The Antidote

Counterspin for Health Care and Health News

Sunday, May 27, 2007

Cuba vs. the US on the health front: what do we know?

Today's New York Times has a thought-provoking little piece on health care in Cuba, where life expectancy is longer than in the U.S. apropos of Michael Moore's forthcoming movie "Sicko."

After presenting possible reasons for lower infant mortality (more abortions) and longer life-expectancy (failing to take account of the death of refugees), the article muses as to whether Cubans' relative privations (fewer cars=more walking, less [but adequate] food=less obesity) might actually improve their health. A Cuban doctor who defected and now works in Miami points out that there are actually two health care systems in Cuba, one for public officials and visitors, which has everything, and one for everyone else. The second-tier system is pretty bare-bones, but begs the question - not asked by the article - of what are the essential elements of a functioning health care system that actually improves health?

As always, it's hard to separate the impacts on longevity of lifestyle (and socioeconomic) factors from that of health care itself. However, there's certainly lots more to be learned about the Cuban system(s), which we may not be able to learn, given restrictions on access.


At 10:24 AM, Anonymous Catron said...

As usual, you have completely missed the point. Did you not read the comments of Dr. Cordova?

At 12:18 PM, Blogger Emily DeVoto, Ph.D., said...

I did read his comments. In fact, I was going to comment that antibiotics are not recommended for uncomplicated acute bronchitis, but I decided to give him the benefit of the doubt since that was just an example.

He was just one voice cited, and a voice of anecdote at that, not to mention he's not entirely credible since he did defect to the U.S.

Did you read my post? My conclusion was that it is hard to get good data from Cuba. Do you not agree? I actually thought the article was, on the whole, pretty well balanced.

Thanks for your support.

At 12:22 PM, Anonymous Walter Lippmann said...

Thanks for posting your comment. There is a mixture of good and bad in the article.

Some crude mis-statements begin in the first sentence. Hollywood films are rampant in Cuba, on television, in movie theaters, and in bootleg editions on the street.

Please, don't take my word for it, check out the schedule of the Cinemateca de Cuba which I've been posting to the net for a year.

Beyond that, anyone can turn on any Cuban TV set on Saturday and Sunday and see any number of U.S. commercial Hollywood films as they are part of the regular staple of fare there.

One challenge for viewers from the United States: there are no commercials on Cuban television. Not a single message telling you what kind of toilet paper you need, or any other thing you need to buy to get your breath smelling clean or to make you more sexually attractive.

CINEMATECA DE CUBA and you can scroll back for at least a year

Not to worry, they showed a bootleg copy of Fahrenheit 9/11 on Cuban TV. Thousands of us would have happily sent them an original. They also showed Bowling for Columbine and Roger and Me, as they show all sorts of good Hollywood films, and dreadful Hollywood Garbage on Cuban TV as well as in Cuban theaters and even on cross-country buses there. I'm sure they'll get one decent copy of Moore's movie to show on TV and in the theaters in Cuba. Admission: two pesos (which, by the way, is the equivalent of eight U.S. pennies. Well, at the nice new multi- plex on Infanta in Havana they've had a massive 50% price increase, so admission is now he equivalent of twelve U.S. pennies.

I considered myself lucky when, on a cross-country Cuban flight, I'd gotten on an old Soviet-era YAK aircraft which luckily did not have televisions with which to broadcast movies with Schwarzenegegger.

Other points worth noting here include the interview with the doctor who defected from Zimbabwe. He's practicing as a physician now, but got his medical education in Cuba, so it seems Cuba's med schools can produce doctors capable of passing U.S. licensing examinations.

DePalma leaves out mention of the fact that over a hundred students from the U.S. are studying medicine in Cuba, TOTALLY FREE OF CHARGE, so when they complete their medical education they will begin their careers 100% DEBT FREE, unlike their U.S. counterparts who will be in hock up to their eyeteeth after six years in med school.

DePalma also omits to mention that Cuba offered to send FIFTEEN HUNDRED physicians to provide health care in New Orleans after Hurricane Katrina, an area STILL in need of medical care two years later.

