Free Health Care in Cuba?

Moses Patterson

The Havana Maternity Hospital. Photo: Caridad

HAVANA TIMES — A much heralded triumph of the Cuban revolution is the “free health care system”. Cuban propagandists will even favorably compare the Cuban system to US health care delivery.

I imagine, few, if any, of these apologists, have ever experienced either one, let alone both systems. I just spent last week experiencing the Cuban health care system. Let me explain:

My wife and I travelled to Cuba last week to help my mother-in-law recover from surgery. She was going to have to spend at least three days in the hospital post-op and several more days motionless in bed at home.

We arranged to rent a large ‘casa particular’ or rental apartment close to the hospital with two bedrooms and two bathrooms so that my wife and I could be comfortable and attend to her mother.

My wife’s family is from Guantanamo, but the surgical hospital in Guantanamo, which was damaged by hurricane Sandy last year did not have the surgical equipment available for the specific surgery my mother-in-law needed, so for a variety of reasons, we decided to have the surgery in Havana.

Prior to the trip, my wife wisely purchased towels and two sets of sheets and pillowcases for her mother’s use during her hospital stay. In addition, we packed several aerosol cans of spray disinfectant, special soap used for sponge baths and a room air-freshener that plugs into to an electrical outlet.

Although this Havana hospital provides linens, the quality and hygiene of the supplied linens is questionable. Needless to say, you don’t need to bring your own linens for US hospitals.

The morning we brought her to the hospital, it was hard to ignore the dimly lit halls inside and the faint smell of urine and disinfectant that seemed to be nearly everywhere. Even though I knew this was the best option available to us in Cuba, I could not help but think that if this was the US, there would be no way I would leave my mother-in-law in a hospital that smelled like this.

We were told the elevators weren’t working that day so we had to trek up to the fourth floor for the pre-operation prep and to speak with the surgeon.

It was clear to me that the staff in this hospital worked and moved about similar to the way hospital staffs move about in the US. Although there were some staff who seemed content to simply sit around and talk, there were others who kept busy doing their jobs.

My wife is still recognized on the street from her days as a national newscaster several years ago so it was hard to tell how much of our initial ‘special treatment’ was just because of her former status in Cuba and how much was standard customer service.

Still, it is fair to say we were well-received and everyone was polite and even pleasant. Under these working conditions, that is worth no small recognition.

After I completed my job carrying the small suitcase with the sheets and towels and personal items up the stairs, I decided to wander around the hospital a little while my wife and mother-in-law met with the surgeon.

It was clear to me that the staff in this hospital worked and moved about similar to the way hospital staffs move about in the US. Although there were some staff who seemed content to simply sit around and talk, there were others who kept busy doing their jobs.

It was raining outside so it was even more hot and humid inside than normal and if there was any air-conditioning it was fighting a losing battle. There were noisy fans on all the floors and pushcarts half-filled with soiled linens left in the halls.

The real difference was the hospital itself. There were more broken than unbroken windows. Even the unbroken ones still had the “X” tape-blocking from the last hurricane to threaten La Habana nearly five years ago. If the interior of the hospital had once had a color scheme, it was no longer evident.

Most of the walls needed a couple fresh coats of whatever color to hide the years of gurney crashes and greasy hands.  Floor tiles, mostly broken, were a hodge-podge of colors and markings as well.

Even the most conscientious janitor would have to go about their cleaning chores by memory because the structural deterioration as well as imbedded dirt and grime would never betray what was clean and what was not.

Despite these physical conditions, the two hour surgery thankfully went well. My wife, upon hearing the good news from the surgeon prompted me to slide a 100 cuc bill in his hand (Keep in mind that this ‘tip’ tripled his monthly salary).

We thanked him and asked if he would continue to visit ‘mi suegra’ and we would see to it that he was taken care of again before we took her home. He nodded his understanding. I still can’t imagine tipping a surgeon in the US.

We thanked the doctor and asked if he would continue to visit ‘mi suegra’ and we would see to it that he was taken care of again before we took her home. He nodded his understanding. I still can’t imagine tipping a surgeon in the US.

I then left for the store to buy juice for my mother-in-law, the Cuban equivalent of flowers in the US. When I returned to the hospital later, she was still in recovery. Since she was going to be groggy for the next few hours, my wife busied herself finding out who would be on staff that night.

She arranged that the bed was made up with the new sheets. Ten cuc to the shift ‘jefa’ assured that she would get the best mattress available and that her suitcase would be unmolested.

The next two days for me was spent shuttling food and juice to the hospital for my wife and her mother. I even brought back pizzas and soda for the staff. The spray disinfectant came in handy for the bathroom.

Her ‘room’ had ten beds and 8 men and women patients with no dividing curtains for privacy. Again, even the worst private and semi-private rooms that we take for granted in the US were simply not available in this hospital. Believe me, we asked.

We plugged in the air-freshener across the room and by the second day it began to have an effect. The other patients in the ward also brought sheets and towels and their own food. Fruits and juices were offered and shared by everyone.

The doctor managed to look in on my mother-in-law frequently. So did the nurses and even the staff responsible for cleaning. Word must have gotten out that my wife was a good tipper.

At the end of the third day, my mother-in-law had arranged to trade her used sheets and towels for a week’s supply of Vicodin and Percocet with another MD on staff.

