Sunday, July 15, 2007

"Sicko" Presents a False View of Cuba's Health System

Leftist filmmaker Michael Moore claims his latest documentary, "Sicko," will "rip the band-aid off America's health care industry,"1 which Moore sees as wrongfully dominated by private drug companies and profit-seeking HMOs.

In part of "Sicko," released June 29, Moore takes a group of ill 9/11 rescue workers to Cuba for health treatment.2 Though most of the workers on Moore's two-week sojourn in March 2007 were insured,3 Moore's motive in going to Cuba is to showcase the supposed superiority of the communist country's "free" national health care and to compare this to "the misery people are put through on a daily basis by our profit-based system" in the U.S.4 (The Department of Treasury has opened an investigation into whether Moore violated the U.S.'s longstanding embargo of Cuba.)5

As with Moore's previous documentaries, "Sicko" provides a brash handling of public policy disputes. The film's underlying push is to, in Moore's words, "ignite a fire for free, universal health care."6 When this premise is examined, the rosy myth of socialized medicine's achievement in Cuba is crushed.

Cuba's Heath Care System: The Reality

Under the Cuban government's health care monopoly, the state assumes complete control. Private, non-governmental health facilities, where ailing citizens could buy treatment, are illegal.7 As a result, average Cubans suffer long waits at government hospitals, while many services and technologies are available only to the Cuban party elite and foreign "health tourists" who pay with hard currency. Moreover, access to such rudimentary medicines as antibiotics and Aspirin can be limited, and there are reports that citizens excluded from the foreign-only hospitals often must bring their own bed sheets and blankets while in care.8

Despite the reality, Cuba's universal health system continues to be glorified. "Defenders of Cuba's communist government cite universal health care and education as 'gains of the revolution,' claiming the average Cuban is far better off today than under the dictatorship of Fulgencia Batista," wrote Tom Carter of the Washington Times.9 Moreover, "The health care system is often touted by many analysts as one of the Castro government's greatest achievements," says an updated 2002 State Department report, which rejects the notion that Cuba's health conditions have significantly improved for most Cuban citizens since 1958.10

When examining the woeful reality of health care in Cuba, Moore's and other liberals' drive to establish a 'socially equitable,' centrally-planned medical system in America should be rejected as a foolish proposal. Though state-sponsored health care is trumpeted in Cuba as a basic human right achieved by the revolution, according to many reports, including those by Cuban defectors, universal availability of and accessibility to top quality care are fantasies.

Below is a snapshot of reports from those who have witnessed Cuba's health care system up front. They serve notice of the horrors of socialized medicine.

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:

[S]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, 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


NHS aged-care "lottery"

An "unjustifiable postcode lottery" means that some elderly people are 160 times more likely than others to get long-term care paid for by their local authority, according to a report.

Age Concern found that Derby City Primary Care Trust paid for seven people to be looked after last year, or 0.26 people per 10,000, while Harrow PCT funded the care for 826 people, or 41.75 people per 10,000. Age Concern said that this was despite Harrow having a younger population. "Individuals face a postcode lottery in getting NHS continuing care. There can be no justification for such huge variations," Gordon Lishman, director general of the charity, said.

From October 1, a national framework will exist for PCT staff to determine who receives continuing care, in which the NHS fully funds care outside hospital. The new criteria should increase the numbers of people receiving continuing care by about 7,000, at a cost of œ220 million.


Queensland government ambulance system still not fixed -- despite much outcry and many promises

INCOMING Emergency Services Minister Neil Roberts is facing a revolt from disgruntled ambulance officers, with a new report revealing high stress and fatigue levels and plummeting morale. Paramedics fed up with a controversial roster system they say is ruining their lives want Mr Roberts to go on the road with them to see first-hand the pressure they are under. They say the system is leaving them exhausted, compromising patient care and leading to marriage break-ups and health problems.

A survey by the Emergency Medical Service Protection Association, which represents ambulance officers, found 94 per cent of paramedics had low morale. More than 90 per cent said their fatigue and stress levels had risen, 70 per cent felt their job satisfaction had decreased and 70 per cent were taking more sick leave. "To say I am unhappy is an understatement," one said. "I have no time to see my family, and I find I may not actually see my partner for days." Another wrote: "In the 10 years I have been in the job, I have not seen morale so low or job dissatisfaction so low. Stress is increasing, not only mental, but physical stress-related illness as well."

Paramedics previously worked two 10-hour days and two 14-hour days before having four days off. But in 2005, the Queensland Ambulance Service introduced 10-hour maximum shifts, which it said were designed to improve home and work life for paramedics. But EMSPA president Prebs Sathiaseelan said it had done the opposite, with paramedics still working long hours but not getting adequate down-time. "We are so tired, we are so fatigued - and if something isn't done soon, we're going to burn out," he said. "We are not shop workers. We confront trauma and have the lives of the public in our hands daily, and we need time off to recuperate."

Mr Sathiaseelan said former emergency services minister Pat Purcell, who was forced to resign last week after allegedly assaulting two senior bureaucrats, had failed to listen to paramedics' concerns. "We're hoping the new minister will discuss this issue in a civil manner - I'd love him to come out on the road with us to see exactly what we're talking about," he said. "We learn how to use new equipment and new drugs without complaint - but these rosters are causing untold distress."

The QAS has been beset by problems including emergency response time blowouts and high sick and stress leave rates.



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

For more postings from me, see TONGUE-TIED, GREENIE WATCH, POLITICAL CORRECTNESS WATCH, FOOD & HEALTH SKEPTIC, GUN WATCH, EDUCATION WATCH INTERNATIONAL, AUSTRALIAN POLITICS, DISSECTING LEFTISM, IMMIGRATION WATCH INTERNATIONAL and EYE ON BRITAIN. My Home Pages are here or here or here. Email me (John Ray) here. For times when is playing up, there are mirrors of this site here and here.


1 comment:

PPAC said...

There are many european countries where the socialized medicine is very good and better than in EEUU. I lived in Spain; there are some problems but in integral way is better than the States. The Insurance Agencies that dont't assure anythings is a very good business for owners but not for
the people with low resources.
The medicine in Cuba is very bad and before the Revolution it was better than after. Cuba had free public medicine and private and cheap medicine . Cuba , for example, had almost doubled medicians per habitant than the United States in 1958. There was a problem: in the mountains very far of the town or city there wasn't hospitals.
I invite you to visit this site
It's editor is Eloy Gonzalez an specialist in Oncology who is a cuban political refugee that emigrated to the States a few years ago.
Excuse my bad English Language.