The Cuban government operates a national health system and assumes fiscal and administrative responsibilities for the health care of all its citizens. There are no private hospitals or clinics because all health services are run by the government. The current Minister of Public Health is Roberto Morales Ojeda.
Like other Cuban economies, Cuban medical care suffered after the end of Soviet subsidies in 1991 and an increase in the US embargo against Cuba now also has an effect.
Cuba historically - both before and during Communist rule - performed better than any other country in the region about infant mortality and life expectancy. Experts say that official statistics by the Castro regime should be treated skeptically.
Video Healthcare in Cuba
Histori
Modern Western medicine has been practiced in Cuba by formally trained doctors since at least the beginning of the nineteenth century and the first surgical clinic established in 1823. Cuba has had many world-class doctors, including Carlos Finlay, whose theory of yellow mosquito transmission fever was given the latest evidence under the direction of Walter Reed, James Carroll, and Aristides Agramonte. During the period of US presence (1898-1902) yellow fever was essentially removed due to the efforts of Clara Maass and surgeon Jesse William Lazear.
In the 1950s, the number of doctors per thousand population over England, France, and the Netherlands. In Latin America ranked third after Uruguay and Argentina. Yet there remains a marked inequality. Most Cuban doctors are based in relatively affluent cities and regional cities, and conditions in rural areas, especially Oriente, are significantly worse. The death rate is the third lowest in the world. According to the World Health Organization, the island has the lowest infant mortality rate in Latin America.
Following the next US revolution and embargo against Cuba, the increase in infant's disease and mortality worsened in the 1960s. The new Cuban government insists that universal health care will be a priority of state planning. In 1960, revolutionary and physician Che Guevara outlined a goal for Cuban health's future in an essay entitled About Revolutionary Medicine , stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide health services the community to as many people as possible, institutionalize preventive treatment programs, and orient the community to the performance of hygienic practices. "This goal was hampered almost immediately by the exodus of nearly half of Cuban doctors to the United States, leaving the country with only 3,000 doctors and 16 professors in medical universities University of Havana. Beginning in 1960, the Ministry of Public Health initiated a nationalization program and the regionalization of medical services. In 1965, Cuba became the first Latin American country to legalize abortion.
In 1976, Cuba's health care program was enshrined in Article 50 of the revised Cuban constitution which states "Everyone has the right to health care and protection The State guarantees this right by providing free medical care and hospitals through rural medical installations, service networks, polyclinics, hospitals, prevention and special care centers, by providing free dental care, by promoting health publicity campaigns, health education, routine medical examinations, general vaccinations and other measures to prevent outbreaks of these activities and plans through social and mass organizations. "Privatization health care in Cuba is illegal and unnecessary because of the high quality, equivalent, state-covered care available to everyone as required by the Cuban constitution.
The ratio of doctors to Cuban patients increased significantly in the second half of the 20th century, from 9.2 doctors per 10,000 population in 1958, to 58.2 per 10,000 in 1999. In the 1960s the government implemented an almost universal vaccination program. This helps combat many infectious diseases including polio, tetanus, diphtheria and rubella, although some diseases increased during periods of economic difficulties of the 1990s, such as tuberculosis, hepatitis, and chickenpox. Other campaigns include a program to reduce infant mortality in 1970 aimed at maternal and pregnancy care. By 2012, infant mortality in Cuba has dropped to 4.83 deaths per 1,000 live births compared with 6.0 for the United States and only behind Canada with 4.8. However, experts note that these statistics may reflect severe treatment for pregnant patients or that statistics can be falsified. An expert, for example, notes that pregnant women may be forced to have an abortion if fetal abnormalities are detected or placed forcibly under monitoring. Doctors also have an incentive to falsify statistics, because the spike in infant deaths will make them lose their jobs. Cuba does not allow independent verification of its health data.
Post-Soviet Union
The loss of Soviet subsidies brought food shortages to Cuba in the early 1990s. Hunger during the Special Period was caused by an authoritarian regime that rejected the food people they were entitled to when the distribution of public food collapsed; priority is given to elite and military classes. The regime did not receive donations of food, medicine and money from the US until 1993.