These top-shelf painkillers are normally not available in Cuba. She had also arranged for one of the nurses who worked in the afternoons to drop by the rental house to check on her in the mornings on her way to work. (10 cuc per visit)

When we added up the costs of linens, juices, pizzas for the staff, tips for the doctors and nurses and other odds and ends, my mother-in-law’s three day hospital stay in La Habana costs my wife and I just less than $400.  If she had had the same procedure done in the US, her deductible would have been at least $1000.

As far as we know, she is no worse for the wear. Her surgeon and the staff seemed caring and attentive. I have no way of knowing how much of a difference was made because we had resources typically not available to the average Cuban.

We also do not know if the same service would have been better or worse in Mexico City, Guatemala City, or Buenos Aries. We do know now that hospital conditions are much better in the US. We also know that without ANY resources, her experience could have been worse. Much worse.  Cuban health care is at least adequate but it is certainly not free.

63 thoughts on “Free Health Care in Cuba?

  • Maybe you can do your African witch doctor routine and help out. Got your bone in your nose, and your bag of chikin bones to heal with?

  • Right. Because the US is the only country in the world that can sell white sheets to Cuba. I don’t know who is worse, the Americans for not selling bleach and white sheets to Cuba or every other country in the world who has not bothered to buy white, American sheets and bleach and resell them to the Cubans.
    If Cuba is this bad off and the only reason is the US embargo, imagine how bad off the world would be without America!

  • I just want to comment on “I still can’t imagine tipping a surgeon in the US”

    Of course there is no way to imagine such thing because that would never actually happen. The context itself is misleading!

    Cuban and American culture, although similar at times are very different one from the other. In the US you tip someone when you believe they have given you a great treatment or just because you feel is the polite thing to do. In Cuba, that rule does not apply, especially with doctors. They would do their best regardless. However, due to the economical situation in Cuba and the low salary of doctors, even for Cuban’s standards, may of the patients would go to see their doctors bearing gifts. Of course, they would not all be 100cuc. While I was at the hospital I saw patients inviting their doctors over for a “coladita” (cuban coffee), other times they would bring a basket of fruits, a pack of cigars, or pretty much whatever they felt the doctors would like. This is a way for the patient to thank the doctors, for their hard work and continuous desire to help despite the economical conditions. Take into consideration that many of those surgeons have to commute and bike their way to the OR. Can you imagine a doctor in bicycle from their hose to the hospital before surgery in the us? As you might imagine, there is a great cultural difference between given a tip and giving a gift.

    I am not gonna deny the hospital’s conditions are pretty different from that of the US, but the cubans themselves are the ones who would most often see the differences. There are many other clinics and hospitals for the treatment and care of tourists and non-cuban residents. Those are much closer to fitting the american idea of a hospital than the hospitals the population have access to.

  • Not getting 30% of the education you need has nothing to do with emphasis. It has to do with knowing your stuff.

  • There will no doubt be differences in emphasis in the training of doctors in two such different countries — one geared primarily to serving the rich with their relatively limitless resources, and one dedicated to serving most of the rest of humanity.

    I’m sure a US GP intending work in Cuba or in any developing country outside the exclusive enclaves of the rich will have to learn quite a bit about practical medical procedures there and making due with the limited resources, especially if that the country has been the subject of over half-a-century of genocidal US trade sanctions that restricts access to the latest medicines and technology.

    There is nothing at either of your links about the Brazilian program — your “Oppositor” link very dubious in any case.

  • This is what in fact happens in California:

    “Note: Students from some recognized international medical schools may have deficiencies in their training and will not meet the requirements for licensure in California. Any training deficiencies will require remedial training prior to licensure in California.”

    http://www.mbc.ca.gov/applicant/schools_recognized.html

    Deficiencies in training: just like Costa Rica said.
    Remedial education needed; just like Brazil said.

    130,000 dollars:

    “Opositor venezolano: La Habana se guarda $130.000 anuales por cada cooperante”
    http://www.martinoticias.com/content/article/20887.html

    “Compiled by the Government Communication and Information System
    Date: 11 Jul 2012
    Title: SA allocates R268m in aid to 19 countries”
    http://7thspace.com/headlines/416664/south_africa_sa_allocates_r268m_in_aid_to_19_countries.html

  • Memo: Don’t feel like the Lone Ranger with your just rage against a lot of the slime that oozes out of this “comments” blog. All I’m saying is, let’s not make overt accusations of people being employed by you-know-what-and-who.

    BTW, I’m intrigued by your idea that “all property is private.” But I think we’ll have to communicate directly, in order to discuss it. Cheers.

  • Contrary to your wacky conspiracy theories, I doubt that the Brazilian government has millions to waste on health care for purely ideological reasons. It can only be after much debate and soul-searching that they approached their poorer cousin for help in this critical area.

    I don’t know where you are getting this $130,000 figure, but whatever the Cuban government is receiving for these services, you can be sure it is a good deal for the Brazilian people. The private sector there has never been able to adequately meet their needs. Given the political and economic realities of the international capitalist system, this shouldn’t be surprising. It may work well for some, but many more are falling through the cracks.

    Also I don’t know about Costa Rica, but, from a quick search, I see that both the Medical Board of California and the Medical Council of Canada recognize degrees from several Cuban medical schools. Must be frustrating as hell for you.

