Best in the World? An Amazing Comparison of the U.S.'s vs. Cuba's Healthcare Systems

This is a topic that bothers me as a cancer survivor -- a cancer not thought to be caused by lifestyle and one that forced financial disaster upon my family. Everytime I read people raging about "socialized" medicine I want to scream. In truth, near all Americans are utterly clueless about other systems, mostly regurgitating talking points from either side. But many of us know better; we have experienced the glaring inequities in the U.S. and/or lived in other "civilized" "1st world" countries and experienced their healthcare. Some of us have experienced it both here and in one of the other countries, so we have 100% perfect knowledge arising from our own pain and relief.

In this spirit I wanted to post a short paper my wife recently submitted (she received 100% -- the only one in her class). She works in healthcare, though not at the clinical edge. But, she does EVERYDAY see the grotesque abuses of the insurance cartels. She began preparing this paper with zero knowledge of the Cuban system, except that which I had heard. What she found was shocking. I look forward to your informed feedback. All comments are welcome and I expect the usual jingoistic "America is number one. If you don't like it, move," even as we all know the level of willful ignorance from which these sort of posts emerge that makes a sane evaluation of policy near impossible in modern America.

Here we go, with all source intact and fully referenced at the end of the paper:

Efficacy of Cuba’s Healthcare System Compared to the United States

The health care systems of Cuba and the United States were compared, evaluating the cost and efficacy of each system. Cuba maintains a socialist healthcare system has managed to keep healthcare costs among the lowest in the world per capita despite overwhelming adversity (Offredy, 2008). Statistics for overall health are almost equal to the most developed countries like Switzerland and the United States where the costs per capita are the highest. The Cuban system has mastered preventative and proactive family, community and acute care making it one of the most efficient and cost-effective in the world. Although Cubans do not get to choose their doctors, every citizen has an assigned doctor who provides healthcare, unlike the 47 million individuals in the United States who were unwillingly without health coverage in 2007 (Niles, 2011).

Since the 1960s Cuba has faced many adversities with the United States and her allies, such as trade embargos. Combined with the fall of its former patron, the Soviet Union, Cuba was forced to operate its universal goals of healthcare autonomously and with few resources. Prevention through community action and efficiency has become the only affordable way to keep its population healthy (Johnson 2011).

Compare Cuba’s annual per capita spending to the United States in 2005: healthcare spent per capita in Cuba was $260 per capita, while the spending in the United States was 25 times higher at $6,543 (Offredy 2008). This type of discrepancy should yield 25 times better care for the citizens of the United States, but it does not. Standard ways to measure the overall health of a countryinclude infant mortality and life expectancy rates. Cuba is nearly equal to the United Sates in both categories. In 2005, Infant mortality per 1,000 live births is seven in Cuba and 5.3 in the United States and overall life expectancy is 77.6 years in Cuba versus 77.7 in the U.S. (Offredy 2008). Additionally, Cubans are paying zero dollars out of pocket with extremely high approval ratings of their healthcare (Offredy 2008), at the same time Americans are struggling to keep up with rising insurance premiums and those who cannot afford to pay for insurance are at risk of financial disaster in case of an accident or major illness in the family. Finally, Cuba’s doctor to patient ratio was 1:158 in 2005 (Offredy 2008) while the ration in the United States was a staggering 1:600 in 2004 (Nair 2004).

The three tier efficiency system of family doctors, specialty clinics and hospitals, which are all interconnected, eliminate inefficiency. First, Cuba educates its brightest and most ethically sound high school students, for free, to be doctors. As a result, in every neighborhood there is a doctor who often knows entire families for many years. The commitment of doctors is apparent since they commonly make house calls if someone misses an appointment, as phones are not commonplace. Every individual gets a check-up twice a year regardless of her health status. The personal relationships Cuban doctors build with patients often lead to early detection of disease, and more importantly, prevention of disease. If the Cuban doctor notices an elderly person becoming depressed he will encourage healthy social behavior like getting involved in community programs that are widely held (Offredy, 2008).

The second tier includes the specialty clinics, or polyclinics, which offer multiple and more formal medical services like rehabilitation, laboratory services, endoscopy and social work. The polyclinics reduce the incidence of hospital visits and therefore drive costs down. Family doctors ensure the patient has transportation and often accompany the patient to the clinic to personally participate in coordination of care. The entire clinic staff takes on the responsibility of health and prevention education (Offredy, 2008).