Shortages of medicines can be attributed in no small measure to Washington's policies which make it virtually impossible for U.S. companies to sell medicines to Cuba. The regulations are so stiff that it is all but impossible for Cuba to purchase medicines from the U.S., or from companies owned by U.S. companies in third countries, which will find themselves in violation of the Helms-Burton law and so forth.

The defecting doctor quoted here also benefits from the Cuban Adjustment Act which encourages illegal immigration from Cuba so that ALL Cubans who find their way to the U.S. can get in: this while Congress is debating how to exclude larger or smaller number of immigrants from all other countries. Indeed, there is even a special program targeting Cuban doctors to encourage them to defect to the United States. I saw this advertised in the windows of the U.S. Interests Section in Havana last year.

The U.S. Interests Section meets openly with opponents of the Cuban government and puts those meetings and those opponents on their web-page:

While defending Cuba against such articles as this is a responsibility anyone who is honest must take up, there can be no doubt that there are real medical problems in today's Cuba, of which not all can be attributed to Washington's blockade of the island. These include smoking and alcoholism, against which there are public education programs and the start of some efforts to limit smoking in public places. Obesity has been observed as a problem and I noticed fat grade school children on my most recent three-month visit to the island (I'm back two weeks now) which I had not noticed before. Drug abuse: both legal and illegal are problems which exist in Cuba. Public education is active in these areas, and a tough, law-and-order tack has been taken regarding drug dealers.

Women with unplanned pregnancies in the United States may or may not have the right to terminate such pregnancies through abortion, if it is legal where they live, or if their parents give consent if they are underage. Abortion is not the best way to solve such problems: contraception is the best way to prevent unwanted pregnancies. But what if contraception fails, or if na?ve people think they can't get pregnant "the first time", etc? In Cuba abortion remains legal and it is completely free. The government in Cuba thinks abortion is not the best option, but they do not limit the right of Cuban women to have one. This is old, but it's an official statement:

This article should be both widely circulated and effectively critiqued. Since the perfect is the enemy of the good, I've decided to send this out without further comment, and will hope that others will take up where I've left off, or discuss these and other aspects of the article.

There's an accurate photo of a Cuban medical clinic waiting room. You can't see the cashier's window, or the insurance window, because they don't have such things where Cubans go. Being Cuban is all you need to be seen.

Walter Lippmann

At 6:08 PM, Blogger Arrow said...

I have taken note that the Cuban medical system uses ozone therapy, a highly effective treatment for a number of diseases that plague the USA, including MRSA. They have published many studies written in Spanish on its use and effectiveness for a multitude of diseases.

It has been to the advantage of the Cuban government and medical organizations to advance the research on ozone therapy and to utilize it in their hospitals, much as Germany and Russia and other foreign countries do. It is highly cost effective.

And since Cuba has no pharmaceutically backed corrupted FDA to tell its doctors what to do they have done extensive research on ozone therapy and can provide this wonderful modality to its citizens, hence increasing life expectancy. Perhaps they are better off without US drugs, as it is a well recognized fact by J.A.M. A. that perscription drugs kill over a hundred thousand US citizens every year.

The pharmaceutical company backed FDA works diligently to keep therapies out of the USA that would detract from drug company profits. Since ozone can cure MRSA what would they ever do with all that dangerous and deadly vancomycin?

At 9:30 PM, Blogger Emily DeVoto, Ph.D., said...

Walter Lippmann: Thanks for your very informative comments re. the Cuban health care system.

Arrow: What's the evidence that ozone therapy is useful against MRSA? High quality randomized trials? If true, its benefit should not be hard to demonstrate. If you could send me the papers in Spanish, I'd be happy to look at them.

It's misleading to say that prescription drugs kill 100,000 people per year, because they undoubtedly save many more lives than that. I agree that corruption and poor evaluation systems exist and more should be done to monitor safety, but it's pure emotion to posit that pharmaceuticals are inherently dangerous because of the influence of the evil pharmaceutical industry.


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