  • Increases of salaries always have real effect, In many countries bonuses are offered to people that accept postings in remote areas in all sectors of life.
    Brazil is a rich country. If, as you claim it can afford the $130,000 that Cuba charges per doctor, they can afford to pay local doctors that make far less a bit more to take up postings in remote areas. Brazilian doctors in the national health service do not make $130,000 a year.
    The solution to hire these Cuban doctors would be the drain on national resources. Those would be more wisely spent on bringing over people that will stay, give incentives to local doctors to take up these postings and create an environment in which more people want to study medicines and can do so in their own country. That is the responsible long term solution.
    If any doctors need to be brought in as a temporary measure they should be well trained and be likely to remain in Brazil and integrate in society. Doctors from Spain and Portugal that come with their families or create families in Brazil and that are paid a similar salary as local doctors solves that problem. Doctors from Cuba aren’t allowed to bring families and aren’t allowed to permanently remain in Brazil as the Castro regime protects its economic interests.
    The Cuban solution is the worst one all the way. It offers no real solution in the long term and is the most expensive in the short term.
    You sound like a salesman selling Cuban doctors. You have the economic concerns of the Castro dictatorship at heart it seems. Not what is best for Brazilians.

    Note: a comparison of education in Costa Rica and Cuba showed only 69% of the minimum material required by Costa Rica was covered by the Cuban system. No wonder they fail in droves in lots of countries. This discrepancy also is a very good reason to have these equivalency tests.

    “‘Varados’ 26 doctores que estudiaron en Cuba
    Jairo Villegas S. [email protected] 12:00 a.m. 26/08/2012″
    http://www.nacion.com/2012-08-26/ElPais/-varados–26-doctores-que-estudiaron-en-cuba-.aspx

    More on the plight ofe the Cuban doctors:
    “Fuedal Serfdom: The Fate of Health Professionals in Cuba”
    Yoani Sanchez, Award-Winning Cuban Blogger
    Posted: April 1, 2010 01:26 PM
    http://www.huffingtonpost.com/yoani-sanchez/fuedal-serfdom-the-fate-o_b_521920.html

  • Salaries could double or triple with no real effect on the situation. Developing countries in general can never hope to be able to compete with the salaries and working conditions offered to doctors in the advanced industrialized countries. The solution is not to drain their national treasuries to pay first world salaries in the third, but some kind of political or moral intervention. Cuba’s intervention on both fronts has been remarkably successful in the medical field.

    The problem of medical accreditation is widespread. Here is a balanced account of it from a Canadian (British Columbia) source that looks at all sides of the debate on the accreditation of foreign-trained doctors: http://www.health.gov.bc.ca/library/publications/year/2007/conversation_on_health/PartIII/PartIII_ForeignTrainedProfessionals.pdf

  • Insults are the arguments of idiots, an old friend once told me.
    I did indeed read your lame excuse and replied to it.
    I never saw any statistics on US and European trained doctors overwhelmingly failing the Brazilian medical exam.
    The fact that the problem of failure is concentrated in the Cuban trained doctors is clear. The Brazilian government even set up a special scheme to provide additional training for students graduating from Cuba. (see link in my other post replying to Dan Christensen)
    It never felt it had to do so for doctors from anywhere else.
    There is no international conspiracy against Cuban doctors as you so foolishly suggest. That is propaganda nonsense.
    Results from various countries show the lack of training clearly.

  • As usual you are misrepresenting the words of other people, Dan Christensen.
    I never said the Brazilian government had any bias against its own doctors. I just said that they were trying to chose the wrong way to go about solving the problem of health coverage: importing doctors at a cost higher than the salaries paid to local doctors.
    Education and adequate rewarding are the best solution. otherwise a flight of doctors will happen. Zimbabwe that also imported Cuban doctors is a good example.
    As far as Brazil goes: it has an accreditation system for doctors trained abroad. they have to pass a test. I never heard of doctors trained in Europe or the US massively failing that test. Cuban doctors did. Cuban trained doctors as similarly failing in Costa Rica and Chile. The failure rate in Brazil is no isolated case.
    This accreditation of foreign trained doctors is far from unnecessary. it is a way to protect patients through ensuring doctors are adequately trained.
    In any case: Brazil will not be importing Cuban doctors it said. Instead it will bring better trained people from Spain and Portugal.

    “Brasil rectifica: contratará a médicos españoles y portugueses en vez de cubanos, DDC | Río de Janeiro | 22 Mayo 2013, http://www.diariodecuba.com/cuba/1369177306_3366.html

    I guess they gave up on them for cost and quality most likely being the main reasons.
    Brazil had already being investing in schemes to bring the Cuban trained doctors up to speed.

    “Brasil pagará un curso de actualización a sus médicos formados en Cuba”, DDC, Brasilia 12-11-2011
    http://saludcuba.blogspot.se/2011/11/brasil-pagara-un-curso-de-actualizacion.html

  • It seems far-fetched, as you seem to be suggesting, that the Brazilian government has some kind bias against their own local doctors. If they are having to get doctors from abroad to work in certain areas, it can only be because of a lack of local candidates. This is a problem in just about every country.