Last resort tertiary, or acute care, at hospitals are open and available with excellent care, but are used only if really needed. Since the patients had care prior to being admitted, a doctor already knows the condition of the patient and is able to validate whether hospitalization or acute care is necessary (Offredy 2008). In the U.S. people end up using hospital emergency rooms as their primary care because they cannot be refused care if it is an “emergency” (Niles, 2011).

Cuba’s Che Guevara (also a physician) had a vision to provide excellent preventative healthcare to every citizen in 1960. Finally in 1984, Cuba initiated the Family Doctor Programme where the goals are mainly preventative medicine, teaching and research (Offredy 2008). Despite major obstacles like a lack of supplies and a weak economy, Cuba forged ahead with its plan. Placing readily accessible doctors in every community increases the efficiency of care and it works. It is currently considered one to the healthiest countries in the world (Johnson 2011).

P.S. note from Pajoly -- This is just a short paper. She could have gone into much more detail. For example, did you know Cuba has the LOWEST AIDs per capita in the world?

References
Fawthrop, T. (2003). Health for export. New Statesman, 132(4665), 32. Retrieved from EBSCOhost.
Hood, R. J. (2000). Cuban system offers an uncommon opportunity. Journal of the National Medical Association. Retrieved from www.ncbi.nlm.nih.gov...
Johnson, T. (2011). APHA members travel to Cuba for insight on health strategies. Nation's Health, 41(2), 6. Retrieved from EBSCOhost.
Nair, S. (2004). Doctor shortage facing the U.S.. College Media Network. Retrieved from media.www.jhunewsletter.com...
Offredy, M. (2008). The health of a nation: perspectives from Cuba's national health system. Quality in Primary Care, 16(4), 269-277. Retrieved from EBSCOhost.

Cuba also is number 2 in literacy while united states is at 45.
I guess that's why I will take statistical data over emotional rhetoric any day.

List of countries by literacy rate
en.wikipedia.org...

plus the cuban health system actually profits and sustains itself with the money spent by the thousands of foreigners who specifically go to cuba to get treatment there.

wich is only an indication on how trully great it is.

so what the cubans dont have the toys and entertainment level americans have?

at least they have health and education

because those are the real priorities in life.

not goin to las vegas

the american dream is nothing but a casino scheme.


Posted Via ATS Mobile: m.abovetopsecret.com

Since Cuba has such a great system, I'm sure you wouldn't mind living there with the lifestyles most Cubans endure, I mean, enjoy, including per capita income and the many civil freedoms they have. When will you be leaving?

Reply to post by schuyler

your cliche reply just furfilled the op's prophecy of expecting such a cliche reply.

to sink down to your level one could say:

so i have noticed you have a brain, but when exactly will you start using it?

instead of repeating such old memes like

america, love it or leave it.

i have a better one


brain, use it or donate it to science.


Posted Via ATS Mobile: m.abovetopsecret.com

Considering Cuba has two health care systems in place- one for foreigners and Party officials and one for the regular old proletariat I'm gonna say this "study" was on the former and not the latter.

My main question is if Cuba is so damn wonderful how come Cubans will pile onto innertubes and mattresses and try to paddle their way to Florida?

Reply to post by SFA437

and why are you insisting on the discussion of wich country is better to live in general when the op is clearly and specifically discussing both countries health care systems.

not both countries systems in general.

some dont want healthcare and education, they want flatscreens and big macs.


Posted Via ATS Mobile: m.abovetopsecret.com

reply to post by AnotherYOU


Just asked a rhetorical question and you seem to have missed my main point which was....

Considering Cuba has two health care systems in place- one for foreigners and Party officials and one for the regular old proletariat I'm gonna say this "study" was on the former and not the latter.

The system in place for "regular" folks is one step above bush medicine. I wouldn't allow them to remove an ingrown toenail if I was a Cuban citizen of no importance.

The study is flawed as it is based on only certain aspects of the system. Even the quote on AIDS infection rates is about as believable as Iran saying there are no homosexuals or drug addicts in the country

Reply to post by SFA437

bottom line is

i did not miss your point, i am aware cuba has two healthcare systems.

fact is both systems are still better than the american one.

wich consists of treating patients more like clients.