Epidemiologist Manuel Franco described the Special Period as "the first, and perhaps only, natural experiment, born of unfortunate circumstances, where major effects on diabetes, cardiovascular disease and all-cause mortality have been associated with sustained population weight loss as a result of increased physical activity and reduced calorie intake ".
In 2007, Cuba announced that it had computerized and created a national network in blood banks, nephrology and medical images. Cuba is the second country in the world with such products, only preceded by France. Cuba is preparing a list of computerized healthcare, hospital management systems, primary health care, academic affairs, medical genetic projects, neuroscience, and educational software. The goal is to maintain the quality of free health care for the Cuban people, improve exchange among experts and enhance research development projects. An important link in the cabling process is to ensure access to the Cuban Data and Health Network Data Transmission (INFOMED) to all national health system units and workers.
United States embargo
During the 1990s the ongoing United States embargo against Cuba caused problems because of drug export restrictions from the US to Cuba. In 1992 the US embargo was made tighter with the passage of the Cuban Democracy Act that resulted in all trafficking of US subsidiaries, including food and drug trade, banned. The law does not state that Cuba can not buy drugs from US companies or their foreign subsidiaries; however, the license request has been rejected on a regular basis. In 1995, the Inter-American Commission on Human Rights of the Organization of American States informed the US Government that such activity violated international law and had requested the United States immediately take steps to free the drug from the embargo. The Lancet and the British Medical Journal also condemned the embargo in the 90s.
Embargo forces Cuba to use more of its limited resources on medical imports, either because equipment and medicines from foreign subsidiaries of US firms or from sources outside the US tend to be higher in price and due to higher shipping costs. The Democracy Act of 1992 further exacerbates the problems in the Cuban medical system. It prohibits foreign subsidiaries from US companies to sell to Cuba, thus further restricting Cuba's access to medicines and equipment, and raising prices. In addition, the move bans ships docked at Cuba's port from docking at US ports for six months. This very limited delivery, and increased shipping cost about 30%.
In 2000, the Reform of the Trade Improvement Sanctions and Export Improvement was passed. The US is now the largest source of imported food from Cuba. The Cuban American National Foundation (CANF) states that Cuba should prefer not to buy from the United States, it can buy drugs or medical equipment it needs from other countries. The third country transactions cost only about 2% -3% more than purchases from the US due to higher shipping costs. CANF also asserted that the United States is the largest humanitarian aid donor to Cuba and consists mainly of medicines and medical equipment.
The US government stated that since 1992, 36 of the 39 licensing requests from US companies and subsidiaries for the sale of medical goods to Cuba have been approved. The dollar amount of this sale is over $ 1,600,000. Furthermore, the US government licensed more than $ 227 million in donations of humanitarian drugs and medical supplies to Cuba between 1993 and 1997. There are other factors besides embargoes that explain the lack of imports, especially the lack of Cuban hard currency. Those with dollars can easily buy drugs and food in Cuba from Latin America and Canada. Cuba failed to pay its debts to Western banks in 1986 and did not have access to the international credit system to earn foreign currency. In addition, the collapse of the Soviet Union led to the loss of several billion dollars in annual subsidies and overnight requires hard currency for all imports.
In a 2006 report to the UN Secretary General, Cuba acknowledged drug authorization, although it stated that they are subject to stringent restrictions and complex procedures. Cuba is obligated to make payments in cash and in advance, and is prevented from obtaining credit financing, even from private sources. Sale and transportation of goods requires a license to be obtained for each transaction. Cuba can not use its own trading fleet to transport these goods, but must use ships from third countries, especially the United States. Payments are made through banks in third countries, because direct banking relationships are prohibited. The Cuban delegation concluded that restrictions on imports of medical products "are so wide as to make such imports almost impossible". The World Health Organization/PAHO and UNFPA agree that it is impossible for Cuba to purchase equipment, drugs and laboratory materials manufactured by the United States or protected by US patents, even though the product is purchased through multilateral cooperation. Cuba can not buy the I-125 isotope used to treat eye cancer in children. Companies that produce reagents and equipment are 70 percent owned by the United States, which makes it difficult to buy necessary medical equipment and other items.