    Also, there is no universal set of medical procedures. Conditions for the practice of medicine vary greatly from one country to the next. The curriculum and the exams set by medical boards will vary accordingly.

    It is usually a long and difficult process — unnecessarily so according to many — for foreign-trained doctors to get accreditation anywhere. It is a widespread problem, not just for Cuban-trained doctors.

    Also, I don’t think I have heard of any complaints about Cuban doctors in the field from any of their peers. On the contrary, the Cubans seem to be universally admired for their ability to work under the most adverse conditions.

  • Thanks for proving my theory that every reactionary propagandist is or pretends to be a functional analphabet – you simply did NOT read what I wrote! 95% of not ONLY Cuban doctors fail this exam, but doctors graduated EVERYWHERE fail these exams in order to propagate a segregated health care model which favors the private sector! It’s a mafia! Have you seen the graph in the other topic showing the pathetic physicians per population in remote areas of my country?! Can you fathom to interpret this? No? Then go home.

    Cuban doctors in Venezuela, Equador, Bolivia are performing very well, thank you.

    http://www.aljazeera.com/indepth/spotlight/venezuelaelection/2012/10/20121039242915607.html

    “Not everyone loves Chavez here,” [Alba] Castro said, pointing up the mountain where small homes cling to the hillside. “But they like being treated at the clinic.”

    http://dominicanewsonline.com/news/homepage/news/health/cuban-doctors-performed-600000-eye-surgeries-in-bolivia/

    All opposition to Cuban doctors where they act have a clear classist bias and fear from the wealthy medical ‘community’ in those countries, those elitist doctors who wouldn’t dare to place a foot in the slums to provide care to the poor.

  • The point is: for the same price as Cuban doctors, $130,000 plus living expenses, a lot of Brazilian doctors would be very willing to go. Even for less. Brazil does not have to import Cuban doctors at all, just pay a better wage to Brazilian doctors that then will move to these postings. The service is filled and Brazil saves money.
    The second point is that people educated in Cuba don’t make the grade. That is confirmed by facts from your and other countries (Chile, Brazil, Costa Rica, Namibia, …). The assessment of the quality of Cuban educated specialists is valid for any country. They fail not just in Brazil with its “extremely difficult exam”. They fail everywhere. Those are facts, not propaganda. Nothing to do with a bias of any system in Brazil. In Pakistan they graduates from Cuba even want to be exempt from the qualifications test out of fear of failing. It is you that is coming up with propaganda excuses.
    What happens when countries start importing Cuban doctors and paying them more than local doctors are very clear from the case of Zimbabwe: a total health disaster.
    Brazil should encourage local education of doctors and pay decent salaries for posting in the state system in remote areas. Importing expensive doctors will only increase resentment, promote emigration and destroy the local health service in the long term. Counterproductive all the way.

  • ‘I think that Brazil could find some doctors willing to go to the
    sertao or another remote place for $130,000 and living expenses a year.’

    That’s exactly the argument I countered – NO ONE is interested in going to give medical care in remote and/or poor places, because there’s no money involved. Read first before posting your usual propaganda, I’m talking about my country, not Namibia.

    Another reactionary piece of crap of yours, my other argument is that in Brazil an extremely difficult exam must be taken by doctors graduated in foreign lands – not just Cuban graduates, 95% of them overall fail the exam – in order to keep this excluding health system which favors the private sector and undermines the public one. It seems other countries in Latin America which also promote excluding health care models also do this abject procedure.

    The practical results of Cuban doctors where they are allowed to work – see my translated piece on what happened in Tocantins – speak for themselves.

    http://mrzine.monthlyreview.org/2012/fitz071212.html

  • Again with the non-sequitors and unfounded accusations. Your standard tactic of accusing me, or Moses, of “selective pro-imperialist” views without providing a single shred of evidence is really getting tiresome. Considering the tens of millions of victims of Communism over the past 100 years, one can see that typical leftist reaction as a form of psychological projection.

    The topic of this thread is the Cuban Health Care System. It’s not about the US or terrorism, although I did allow myself to comment on terrorism in response to one of Luis’ bizarre rants. My mistake.

    By the way, your facts are wrong:

    China produces 43% of all tobacco grown in the world, more than the next nine largest producers. The amount of tobacco grown in the US has been declining since 1975. Brazil is the largest exporter of tobacco leaves in the world.

    http://www.tobaccoatlas.org/industry/growing_tobacco/leading_producers/

  • Paying a lot in bribes has become customary to get decent medical care in Cuba, Luis.

  • I’m sorry Grady while I can maintain politeness and sincereness when I want to but I, as an imperfect human being, have limited patience.

    There’s a ‘famous’ quote I got so upset with that managed to pass my ‘limit’ for these ‘surreal’ people quite a while back ago:

    “The American people, from the sweat of our brow, continue to foot the bill to defend freedom all over the world.”

    I mean this is so offensive to the memory of Latin American people that I felt the same thing whenever I hear the terms ‘feminazi’, ‘gay tyranny’ or worst of all, ‘human rights for right humans’ (believe it or not, this is a common catch-phrase amongst the most conservative sectors of my society when horrified with a homicide committed by a poor person raging for having him hanged in a public square or rationalizing torture methods applied by our police against the poor and black population).

    Again, I’m no hero. I just cannot stand low-grade propaganda.

  • Well, yuck.