Posted Via ATS Mobile: m.abovetopsecret.com

reply to post by AnotherYOU




I'd have given you the Party/foreigner one being better (of course they use American medical equipment and advances) but both??? The lower tier medical system doesn't even have enough antibiotics to combat disease, insufficient vaccines for inoculation....

Thanks for the laugh. OMG that was HILARIOUS!

Originally posted by schuyler
Since Cuba has such a great system, I'm sure you wouldn't mind living there with the lifestyles most Cubans endure, I mean, enjoy, including per capita income and the many civil freedoms they have. When will you be leaving?

How funny...and predictable, as I said in the thread there would be people like you chiming in with silly and ignorant jingoistic blabbering.

The truth that certain people will never get because they never take the effort to actually learn anything beyond soundbites is that Cuba is poor because the U.S. has f'ed them. A few brave Cubans had the balls years ago to rile up their fellow citizens to throw out the American gansters (literally) and big American companies that were raping them. Then, as now, the American government went to bat for corrupt American multinational corporations and still are. Of course, you'll never acknowledge this because you have no inclination or work ethic to learn even basic history. Good luck with your Sarah Palin vote though...hey, it is just an informed guess on my part.

Originally posted by SFA437
reply to post by AnotherYOU

 

Just asked a rhetorical question and you seem to have missed my main point which was....

Considering Cuba has two health care systems in place- one for foreigners and Party officials and one for the regular old proletariat I'm gonna say this "study" was on the former and not the latter.

The system in place for "regular" folks is one step above bush medicine. I wouldn't allow them to remove an ingrown toenail if I was a Cuban citizen of no importance.

The study is flawed as it is based on only certain aspects of the system. Even the quote on AIDS infection rates is about as believable as Iran saying there are no homosexuals or drug addicts in the country

edit on 8-7-2011 by SFA437 because: (no reason given)

This "study" is a simple paper written by my wife over the course of one night's data gathering. In your America-is-number-one-in-everything fantasy taught to you as a kindergartener (and you still can't come around to the truth) the "study" is flawed, when in fact the data is simple and legit. Check out the sources yourself or be the typical righter winger and be lazy and not check out facts for yourself. The study is about the PEOPLE of Cuba, not visiting foreigners. It is clear you were too lazy to even read beyond the first few paragraphs, but that is what I expect out of anyone championing either of the two American parties -- intellectually lazy warring chest beaters.

Okay, I'll try to calm down. Sorry for being so strident, but here is the simple, horrific, abysmally disgusting fact I know because I have lived it:

IN AMERICA, A DYING CHILD IS A PROFIT OPPORTUNITY. THAT IS HOW OUR HEALTHCARE SYSTEM WORKS. THAT IS THE RAW, UGLY FACT. PERIOD. END OF STORY.

Pray God you never have to be faced with this basic reality.

reply to post by pajoly


Libertarian so you're wrong there.

Sister in law is a Cuban immigrant and lived through the Cuban medical system as a nobody so I am not referring to internet sources but a former Cuban citizen who wasn't chosen by Uncle Fidel to testify how great their medical system is.

I'm not saying our system works- just that there are MUCH better examples than Cuba. IMO the Germans have health care down pat and the French are a close second.

ETA that middle part of your last post I agree with 100%. That's why AIDS has no vaccine- it can be "managed" with "medicines". More money in that than keeping people from getting sick to begin with.

reply to post by pajoly


Taiwan also has excellant healthcare and worthy of a much closer look

reply to post by bluemirage5


Never looked into Taiwan- got some reading to do.

The system in the US is so flawed it is flat out broken. From the insane profits of drug companies to the insane profits generated by the tort system to insurance companies denying and/or dropping you because you happen to be sick.

Even government healthcare simply stinks. I had a broken spine and it took 2 YEARS to get a spinal fusion. 2 effing years!!!!!

The whole thing needs to be torn down and rebuilt from scratch.

reply to post by SFA437


SF, one of the main points has to do with the numbers: Cuba achieves a better end result in the U.S. eventhough it is resource constrained and spends less than $300 per capita. We spend over $6,000 per capita and yet much of our population has no real access and/or is forced into destitution just to get the healthcare they or their family needs. I am well-insured now (thank goodness my wife works for a hospital, but even then we forego LOTS of basic care for ourseleves (not for the kids) because of the out-of-pocket expenses we can't afford...even as well insured as we are.