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National health system
Cuba's national health system consists of several levels: 1) community consisting of individuals and families, 2) doctors and family nurses, 3) basic work teams, 4) community polyclinics, 5) hospitals, and 6) medical institutes.
The Cuban Family Doctor and Nurse Program consists of doctors and nurses who serve their individuals, families and communities. They live above government-built family medicine offices, live directly in the communities they serve and are available 24 hours a day. These teams work to improve public health issues in the environment as well as provide medical care. They make an environmental health diagnosis twice a year in which community risk factors are evaluated to focus priorities for improving public health. Clinically, the family doctor-and-nurse team follows the Continuous Assessment and Risk Evaluation (CARE) method that monitors individual and family health by examining the community and home environment, current health, and medical history. Teams make home visits to each family at least once a year to assess and evaluate their health. Individuals with chronic diseases are seen at least every three months. The roles of these teams combine the importance of focusing on public health and clinical medicine.
Polyclinic is a community-based clinic that has a primary care specialist. They are in every Cuban community and are well acquainted with the people and communities they serve. They can see the social and environmental determinants that affect public health, increasing their ability to serve their patients. Specialists in the clinic are there to support the doctor when needed. Each specialist clinic supports 20-40 teams of doctors and nurses. The basic work team in the polyclinic oversees and evaluates the clinical health and work environment of the family medical office.
While preventive medical care, diagnostic tests and treatment for inpatients are free, some aspects of health care are paid by the patient. Items paid by patients who can afford it are: drugs prescribed in outpatients, hearing, teeth, and orthopedic processes, wheelchairs and crutches. When a patient can obtain these items in state stores, prices tend to be low because these items are subsidized by the state. For low-income patients, these items are free.
Like other Cuban economies, many reports have shown that Cuban medical care has long suffered due to severe material shortages caused by the US embargo. The end of Soviet subsidies in the early 1990s has also affected him.
Alternative health care
Economic limitations and drug restrictions have forced Cuba's health system to combine alternative and herbal solutions for health problems, which can be more accessible and affordable for the wider population In the 1990s, the Cuban Public Health Ministry officially recognized traditional medicines and traditional and start its integration into an established Western medicine model.
Health statistics
Cuba has 128 doctors and dentists per 100,000 people in 1957. This is comparable to levels in many European countries and is thought to be the highest in Latin America. In 1986, Cuba had 219 doctors per 100,000 people (compared to 423.7 doctors in the Soviet Union, which had the most doctors among industrialized nations). In 2005, Cuba had 627 doctors and 94 dentists per 100,000 inhabitants. That year the United States had 225 doctors and 54 dentists per 100,000 population; ismus Central America has 123 doctors and 30 dentists per 100,000. In 2005, Cuba became the world leader in the ratio of doctors to the population with 67 doctors per 10,000 population compared with 43 in the Russian Federation and 24 in the United States.
The rate of abortion, which is high in Cuba, increased dramatically during the 1980s, but almost half in 1999 and declined close to the 1970s level of 32.0 per 1,000 pregnancies. This figure is still among the highest in Latin America.
Sexual health
According to UNAIDS report in 2003 there are about 3,300 Cubans living with HIV/AIDS (approximately 0.05% of the population). In the mid-1980s, when little was known about the virus, Cuba forcibly tested thousands of its citizens for HIV. Those tested positive were taken to Los Cocos and were not allowed to leave. The policy drew criticism from the United Nations and was terminated in the 1990s. Since 1996, Cuba has begun producing generic anti-retroviral drugs that reduce costs far below developing countries. This has been made possible through large government subsidies for treatment.
In 2003 Cuba had the lowest HIV prevalence in America and one of the lowest in the world. Education in Cuba on the issue of HIV and AIDS infection is implemented by the Cuban National Center for Sex Education.
According to a 2005 report by UNAIDS and the World Health Organization, "the Cuban epidemic remains the smallest in the Caribbean." They added that,
... new HIV infections are on the rise, and Cuba's preventive measures appear to be inconsistent with conditions that support the spread of HIV, including widening income gaps and the ever-expanding sex industry. At the same time, prevention of mother-to-child transmission programs from Cuba remains highly effective. All pregnant women were tested for HIV, and those tested positive received antiretroviral drugs.