  • And abortion and falsifying data is widely used to achive these numbers, aren’t they Dan christensen?

    ”If there was any malformation in the fetus, they would interrupt the
    pregnancy,” said Monzón, now a lab technician at Mercy Hospital in
    Miami. A heart murmur or other serious problems required an abortion. This was ”automatic,” he said. If the mother objected, a team from the hospital would persuade her an abortion was necessary.

    Other sources also say abortion is a tool used to keep infant mortality low, including Andy Gomez at the Institute for Cuban and Cuban-American Studies at the University of Miami, and Carmelo Mesa-Lago, a retired University of Pittsburgh economics professor who has spent decades studying Cuba.

    Posted on Sun, Jan. 28, 2007

    STATISTICS
    Infant mortality rate in Cuba raises eyebrows
    Cuba is known to have one of the lowest infant mortality rates in the world, but the issue is how Cuba goes about keeping its death rate among babies down.
    BY JOHN DORSCHNER

  • Which argument did you counter, Luis?

    The main argument by the Brazilian doctors is that Cuban trained doctors did not meet Brazilian standards. 90% failed their qualification tests. Similar results have been posted on Costa Rica, Chile, ..

    The second argument against Cuban doctors in Brazil was the cost: up to 130,000 dollars a year per doctors (as paid by Venezuela, South Africa for doctors in Sierra Leone).
    I think that Brazil could find some doctors willing to go to the sertao or another remote place for $130,000 and living expenses a year.

    Sources:

    “Once Renowned, Cuban Doctors Are Failing their Medical Exams in Droves”By Luís Henrique Vieira, Published October 25, 2011http://latino.foxnews.com/latino/health/2011/10/24/cuban-doctors-get-sickly-results-in-brazilian-medical-exams/

    Wednesday, January 25th 2012 – 07:32 UTC

    “Most Cuban trained doctors fail basic test to practice medicine in Chile”http://en.mercopress.com/2012/01/25/most-cuban-trained-doctors-fail-basic-test-to-practice-medicine-in-chile

    “Costa Rica rejects high number of medical graduates from Cuba”, Chrissie Long, 30 September 2012 Issue No:241http://www.universityworldnews.com /article.php?story=20120928140901202

    “Cuban doctors become costly”, By: DENVER KISTING, http://www.namibian.com.na/news/full-story/archive/2012/september/article/cuban-doctors-become-costly/

    “Namibia: Cuban Engineering Degrees ‘Useless'”By Selma Shipanga, 30 August 2012, http://allafrica.com/stories/201208300701.html

  • Isn’t tobacco one of Cuba’s biggest exports an,d didn’t the Castro dictatorship recently not protest the health warnings and bland packaging the Australian government wanted to impose.

    Your argument, in the case of Cuba, is badly chosen, Grady.

    “Cuba Challenges Australian Tobacco Rules
    Reuters”, By DAVID JOLLY, Published: May 6, 2013.
    http://www.nytimes.com/2013/05/07/business/global/07iht-smoke07.html?_r=1&

    As far interventions go: Cuba intervened in Africa (Angola, Ethiopia, …) ever since Che made a fool of himself in Congo.

  • Do you realize that you just have confirmed that medicines from the Us do make it routinely to Cuba.

    When you say: “it is largely self-financing” you are admitting that money is the reason why the medicines for the Cuban people from the USA aren’t purchased. These purchases for the people are to be government financed and the government can not afford to.

    When you say that “quantities of imports required by the tourist sector are much smaller than those required by the national system”, you confirm that these medicines for tourist hospitals accessible the paying tourists and the regime’s elite are easily arriving in Cuba. There is clearly no reason, expect the lack of funds you yourself gave as an explanation, why medicines from the US aren’t available to the Cuban people.

  • Stories, stories, keep them coming. I assume she’s old enough to be retired, right? I don’t believe you actually spent 400 bucks in ‘linens, towels, soda and pizza’, unless you paid a lot in bribes, which makes you a criminal.

    No it was FAKE NEWS, propaganda. The Cuban doctors are coming, thankfully.

    And by the huge amount of propaganda and lies – like not being able to connect to Facebook from Cuba for instance – is more than enough to provide me with suspicious feelings.

  • Oh you don’t fool no one. You say in one topic that ‘corruption is everywhere in Cuba’ but when it involves YOU it’s ‘suddenly’ not the case, it’s a ‘mere tip’. Slippery as a snake. You cannot deny you TOOK PLACE on it, this ‘tip’ was for ‘premium care’ from the doctors. You speak of high morals but are no better than a corrupt officer.

    Hypocrite.

