APN Special Report from Cuba on Health Care for All
(APN) HAVANA, Cuba — This Atlanta Progressive News reporter recently visited Cuba from October 08 to 15, 2016, along with a team of academics, activists, and reporters organized by The Nation magazine to learn more about Cuba’s public healthcare system, their culture, and so much more.
What APN found is riveting: Cuba has achieved universal health care and better health outcomes for less money per person, than it costs the private insurance industry in the U.S., per person, simply to operate.
As President-elect Donald Trump prepares to take office having run on a platform of repealing Obamacare, it turns out that the Cubans have come with a better alternative decades ago – an alternative that removes the unnecessary “middle man” of the private insurance industry.
BEFORE THE CUBAN REVOLUTION
Cuba always had good doctors, but prior to the Cuban Revolution of 1959, these doctors were only for wealthy Cubans, which excluded most Cubans who lived in extreme poverty.
At that time, the wealthy elites sent their children to the best universities in the world, while more than one million Cuban children did not have schools to attend, and a million more Cubans were illiterate.
Seventy-five percent of the land was owned by eight percent of the population of seven million people.
Then by the early 1950, the Mafia had totally corrupted Havana with drugs, gambling, and prostitution. It was an island of the haves and the have not’s.
HEALTH CARE IN CUBA TODAY
After the revolution of 1959, education and universal health care were assessed as top priorities for the new Cuban government.
Che Guevara, the revolutionary physician, outlined the future of Cuban healthcare as a fundamental human right guaranteed by the state.
Everyone in Cuba receives free health care from birth to death.
Rural Medical Service was the first program to have an impact on public health because the rural population had long endured poverty and neglect.
Primary Health Care Units were created in the 1960’s and followed by Comprehensive Polyclinics.
Today, the Cuban healthcare system is set up in three levels: (1) the family physicians clinics in neighborhoods for general care, (2) the Polyclinic to receive more extensive care and diagnosis, and (3) finally, the hospital if a problem is too complicated or severe.
Prevention is a big part of healthcare in Cuba. Everyone receives a compulsory annual full health check-up.
Cuba was able to make these social advances to solve health problems by taking private profit out of the healthcare system, and by doing away with corruption of the Batista regime that had siphoned off state-budgeted resources.
The World Bank reports that Cuba spends the equivalent of 431 dollars per person per year, on healthcare, compared with 8,553 dollars per person in the United States – and not all people in the U.S. are covered, and even fewer use health services.
In contrast, the U.S. spends approximate 421 dollars per person per year on the administration of the private healthcare insurance plans – which is almost as much as Cuba spends on its entire healthcare system.
Cuban doctors have become the island’s biggest export.
As part of their humanitarian outreach to other poor countries, Cuba sends for free teams of doctors and nurses to countries, like Haiti, that have been devastated by hurricanes and/or outbreaks of disease.
In other instances, the Cuban government leases out their doctors to foreign governments for payment or barter.
According to Cuba’s state-run newspaper Granma, the Cuban government expects to make some 8.2 billion dollars from its medical workers overseas in mostly Latin America, the Caribbean, and some African countries.
Cuban doctors are often the first doctors many patients see in other poor countries around the world.
In 1999, the Latin American School of Medicine in Cuba (ELAM) was established for international students from outside of Cuba.
The first year, over one thousand international students enrolled. Today, students from over one hundred countries study at ELAM and some are from the U.S.
Preference is given to applicants who are financially disadvantaged and people of color, who show the most commitment to working in poor communities.
Everything is free from tuition, housing, meals, textbooks school uniforms, and the students receive a small stipend.
Students study at ELAM for the first two years and then are transferred to one of Cuba’s other medical schools for four years, including a one-year rotating internship.
When students graduate, they are not burdened with huge debt for their medical education, unlike debt-ridden U.S. students.
Cuba outperforms other low and medium income countries and even some high income countries in terms of healthcare and healthy people. Their infant mortality rate is lower than the U.S.
Several U.S. students studying at the medical center in Havana shared their thoughts on the Cuban healthcare system.
They especially like the community-based model of medical care in Cuba with a doctor in every neighborhood. The ratio is approximately 155 patients to one doctor.
Cuban doctors look at patients in a more holistic way, they are integrated into the community and know the families, the neighborhoods, and the patients’ backgrounds. They practice preventive medicine, so that problems can avoid becoming chronic.
U.S. students in Cuba would like for the U.S. to lift the embargo so they could have more medical resources to help people.
The Cuban healthcare system where no sick person is left untreated is an example from which other countries can learn.
In contrast, Georgia politicians refuse to even accept federal money to expand Medicaid.
Georgia could save about 1,700 lives each year if Medicaid was expanded, according to the New England Journal of Medicine.
Not only are Georgia citizens dying because our elected officials refuse to expand Medicaid, but six rural hospitals have closed on Gov. Nathan Deal’s watch.