In 2015, Cuba became the world's first country to eliminate HIV transmission and maternal-to-child syphilis, the achievement of great public health.
In recent years due to increased prostitution in Cuba due to tourism, STD is increasing.
Train doctors
The Cuban health system remains, in part, because of its medical education system. In Cuba, medical universities are not separate entities from health services, but they are in the system. Mentor students and medical nurses and internships in the national system from the first years of their training, especially in primary care facilities rather than hospitals. This creates community-based teaching methods rather than typical hospital-based teaching methods. Primary care, being the first contact level to the patient, lies close to home and patient work. Here, students are exposed to drugs and social, economic, and political factors that affect health. At primary care facilities, ethics and values ​​are taught as a large part of Cuba's health system along with science and technology. Graduate students are able to solve health problems and know when to report to someone higher in the health pyramid. Students graduate with a commitment to provide and maintain quality and equity in health care for their communities. The world's largest medical university is in Cuba, the Latin American Medical School.
Cuba and international health care
Cuba provides more medical personnel to developing countries than all G8 countries combined. In the 1970s, Cuba began bilateral service contracts and various money-making strategies. Cuba has signed agreements with UN agencies specializing in health: PAHO/WHO, UNICEF, the United Nations Food and Agriculture Organization (FAO), the United Nations Population Fund (UNFPA) and the United Nations Development Fund (UNDP). Since 1989, this collaboration has played a very important role in Cuba, in addition to benefiting as a member, has strengthened its relationship with the institutions of excellence and has been able to disseminate some of its own progress and technology.
Cuban doctors have become part of a large-scale plan by the Cuban state to provide free medical care and services to the international community (especially third world countries) following natural disasters. Currently dozens of American medical students are trained to assist in this donation at Escuela Latino Americana de Medicina (ELAM).
The Cuban mission in 68 countries is manned by 25,000 Cuban doctors. The medical team has worked in crises such as the South Asian tsunami and the 2005 Kashmir earthquake. Nearly 2,000 Cuban doctors currently work in Africa in countries including South Africa, Gambia, Guinea Bissau and Mali. Since the Chernobyl nuclear plant exploded in 1986, more than 20,000 children from Ukraine, Belarus, and Russia have traveled to Cuba for the treatment of radiation diseases and psychological-based problems associated with radiation disasters. In response to the 2005 Hurricane Katrina disaster, Castro offered to send a "brigade" of 1,500 doctors to the US to provide humanitarian assistance, but was never accepted.
Cuba currently exports healthcare and personnel to Venezuela in exchange for subsidized oil. Cuban doctors play a leading role in the Mission Barrio Adentro (Spain: "Environmental Mission") of the social welfare program established in Venezuela under former Venezuelan President Hugo Chà ¢ ¡vez.
Cuba has also successfully exported many medical products, such as vaccines.
Health tour
Cuba attracted about 20,000 paid health tourists, generating revenues of about $ 40 million per year for the Cuban economy. Cuba has been serving health tourists from around the world for over 20 years. The country operates a special hospital division dedicated to the care of foreigners and diplomats. Foreign patients travel to Cuba for a variety of treatments including eye surgery, neurological disorders such as multiple sclerosis and Parkinson's disease, cosmetic surgery, addiction treatment, retinitis pigmentosa and orthopedics. Most patients come from Latin America, Europe and Canada, and more Americans are coming too. In 1998, according to the Economic Commission for Latin America and the Caribbean, Cuban health sector has increased to occupy about 2 percent of total tourism. A portion of this income is in turn transferred to health care for ordinary Cubans, although the size and importance of this transfer is unknown and controversial. At one of the leading national hospitals/research institutes, foreign currency payments have financed the construction of new bathrooms on the spleen operating wing; Anecdotal evidence suggests that this pattern is common in Cuban hospitals.
Medical research
The Cuban Health Ministry produces a number of medical journals including ACIMED, the Cuban Journal of Surgery and the Cuban Journal of Tropical Medicine. MEDICC Review is an English-language journal that works to bring Cuban health and research policies, research, programs and health outcomes to the global health community. Because the US government limits investment in Cuba by US companies and affiliates, Cuban agencies have limitations in their ability to enter into research and development partnerships, although exceptions have been made for significant drugs.