  • Thanks for sharing your personal experiences with us, Moses. Unfortunately, what you depict is all too typical of the Cuban medical system today; whether doctors, nurses, technicians, aides or maintainance staff, most have to press for additional gratuities in order to survive–or at least survive better. This, coupled with the chronic shortages of medical and maintainance supplies, reflect less-than-ideal conditions. Still, with all its faults, Cuba’s medical system is performing heroically, and far better than expected given the severe handicap caused by the embargo. Even if the needed (U.S.) medical supplies can be obtained through a third party, still, this adds more expense, and taxes Cuba’s limited foreign exchange resources. I really have to praise Cuban doctors, nurses, aides, etc. for perservering under these conditions. In contrast, a friend told me a story of a group of Guatemalans involved in a serious passenger truck accident. She drove several of them from (private) clinic to clinic, but most were denied treatment due to lack of sufficient funds. Subsequently, some, including children, died. The medical system in Cuba would be the envy of folks in Guatemala–if they are poor and lack sufficient financial resources! Likewise, in much of the Third World, and all of the Fourth World, most folks would envy Cuba’s system (which is not to excuse its shortcomings, only to give some comparison and contrast).
    This last trip for the first time I was required to pay the medical insurance for estranjeros. Despite that, when I came down with the worst god-aweful gastro-intestinal problems I’ve ever had, (probably my fault for indulging in street food) I holed up for a week at the Hotel Mariiposa in Novia de Mediodia, running twixt bed and bathroom. Figuring that “whatever doesn’t kill me makes me stronger” and “My BODY doesn’t tell ME what to do, on the contrary, I tell IT what to do” and “body is mere extension of will,” muddied, but unbowed, (although “unbowled”) I survived (even though a hospital and institute, specializing is such problems, was right next door). Instead, I relied on my will plus “green medicines” offered by my friend, and was able to survive.

  • To clarify, Griffin, the US is the biggest terrorist organization on the planet, invading and slaughtering on a scale that is difficult to comprehend.

    The US is also the biggest exporter of dangerous, lethal drugs in the world, i.e., tobacco, which kills millions each year worldwide.

    But none of this matters to you, does it? You’ve got you own selective, pro-imperialist view of reality.

  • Comrade Luis, please allow me to pull your shirt on one important point.

    The covert agents of capitalism have a whole history of sowing suspicion and dissent among the ranks of both trade union movements and the revolutionary socialist movement, etc., by implying or charging people with being paid agents of the employers or gov’t police agencies.

    This is well known. It’s said that a good way to find out who the rat is, is to find out who is spreading rumors of various people being agents-provocateurs. And so, comrade, we want to follow a protocol whereby people are given the benefit of the doubt, and are taken at their word, and their arguments are answered according to their inherent merits.

    I remember over thirty years ago in L.A., when we were organizing mass demonstrations against the Vietnam War, there was a guy (from my home state, actually) who appeared one day and got involved in the coalition work. Luis, it was so goddamned obvious that he was LAPD intelligence that it almost made you want to laugh out loud. I asked him day how he had become a radical, and he answered: “Oh, I guess I’ve just always been an old dyed-in-the-wool communist.” ha ha.

    But he was accepted on face value, and was very useful in liaison work with the LAPD for demonstrations.

    There will always be toadies of the monopoly-capitalists, thinking mistakenly that they are patriotic, who infiltrate or work in various ways to subvert the Left. We are all smart enough to know that. But the worst thing we could do is to start throwing around overt accusations, for this would create the very dissension the counter-revolution desires.

    My point is, HT readers may have firm suspicions as to who is what, but still we have to treat each other as genuine and sincere, and not come right out and make over accusations. To do otherwise would be to create suspicion with the discussion, and degrade or destroy our exchanges.

    And, yes, you’re still something of a hero to me, because you battle valiantly and consistently against the usual suspects. But I hope you will comprehend what I’m saying, and not make overt accusations. We all know what’s happening, so, please be cool. Cheers.

  • “Mi suegra’ belongs to one of the categories of engineers not permitted to leave Cuba due to ‘national security interests’ except on government missions. We would have brought both of my in-laws out of Cuba long ago if it were not so. In fact, we are still trying. I do not trust the Cuban medical system in general to perform the most advanced medical procedures currently being practiced in the US. But for the more routine medical needs, Cuban doctors are sufficiently trained and equipped. I would not trust Haitian doctors either so please don’t assume this is anti-Cuban. BTW, didn’t the 6000 Cuban doctor deal fall through? How is the “US-paid troll” proof coming along?

  • Oh, how could I have not realized that earlier?!

    Did your mother-in-law actually paid for the surgery itself? No? Then be quiet and go home. All the money you said you spent was meaningless to the operation itself – she might have waited longer in line and slept in rougher linens, but she would get her medical treatment either way.

    Alas, if you really wanted ‘the best’ for your mother-in-law, why did you trust the Cuban doctors – those you said to be ‘not well prepared’ in the post where I was able to counter each one of your puny arguments to dust about the 6000 Cuban doctors coming to Brazil – and didn’t pay her a trip the the US, now that the abhorrent exit-permit is gone, and payed the surgery for her in one of the ‘top’ private hospitals over there in the land of the riches?

    You acknowledge that ‘We also know that without ANY resources, her experience could have been worse. Much worse.’ but keep supporting the US sanctions that help cripple the resources available in Cuba.

  • To clarify, I do indeed acknowledge the fact that the Castro government has supported terrorism against other countries, and that to this day they continue to provide sanctuary to numerous wanted criminals and terrorists. Cuba also maintains close diplomatic relations with several other countries who sponsor terrorism, including Syria, Sudan, North Korea and Iran.

    Just one of Cuba’s more infamous alumnea is the convicted terrorist “Carlos the Jackal” who was trained at Camp Matanzas, a guerrilla warfare school run by the Cuban DGI near Havana. Carlos went on to join the Palestinian terrorist group, the PFLP, with whom Cuba still maintains support.

