic duty — as it was during the absurd propaganda spectacle celebrating NHS at the 2012 London Olympics.


Big problems fester because the state can cover them up. Anyone criticizing the NHS is shouted down because bureaucracies resist change, Telegraph writer Daniel Hannan wrote.


So much for socialized medicine being a more "humane" form of health care. The Labour Party, which has touted and enshrined this socialism for decades, is now in crisis over the Keogh findings. Far from extending life, as private health care systems do, socialized health care is a reliable vehicle only for needless death. http://www.investors.com/politics/ed...gated-failure/

 

[Robo]

Socialized Medicine Elsewhere Shows Why It Is a Failure
January 22, 2008 International Health Systems Commentary

By Grace-Marie Turner

Britain’s system of socialized medicine is enough to make your teeth hurt – literally.

Its citizens rely upon the government-run National Health Service that is designed to provide free access to every medical service, including dental care. But like all socialized medicine schemes, it has produced long lines, a shortage of medical professionals, and shoddy care.

William Kelly, a resident of a working-class suburb of Manchester, represented the frustrations of many Britons when he plucked out one of his own teeth last year. Why? Because the pain had become intolerable, and the wait to see a dentist was unbearably long. When he spoke with The New York Times last summer, Kelly had been unable to get a dentist appointment for six years.

At the beginning of 2006, only 49 percent of British adults and 63 percent of children were registered with public dentists. Because dentists are paid on a per-patient basis, the government’s system encourages public dentists to treat as many patients as possible, often leading to inadequate care and roughshod work.

With pay tied directly to the number of patients a dentist sees, for example, it makes more sense — financially, at least — for a dentist to extract teeth rather than perform a more complex and time consuming root canal. And the pool of available dentists is shriking as more are leaving the National Health Service to work in the private sector where they can be paid more.

Last April, 2,000 dentists did just that, according to the British Dental Association. In understandable frustration, many Britons have resorted to “Do it Yourself Dentistry” kits sold in pharmacies.

Take the case of Gordon Cook, a 55-year-old security manager. After failing to find an NHS dentist, he resorted to fixing his front tooth with superglue, according to a November article in the Daily Mail. For three years, Cook constantly reapplied the glue to a loose crown before finally finding a dentist.

“You can't really taste it but you do have to be careful not to use too much, in case you glue your mouth shut,” said Cook.

But don’t expect advocates for socialized medicine to be honest about the major failings of the supposedly utopian English system.

Defenders of European-style healthcare will often observe that the United States spends a greater percentage of its GDP on healthcare than any other country in the world. And, with measures like life expectancy, America’s outcomes are often worse than those countries with socialized systems.

But these arguments fail to take into account the quality of care provided.

Because socialized medicine rejects the basic laws of supply and demand — and because state-administered systems do not pay doctors what the market determines they are worth — there is a serious discrepancy between the number of doctors and number of patients. This leads to the inevitable “waiting times” that one hears so much about in countries like Great Britain and Canada.

A report by the Canadian Fraser Institute found that the average wait time from referral by a general practitioner to a specialist is 18 weeks, the longest ever recorded in Canada.

Despite all the attempts made by the Canadian government to improve this problem, the average wait time actually rose by an astonishing 91% between 1993 and 2006. No matter how much money the Canadian government throws into the program, the problem does not go away. They just haven’t figured out how to repeal the laws of supply and demand.

Further, in the interest of national budgets, state-administered health systems have an incentive to put saving money before patients.

Japan, for example, spends only about half as much of its GDP on healthcare as the United States. But the comparatively low salaries doctors receive have caused a serious shortage of cancer specialists in a country where cancer rates are rising and the disease is the leading cause of death.

Indeed, “cancer refugees” — cancer patients desperately seeking care — have become a national crisis. At a recent event protesting the Japanese government’s lackadaisical approach to battling cancer, a cancer sufferer cried, “While Japan has become economically prosperous, cancer patients are in the same position as refugees who wander in search of food, water and someone who can help.” The patient died seven months later.

Those who advocate for universal healthcare may have their hearts in the right place, but they would do well to examine how the systems they support are actually performing around the world. So the next time you hear about the wonders of socialized medicine, remember Gordon Cook and his mouth full of superglue.

http://galen.org/topics/socialized-m...-is-a-failure/ A not-for-profit health and tax policy research organization