The molecular immunological center (CIM) develops nimotuzumab, a monoclonal antibody used to treat cancer. Nimotuzumab is an epidermal growth factor receptor inhibitor (EGFR), which is overexpressed in many cancers. Nimotuzumab is now being developed with international partners.
In April 2007, the Cuban IPV Study Collaboration Group reported in the New England Journal of Medicine that an attenuated polio virus vaccine (which kills) is effective in vaccinating children in tropical conditions. The Collaborative Group consists of the Cuban Ministry of Public Health, the KourÃÆ' Institut, the US Centers for Disease Control and Prevention, the Pan American Health Organization and the World Health Organization. This is important because countries with high incidence of polio now use live oral poliovirus vaccines. When polio is eliminated in a country, they must stop using live vaccines, as they have a slight risk of returning to a dangerous form of polio. Collaborative groups find that when polio is eliminated in a population, they can safely switch to vaccines that are killed and protected from recurrent epidemics. Cuba has been free of polio since 1963, but continues with mass immunization campaigns.
In the 1980s, Cuban scientists developed a vaccine against the strains of bacterial meningitis B, which obliterate what has become a serious disease on the island. The Cuban vaccine is used throughout Latin America. After the outbreak of meningitis B in the United States, the US Treasury granted licenses in 1999 to a US subsidiary of pharmaceutical company SmithKline Beecham to make a deal to develop the vaccine for use in the US and elsewhere.
Contrasting views of the Cuban health system
The effectiveness of the Cuban health system is politically polarized. According to William Ventres in his review of five books on the Cuban medical system (including one by Katherine Hirschfeld, see below), "it is difficult to understand the reality of Cuban health care."
Praise
In 2006, the BBC's flagship news program Newsnight featured the Cuban Health system as part of a series that identifies "the best public service in the world". The report notes that "Thank you especially for the American economic blockade, but partly to the web of strange rules and regulations that narrow the life of Cuba, the economy in terrible turmoil: the per capita national income is very small, and the resources extraordinarily strict.Health care, however, is the top national priority. "The report states that life expectancy and infant mortality rates are similar to those of the US. Her doctor-patient ratio is compared to any country in Western Europe. The total annual health expenditure per head, however, came at $ 251; more than a tenth of the UK. The report concludes that the amazing health of the population is one of the main reasons why Castro is still in power. A 2006 poll conducted by Costa Rica affiliate of the Gallup Organization - ConsultorÃÆ'a Interdisciplinaria en Desarrollo (CID) - found that about three-quarters of Cuban urban residents responded positively to the question "do you have confidence in your country's health care system".
In 2000, United Nations Secretary-General Kofi Annan stated that "Cuba should be the envy of many other countries" adding that achievements in social development are impressive given the size of per capita gross domestic product. "Cuba shows how many countries can do with the resources they have if they focus on the right priorities - health, education, and literacy." The Kaiser Family Foundation, a non-governmental organization that evaluated Cuban health systems in 2000-1 described Cuba as "a successful example of the power of public health to change the health of a country as a whole with a commitment to prevent and with careful management of resources "World Bank President James Wolfensohn also praised Cuba's health system in 2001, saying that" Cuba has done a great job in education and health ", at the annual meeting of the World Bank and International Monetary Fund. Wayne Smith, former head of the US Interest Section in Havana identified Cuba's "extraordinary dedication" to health, adding that "Doctors in Cuba can make more taxis and work in hotels, but they're not. Dr. Robert N. Butler, who is president of the International Longevity Center in New York and a Pulitzer Prize-winning author at an advanced age, traveled to Cuba to see first hand how the doctor was trained. He said the main reason that some health standards in Cuba approach the high American level is that the Cuban system emphasized early intervention. Clinical visits are free, and the focus is on preventing illness rather than treating it. Furthermore, the London newspaper The Guardian praised Cuba's public health system for what was viewed as high quality in the September 12, 2007 article.
