Saturday, September 15, 2007

Cuba Has Better Health Care Than U.S.?

Cuba has great socialized medicine -- much better than the half-socialized system the United States has, according to Michael Moore and his documentary "Sicko." "They believe in preventative medicine," Moore says in his movie. "And it seems like there's a doctor on every block." To prove his point, Moore took some sick 9/11 rescue workers to Cuba. The group, with a camera crew tagging along, was treated at a showcase Havana hospital.

"I asked them to give us the same exact care they give their fellow Cuban citizens. No more, no less. And that's what they did," Moore insists in the movie. I asked him if he really believes that. "Oh, I know that's what they did," he told me. "One of the 9/11 rescue workers sneaks out of her hospital room, goes downstairs and pretends to be sick. She said the same exact process took place." I suggested that was because Cuban authorities send tourists and dignitaries to special clinics. "They didn't send us there. We went to a number of clinics," he said. It's an average hospital?

"Yes, they have a clinic in every neighborhood in Cuba. This isn't just me saying this, you know. All the world health organizations have confirmed that if there's one thing they do right in Cuba, it's health care. There's very little debate about that."

Oh, there's plenty of debate. Cuban-born Dr. Jose Carro, who interviews Cuban doctors who have moved to the United States, says Moore's movie lies. Dr. Darsi Ferrer, a human-rights advocate in Cuba, told us that Americans should not believe the claims being made. He describes the Cuban people as "crazy with desperation" because of poor-quality care.

George Utset, who writes The Real Cuba Web site, says Moore and his group were ushered to the upper floors of the hospital, to rooms reserved for the privileged. "They don't go to the hospital for regular Cubans. They go to hospital for the elite. And it's a very different condition," Utset says. For ordinary Cubans, health care is different. A video, posted by a woman from Venezuela, purports to show the two forms of health care, one for the privileged who pay in dollars and a far inferior one for regular Cubans.

Moore claims Cubans live longer than Americans. It's true that a U.N. report claims that. But the United Nations didn't gather any data. "The United Nations simply reports whatever the government in Cuba reports, so we have no objective way to know what the real statistics are," Carro says. Exactly. Communist countries are famous for hiding the truth. Twenty years ago, when I reported from the Soviet Union, officials insisted there were no poor people in Russia, but they refused to let me look for myself. Why would we believe the Cuban government's health statistics?

Cuba claims it has low infant mortality, but doctors tell us that Cuban obstetricians abort a fetus when they think there might be a problem. Dr. Julio Alfonso told us he used to do 70-80 abortions a day. And here's an even more devious way of distorting infant-mortality data: Some doctors tell us that if a baby dies within a few hours of birth, Cuban doctors don't count him or her as ever having lived.

Moore told me: "All the independent health organizations in the world, and even our own CIA, believe that the Cubans have a pretty good health system. And they do, in fact, live longer than we do." But the CIA does not claim that Cubans live longer than Americans. In fact, the CIA says Americans live longer.

When I pressed Moore, he backed away from the claims his movie makes about Cuba. "Let's stick to Canada and Britain," he said, "because I think these are legitimate arguments that are made against the film and against the so-called idea of socialized medicine. And I think you should challenge me on these things, and I'll give you my answer."


Australian proposal: Unify health systems to free up $4 billion

A reduction in bureaucracy is a commendable aim but abolishing health bureaucracies altogether would be much better. The many high-quality private hospitals show that no government bureaucracy at all is needed to run hospitals

AN extra $4 billion could be available to spend on patient treatment across Australia if duplication and inefficiency in the health system were fixed. The Australian Institute of Health Policy Studies argues that the nation's health services are not just financially inefficient but they also place Australians in physical danger. "Our healthcare system is unnecessarily dangerous and causes needless deaths and injuries, most of which we never hear about," said Monash University professor of public health Brian Oldenburg, a member of AIHPS. "(And) $4billion could be transferred into treating people without an added cent of taxpayers' money if we improved the productivity of health services."