    I’m sorry (but not surprised) that Luis didn’t get the Caliban comment. It was a play on a witty aphorism by Oscar Wilde.

    http://www.goodreads.com/quotes/431593-the-19thc-hatred-of-realism-is-caliban-s-enraged-reaction-to

  • The $1000.00 deductible is only a small part of US health insurance cost. The average family must pay $12,000.00 each year for health insurance. Part of the $12000.00 may be paid by an employer. The employee’s salary may be reduced for the that part paid by the employer.

  • Humiliated? You should see me dance. I believe you misread Griffin’s comment. He was simply reflecting on the hyper-response of the Castro regime. I did not take from his comment that he agrees with Cuba being included on the list of states which sponsor terrorism. Nor should you. Finally, how is it again that you are qualified to determine how anyone else feels about the Cuban people, let alone mankind? Oh, BTW, how is that proof that I am a “US-paid troll” coming along? May I suggest you piggyback the Venezuelan investigation that Maduro claimed was in motion to ‘prove’ that the US gave Chavez cancer. It seems you are reading from the same playbook.

  • You can always stop reading Luis. I think Granma would love to have a new reader who doesn’t just use the paper to wipe their ass with.

  • Well after I *humiliated* you here with real arguments:

    http://www.havanatimes.org/?p=93217

    When we talked about health-care, you ‘disappeared’ for a week in order to try an appeal to authority fallacy tale which is your favorite. It all makes sense to me.

    You support the embargo, you agree with ‘Griffin’ that Cuba sponsors terrorism (ie the ‘Caliban’), you are not only an enemy of the Cuban people, you are an enemy of mankind.

  • Luis, please provide proof that I am a “US-paid troll’ or refrain from your libelous comments. Hahaha, besides if my comments upset you, I would do it for free anyway.

  • I cannot believe HT is publishing an ‘article’ from a known propagandist and US-paid troll who hijacks a persona. Sorry but you’ve hit the bottom of the barrel.

  • Thanks for an interesting personal story, told from your special point of view.

  • Please post your proof that anyone in Cuba has been denied surgery for any reason — other than, of course, shortages of medicines, etc. resulting from your beloved genocidal embargo.

  • As for health care offered to tourists in Cuba, it is largely self-financing from fees charged to patients themselves or their insurance providers back home. And the quantities of imports required by the tourist sector are much smaller than those required by the national system.

    It must really piss you off, Paul Lamot, but it seems if you pay a high enough price and import small enough quantities from third parties it is possible to evade the scrutiny of the US embargo-Nazis.

    So, this turns out to be just another of your self-serving rationalizations that not even your closest allies are buying into — not for the past 20 years, Paul Lamot. Deal with it.

  • Despite the best efforts of the US regime to undermine the Cuban health care system with its genocidal embargo, even the CIA must concede that Cuba is producing some remarkable health outcomes. While they must be especially loath to do so, the CIA has ranked Cuba’s infant mortality rate — the single most reliable indicator of overall public health — as the best in the Americas, better than either the USA or Canada. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html

  • You’re correct in that wealth does not in and of itself bring happiness but poverty usually goes hand in hand with misery. But that’s not why they immigrate, or rather flee the island. They leave in droves because they are looking for opportunity, something they don’t have in Cuba

  • If that we’re the case, I would assume that after 50+ years of immigration and the constant back and forth communication with the island that myth would have been dispelled. It must be something else Aussieguy.

    I would’ve what it could be?

  • Makodude, what Moses does not explain in the article is that a Cuban makes around 20$ a month. Lets suppose that a person in Cuba can save 25% of their salary, something we know isn’t so, that would be 5$ a month. For them to save enough to pay 400$ in bribes and whatnots would take over 6 years.

    One of my friends saved for 16 years to be able to take his daughter to Varadero on her sweet 15.

    Also, I don’t see the point in comparing? If we are doing the comparison game why not compare with Finland, Sweden, Netherlands or Canada? It’s completely pointless to compare, the article is about Moses Cuban experience and why calling it “free” is a sham.

  • A friend of mine has a cancer surgery on the stomach. He paid about $2000 – no private insurance scheme, just the national one – for a 5 hour surgery and a 24 day stay in hospital.
    Move to Europe.
    If you move to Cuba and end up in the Cuban side of the apartheid system there will be no surgery.

  • Strangely enough the embargo doesn’t seem to affect the elite and tourist part of the Cuban health system. There everything is available. How do you explain that, Dan Christensen?

    The one that is depriving the Cuban people of vital access to medicines, adequate food, … is the Cuban regime.

    As the news report below shows Cuba recanted on 99% of approved deal to save money ate the expense of the health of the Cuban people, Dan Christensen.

    “The U.S. says it approved $142 million in commercial and donated medical exports to the communist island in 2008. So why did less than 1 percent of it get there?”
    “It’s not the embargo,” said John Kavulich, a senior policy adviser at the New York-based U.S.-Cuba Economic Trade Council, which provides nonpartisan commercial and economic information about Cuba. “These are economic and political decisions not to buy.” Cuba often waits for allies to donate what it needs, Kavulich said. “They’d rather get things for free than pay for them.”

    “It’s unclear why U.S. medical exports aren’t reaching Cuba”, Dallas Morning News, 5 December 2009.