In 2001, members of the UK House of Commons Health Committee went to Cuba and issued a report commending the "success of the Cuban health system", based on "a strong emphasis on disease prevention" and "commitment to drug practice in the community".
The Royal Parliament also compiled an analysis of key features of the Cuban care system, comparing comparisons with nationally funded National Health Service (NHS). The overall conclusion is that many of the features identified will not occur if there is no clear commitment to the provision of health services demonstrated by the protection and proportion of the health care budget. This study concludes the following.
- There seems to be little evidence of a separation between prevention/proactive responses and disease management/reactive responses in Cuban health care.
- By far the biggest difference is the ratio of doctors per person. In Cuba it is one doctor per 175 people, in the UK the number is one doctor per 600 people.
- There is a commitment in Cuba to triple diagnosis (physical/psychological/social) at all levels.
- Widespread "patient" and public involvement in decision-making at all levels.
- Integration of hospital/community/primary care through polyclinics.
- Teamwork that works much more clearly in both community and hospital sectors and mental health and care of elderly sites visited has excellent and supported staff.
Criticism
Previous research also points to problems in Cuba's health system, including:
- Low physician payments.
- Bad facilities - the building is in poor repair condition and mostly outdated.
- Bad equipment inventory.
- There are often no essential medications.
- Caution regarding freedom of choice for patients and doctors.
Katherine Hirschfeld, an associate professor of anthropology at the University of Oklahoma, holds a Ph.D. thesis on the Cuban health system, spent nine months doing ethnographic work in Cuba in the late 1990s. According to Hirschfeld, "public criticism of the government is a crime in Cuba", meaning that "formally raising a critical narrative about health care will be seen as a criminal act both for me as a researcher, and for people who speak openly with me." Nevertheless, he can hear from many Cubans, including health professionals, "serious complaints about political disturbances in medical care and health care decision making". He pointed out that "there is no right to privacy in doctor-patient relations in Cuba, no patient's right to informed consent, no right to refuse treatment, and no right to protest or prosecute malpractice". In his view, medical care in Cuba can be inhumane.
Hirschfeld also explained that the Cuban Ministry of Health (MINSAP) sets statistical targets that are seen as production quotas. The most guarded is the infant mortality rate. To illustrate this, Hirschfeld described a case in which a doctor said that if an ultrasound examination revealed "some fetal abnormalities", the woman "will have an abortion", to avoid an increase in infant mortality.
Hirschfeld refers to well documented research on the Soviet Union and People's Republic of China, which shows that "revolutionary" efforts may also include practices such as deliberate manipulation of health statistics, aggressive political intrusion in health care decision making, criminalizing differences opinions and other forms of authoritarian policing of the health sector designed to ensure that health change reflects the (often utopian) predictions of Marxist theory ". However, according to Hirshfeld, "the extent to which these practices are virtually unknown in the West", in which "social scientists often cite the good health statistics provided by these [regimes], without critically seeing these ways were created and nurtured by the state of power ".
Hirschfeld concluded that "the Cuban health indicators at least in some cases are obtained by charging a significant cost to Cuban residents - the costs that Cubans are powerless to articulate or protest, and foreign researchers can not investigate empirically."
Complaints have also emerged that foreign "health tourists" who pay with dollars and senior Communist Party officials receive better quality care than Cubans. Former prominent Cuba surgeon and surgery Dr Hilda Molina insists that the revolutionary goal of a free and quality medical treatment center for all has been eroded by Cuba's need for foreign currency. Molina said that after the economic collapse known in Cuba as a Special Period, the Cuban Government established a mechanism designed to transform the medical system into a profit-making company. This creates a big difference in the quality of health services between foreigners and Cubans leading to the form of tourist apartheid. In 1998 he said that foreign patients are routinely inadequate or false information about their medical condition to increase their medical bills or to hide the fact that Cuba often advertises medical services that can not be provided. Others made similar claims, also stating that senior Communist military parties and military officials can access this high quality system for free. In 2005, a report written by exile and Cuban critic of Fidel Castro, Carlos Wotzkow, appeared to show unsanitary and unsafe conditions at "ClÃÆ'nico QuirÃÆ'ºrgico" from Havana; the article claims that health care for Cubans takes place in worse conditions in other parts of the country.