Professor Oldenburg said there were large differences in healthcare efficiency among the states and territories. "The gap between the most efficient state (South Australia) and the least efficient (the Northern Territory) delivering healthcare (per patient) in public hospitals is 35 per cent."

The AIHPS will today release a paper calling for business to become more involved in efforts to reform the health system. "They are just beginning to realise how important it is to the economy and that the more a consumer spends on health, the less discretionary spending they have elsewhere," Professor Oldenburg told The Australian. As well, he said, "business leaders know how to get things done and that's what we need to have in this debate."

The AIHPS points to a report by the Productivity Commission, released in February last year, that identified billions that could be saved across the health sector. "It's the duplication, the unnecessary tests being conducted. It's no communication between hospitals and doctors on the one hand and community services on the other. It's also people being in hospital when they should be either supported in the community or in the aged care service." Early intervention programs for health problems such as diabetes should also be encouraged, as they had the potential to save thousands of hospital hours.

Despite strong recommendations contained in numerous previous inquiries, virtually none had been acted upon, said Peter Brooks, executive dean of the Health Sciences faculty at Queensland University. "Every opinion poll indicates that health is one of the most important issues for consumers in who wins their vote in federal elections," he said. "It's time for both major political parties to give the public the detail on how they will reform the health system."


Australian PM plans back to basics for nurse training

JOHN Howard has moved to dramatically overhaul nursing education, with a $170 million plan to build 25 privately operated nursing schools in hospitals. The radical shake-up, which will increase the number of nurses by 500 a year, involves a return to a traditional model of hospital-based training to supplement university-based degrees. The Prime Minister will reveal the plan in Sydney today in the first of a series of back-to-basics policy announcements aimed at battlers, the elderly and the bush, and designed to peg back Labor's huge poll lead.

The plan emerged last night with the news that the Government would also consider reviewing all pensions and offering retirees up to $30,000 in taxpayer-funded bonuses if they returned to work to help ease critical labour shortages.

The policy shifts came as the International Monetary Fund yesterday warned the Government against populist election initiatives, saying there should be no new government spending this year. In its annual review, the IMF praised the federal Government's handling of the economy as world-leading but cautioned against further stimulus to a stretched economy.

Coalition MPs were yesterday regrouping after a week of damaging leadership speculation that had many flirting with the idea ofdumping the Prime Minister and replacing him with Peter Costello. Having discarded the option of leadership change, the Government refocused yesterday, with senior ministers confirming Mr Howard would seek to turn the Labor tide by returning to his electoral roots with a large-scale policy revamp.

The new nursing schools will be modelled on the Government's 24 Australian Vocational Training Colleges, built by the commonwealth but run by community groups working with employers. The trainee nurses will provide immediate relief to hospitals suffering staff shortages. The courses will run for three years and students will emerge with a nationally recognised TAFE qualification - equivalent to university-based study. While they study, the commonwealth will subsidise their wages and also pay bonuses in the middle of their courses and at the end of their studies, to encourage their completion. Doctors, hospital administrators and private hospital employers will have input into the training programs to ensure the nurses emerge with skills sought by their industry.

According to a 2004 Australian Health Workforce Advisory Committee report, Australia will need up to 13,500 new registered nurses each year to meet the demand for nursing services over the next 10 years. In 2004 only 5631 nurses completed their training. Despite the shortfall, 2408 eligible applicants were turned away from university nursing courses last year because there were not enough places.

The Government's move is likely to be welcomed by the medical community because university training is often criticised as producing book-trained nurses with inadequate practical experience. The Government has already raised the plans with some hospitals and its announcement will come as the Australian Nursing Federation launches phase two of a four-week TV advertising campaign outlining the negative impact of the Howard Government's industrial relations laws on nurses working in aged care....

The new Government policy proposals followed heavy pressure from Labor yesterday. Kevin Rudd used parliamentary question time to pepper Mr Howard with questions aimed at convincing voters that the Prime Minister had no new policy ideas.


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