Friday, June 29, 2007

Cuba’s Cure

“The Cuban health system is producing a population that is as healthy as those of the world’s wealthiest countries at a fraction of the cost.”

That statement is taken from an article that appeared in the Summer 2007 issue of a magazine called Yes! and was called to my attention by long-time friend and fellow amateur philosopher Bill Busby.

The article went on to point out that Cuba offers universal coverage and in recent years has been exporting doctors to other countries.

Bill asks: Any truth to this?

Having never been to Cuba, I don’t know any more about the facts than Bill does. However, I’m willing to venture a guess that there is some truth to it but not the whole truth.

For example, evaluations of health systems often cite infant mortality statistics. We in the U.S. tend to classify any fetus that shows signs of life as a live birth. Every effort is made to save it, but sometimes the baby dies. Other societies follow a less strict definition. Without the staff or equipment needed to try to save a marginally viable baby, they would consider it to be stillborn, not an infant death.

I have also long believed that our system of health care is based as much on our culture and standard of living as on technical and scientific factors. We want to get our care from highly trained people in modern, well-equipped facilities. When we sense something not quite right with our bodies, we want something to be done about it and we want it done now.

Other cultures are more willing to take these things in stride and give nature time to take its course. And nature does take care of a lot of it, particularly if people adhere to preventive measures like immunizations, sanitation, and sensible eating.

The result is that there is probably less difference between the two systems in terms of actual clinical outcomes than we would prefer to believe. The odds of suffering actual harm because of a more spare system of care may well be lower than we think. Even so, we would probably not accept the store-front clinics and limited access to specialists that I suspect are common in Cuba.

What the comparison may tell us, however, is that getting a less expensive system will require a change in the way we think about health care; i.e., a change in our culture. It doesn’t mean that we have to think like Cubans, but we may need to make other changes, like being willing to accept restrictions on choice of physician. Our political leaders may sense as much and, realizing that culture change is always painful, tend to deal with the matter in vague generalities and avoid specifics.

Anyone interested in reading the article will find it at


This page is powered by Blogger. Isn't yours?

FREE counter and Web statistics from sitetracker.com