How Cubans Live as Long as Americans at a Tenth of the Cost-
A more than a two year old article but worth reading about their health care. I recall reading about their health system years ago---I like it.
It is in their Constitution to have health care--
How Cubans Live as Long as Americans at a Tenth of the Cost
The Atlantic
By James Hamblin
November 29, 2016
A kindergarten student in Havana poses in a doctor costume
Photo by: Enrique De La Osa/Reuters
On public-access TV in 1985, Bernie Sanders defended an element of Fidel Castro’s regime: It was rarely mentioned that Castro provided health care to his country. Sanders grumbled that the same could not be said of then-President Reagan.
The comment came back to haunt Sanders in the wake of Castro’s death. On Sunday on ABC’s This Week, host Martha Raddatz played the old clip and then asked Sanders if he was aware that “this was a brutal dictatorship despite the romanticized version that some Americans have of Cuba.” She reminded Sanders that Castro rationed food and punished dissidents, then hit him with the big question: “So have you changed your view of Castro since 1985?”
Sanders said he didn’t exactly remember the context for his comment (being 31 years ago) but that Cubans “do have a decent health-care system.”
Many consider it more than decent. After a visit to Havana in 2014, the director-general of the World Health Organization Margaret Chan called for other countries to follow Cuba’s example in health care. Years before, the World Health Organization’s ranking of countries with “the fairest mechanism for health-system finance” put Cuba first among Latin American and Caribbean countries (and far ahead of the United States).
Cuba has long had a nearly identical life expectancy to the United States, despite widespread poverty. The humanitarian-physician Paul Farmer notes in his book Pathologies of Power that there’s a saying in Cuba: “We live like poor people, but we die like rich people.” Farmer also notes that the rate of infant mortality in Cuba has been lower than in the Boston neighborhood of his own prestigious hospital, Harvard’s Brigham and Women’s.
All of this despite Cuba spending just $813 per person annually on health care compared with America’s $9,403.
In Cuba, health care is protected under the constitution as a fundamental human right. As a poor country, Cuba can’t afford to equivocate and waste money upholding that. This pressure seems to have created efficiency. Instead of pouring money into advanced medical technology, the system is forced to keep people healthy.
It’s largely done, as the BBC has reported, through an innovative approach to primary care. Family doctors work in clinics and care for everyone in the surrounding neighborhood. At least once a year, the doctor knocks on your front door (or elsewhere, if you prefer) for a check-up. More than the standard American ritual of listening to your heart and lungs and asking if you’ve noticed any blood coming out of you abnormally, these check-ups involve extensive questions about jobs and social lives and environment—information that’s aided by being right there in a person’s home.
Then the doctors put patients into risk categories and determine how often they need to be seen in the future. Unlike the often fragmented U.S. system where people bounce around between specialists and hospitals, Cuba fosters a holistic approach centered around on a relationship with a primary-care physician. Taxpayer investment in education about smoking, eating, and exercising comes directly from these family doctors—who people trust, and who can tailor recommendations..............................
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