Something is WILDLY wrong here. You want to play the habitual, but factually amazingly wrong, game of American "exceptionalism." If we are so exceptional, why is that we are so dumb, stupid or cruel that we can't manage decent care at our level of per capita expense when a poor ass country like Cuba can manage it with $300 or so per person. Take away? The Cuban society at large PROVABLY cares better and more for its people than we do. Apparently, they are much smarter than we are too. It is not even a debatable point. It is hard, simple fact.

Look, imagine you have two neighbors, both drive home in a brand new car. Neighbor A says, "Hey SF, how do you like my new Buick Regal. I paid $1,500 out the door for it." Neighbor B walks up and says, "Hey SF, how do you like my new Ford Focus, I paid only $30,000 out the door for it!" Which neighbor will you say is the smart one? Which one will you snicker about? Well, that idiot with the lesser car he paid 20 times more for than the other neighbor with the nicer car, well that's the U.S.

So what keeps us from getting it right? Stupidity? Yes, that's part. Near religious zeal about the myth of Amercian capitalism (which long since ceases to exist as a legit free market)?eah, that's part too. When will we have the stones to demand to be treated at least as good as dirt poor Cubans?

reply to post by pajoly


My family and I are currently uninsured so I know what the US system is like. Believe me I do.

I also know someone who remembers what the Cuban system was like. To use your analogy the Buick would have one tire, one door, only 2 of 6 cylinders in the engine and no steering wheel

Per-capita spending is a statistic and taken in abstract proves very little.

Cuba once had infant mortality rates of 50 per 1000 live births. Granted this has fallen and in 2009 was 4.4 per 1000, 2 points lower than the US mortality rate. Why did this happen?

Cuba is now using US, European and Asian medical technology and advances. The Cubans did no research, expended no capital, forged no new medical paths through the jungle of disease- they rode the coat tails of other countries who did. Cuba is the replica Rolex of the medical world.

I am not in any way saying the American way is the best way- far from it. Germany and Taiwan seem to have the best handle on how to balance innovation and research with affordability and expenditures.

Heck I was stopping over in Jordan for extensive dental work when I was working in Iraq because it was inexpensive and my guy was a top notch dentist. Spent 1400 out of pocket instead of over 9000 so I get the point you are trying to make and it is 100% valid. I am simply saying there are MUCH better examples out there than Cuba and also to keep in mind that any info disseminated on the Cuban system must be approved by a totalitarian dictator.

Reply to post by SFA437

whats funnier is that excessive use of antibiotics and vaccines is exactly what is rendering our health systems useless and more expensive.

when i was a kid everytime i got a cold or flu i would get prescribed a diferent antibiotic each time.

felt great being sick yearly while being a test subject for big pharma.

now years without taking any prescription or even seeing a doctor, i hardly get sick.

and if i do, nothing i cant cure on my own

an immune system is better than any health system

go figure


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reply to post by AnotherYOU




If I could give more than one star I would.

I don't do docs offices and neither did my parents. That is the reason I don't get sick- my own body fights off 99% of whatever is getting everyone around me sick.

My dog gets treated the same way- BARF diet and only the state mandated rabies vaccine and he is healthy as a horse and goes to the vet once a year for his rabies shot.

Human and veterinary medicine are driven by corporate interests for sure- which is but one facet that needs to be addressed along with tort reform and 100 others I can't even begin to list.

What I'd like to see is rather than nationalized healthcare (going through the process of gov't "healthcare" now and it is utter HELL) is government financing of R&D as well as diagnostic tools and development. Reduce costs on the backend, remove the massive profits from big pharma and lawsuits and we'd be back to being able to pay for a doc's visit.

As it is now health "insurance" is all kinds of screwy. My car insurance doesn't pay for oil changes and gasoline but if it ran the way health insurance does that is exactly what it would be doing. Used to be health insurance was for when you were all kinds of messed up... surgery, broken bones, trips to the ER and whatnot. Your doc's office cost 20-30 bucks and you paid it out of pocket. Then came the HMO which begat the abortion our healthcare system has become.

Now my brain hurts