An article in Canadian newspaper The National Post, based on Cuban interviews, found that in fact even the most common pharmaceutical goods, such as aspirin and antibiotics, are not visible or available on the black market. The surgeon has no basic supplies and must reuse latex gloves. Patients must buy their own stitches on the black market and provide bed linen and meals for extended hospital stay. The Cuban government blames the lack of embargoes and states that people with more severe chronic illness are receiving drugs. However, other sources indicate that those who suffer from the disease lack medication. It is also recommended that in some cases, local non-dollar stocks have been shipped overseas.
The US State Department has stated that during the economic depression "the Cuban government made a deliberate decision to continue spending money to keep its military and internal security at the expense of other priorities - including health care." However, one study found that "available data indicate that the fall of imports of Cuban drugs in the 90s did not match the significant decline in government health expenditures budget support for peso-denominational spending - that is, the cost of professional medical workers, hospitals and clinics - remain strong.The effort to blame the medical shortage in Cuba on misallocation of resources is thus misguided, or at least nuanced incorrectly. "
The latest ABC-TV 20/20 report on Healthcare, based on recordings taken from within the island, criticized Michael Moore's portrayal of the Cuban Health system in the Sicko movie. In the film, Moore took a number of Americans to a hospital in Havana where they bought affordable medicines, and were given free treatments they could not buy in America. The report highlights the dilapidated condition of hospitals accessible to ordinary Cubans by pointing to the gloomy conditions of hospital rooms and the gross conditions of the facility. The report also discusses the quality of care available to Cuba by stating that patient negligence is a common phenomenon. Finally, in discussing infant mortality rates, the report highlights the government's alleged attempts to promote potentially weak fetal abortion and other government efforts to manipulate the number.
Cuban medical professionals are not paid high salaries according to international standards. In 2002 the average monthly salary was 261 pesos, 1.5 times the national average. The salary of doctors in the late 1990s was equivalent to about US $ 15-20 per month in purchasing power. Therefore, some prefer to work in different jobs, for example in the lucrative tourism industry where earnings can be much higher.
Cuban doctors who have been sent on an international mission by the Cuban government have reportedly paid less than local doctors and were badly treated by local authorities. Sometimes they are monitored by the local government in case of defection. The San Francisco Chronicle, the Washington Post, and National Public Radio have all reported to Cuban doctors who defected to other countries while on international missions. Cuban doctors at home have experienced an increase in workload to cover doctors abroad, although there is no evidence that this has a negative impact on health outcomes.
Dark market health care
Difficulties in gaining access to certain medications and treatments have led to health playing an increasing role in the growing black Cuban market economy, sometimes called "sociolismo". According to former prominent Cuban surgeon and surgeon Dr Hilda Molina, "Doctors in the hospital are charging patients under the table for better or faster service." Prices for X-rays outside operations have been quoted at $ 50 to $ 60. Such "under-table payments" are reported to date from the 1970s, when Cubans used gifts and tips for health benefits. The hard economic slump known as the "Special Period" in the 1990s exacerbated these payments. The emergence of a "dollar economy", the legalization of the dollar that causes some Cubans to receive dollars from their families outside of Cuba means that Cuban classes can obtain medicines and health services that will not be available to them otherwise.
See also
- Carlos Finlay
- Molecular Immunology Center
- ELAM (Latin American School of Medicine) Cuba
- Sicko
- Schedule of health care in Cuba
- Cuban international internationalism
- Barrio Adentro Mission
References
External links
- "The Paradox of Good Health and Poverty: Assessing Cuban Health Under the Castro" by Vincent Geloso and Gilbert Berdine
- Cuba Receives Health Award With Preventive Treatment Strategy - December 2010 Video Report by PBS Newshour
- Letter from Cuban Cuba: a lot of care, a little condom, no corruption. Hans Veeken, public health consultant, Medecins Sans Frontieres. BMJ 1995; 311: 935-937 (October 7)
- Cuban AIDS Project - HIV and AIDS in Cuba
- MEDICC review International journal of Cuban health and medicine
- Cuban Affairs "Review the Cuban Health Care System."
Source of the article : Wikipedia
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