    Food sales from the US to Cuba have declined for the same reason, Dan Christensen.
    The Cuban regime – because of its dogmatic mismanagement of the economy – is unable to pay for food imports.

    Cuba slashes projections for 2009 imports, exports | Reuters (21 July 2009)
    http://www.reuters.com/article/GCA-Cuba/idUSTRE56K5PJ20090721

    Cuba slashes purchases from US in 2009 by 37 percent (3 November 2009)
    http://www.malaysianews.net/story/561223

    Neither Amnesty International nor the UN have EVER referred to the trade sanctions as “genocide”, Dan Christensen. In fact – a fact you confirm by failing to post a link for over a decade I have seen on the web – no international organization of any credibility ever has.

    The international convention on genocide to which you refer states clearly that any action has to have the “intent to kill” to be considered genocide. The US sanctions have far from that intent, Dan Christensen. they also don’t have that effect. The US provide the bulk of the 5 billion dollars in remittances that keep people in Cuba alive.

    The international watchdog on genocide, Genocide Watch, only sees this “intent to kill” people in Cuba in the actions of the Castro regime and it has therefore places it on their list of regime guilty of acts of genocide (like it does with Bastista, the other Cuban dictator).

    See:
    http://genocidewatch.net/genocide-2/genocide-and-politicide/

    You can mindlessly repeat your lies. Those are the facts.

  • Corruption is also widespread in the Cuba medical system.

    See:
    “Médicos cubanos venden buen trato por 25 pesos o un bocadito”
    http://cubacorrupcion.impela.net/2011/08/medicos-cubanos-venden-buen-trato-por-25-pesos-o-un-bocadito/

    as far as the quality of the part of the apartheid system that is meant for Cubans goes: very bad.

    “Cuba Surgeons Write to Raul Castro About Disastrous Health Care System”
    http://translatingcuba.com/cuba-surgeons-write-to-raul-castro-about-disastrous-health-care-system/

  • They are attracted by the myth that wealth brings happiness, I expect. Recent postings in HT have told the stories of Cuban expatriates pleading to return home after learning that life in the first world is not as wonderful as they were led to believe.

  • It was not the tourist hospital that I saw. As far as I could tell, my friend and I were the only foreigners in the building. It was the same hospital that Moses describes in this story.

  • You are right about the embargo, Smudge. Internationally, it is a huge black-eye for the US regime. Amnesty International has all but called for the arrests of the perpetrators of this crime against humanity. It has reported:

    “The US government is acting CONTRARY to the Charter of the United Nations by restricting the direct import of medicine and medical equipment and supplies, and by imposing those restrictions on companies operating in third countries.”

    “The RESTRICTIONS IMPOSED BY THE EMBARGO help to deprive Cuba of vital access to medicines, new scientific and medical technology, food, chemical water treatment and electricity.”

    “The US embargo against Cuba is IMMORAL and should be lifted. It’s preventing millions of Cubans from benefiting from vital medicines and medical equipment essential for their health.”

    “Amnesty International calls on the US Congress to take, WITHOUT FURTHER DELAY, the necessary steps towards lifting the economic, financial and trade embargo against Cuba.”

    “UN agencies working in Cuba, such as the WHO, UNICEF and UNFPA, continued [as of 2012] to report the negative effects of the US embargo on the health of the population, particularly members of marginalized groups. Access to specific commodities, equipment, medicines and laboratory materials remained scarce as a result of restrictions imposed on the importation of items manufactured by US companies and their subsidiaries or produced under US patents.”

    http://www.amnesty.org/en/library/asset/AMR25/002/2009/en/e7b1efe4-27f4-4b2c-9a39-23c88749e39e/amr250022009en.html

    http://www.amnesty.org/en/news-and-updates/report/president-obama-should-take-lead-lifting-embargo-against-cuba-20090902

    http://www.amnesty.org/en/library/asset/AMR25/007/2009/en/51469f8b-73f8-47a2-a5bd-f839adf50488/amr250072009eng.pdf

    http://www.amnesty.org/en/region/cuba/report-2012

    Morally and legally, the US embargo can be seen as a form of genocide. Article 2c of the UN Genocide Convention, states that the crime of genocide includes, “Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part.” http://www.icrc.org/applic/ihl/ihl.nsf/Article.xsp?action=openDocument&documentId=2F091964230EADECC12563F700550817

    I defy any of the embargo-Nazis here to deny that sanctions which deprive a target population of vital access to medicines, new scientific and medical technology, food, chemical water treatment and electricity are indeed a form of genocide.

    For 20 years in a row now, these cruel and inhumane sanctions have been condemned by the UN General Assembly. Not even the US regime’s closest allies there are buying into its self-serving rationalizations!

    Makes you proud, don’t it, America?

  • The hospitals in Cuba that tourists see are not the same ones the average Cuban people must use. The upper echelons of the Cuban regime enjoy very nice, clean, well supplied hospitals. The rest of the people, not so much.

  • You would be unique in this regard.

    I wonder why Cubans who actually have to endure these same medical service are so eager to immigrate. I think that speaks volume. Well, remember to take your linen.

  • Actually, while the amount of the tip (bribe implies a payment to do something he would not otherwise do) was my wife’s choice, I am led to believe that some type of remuneration, cash or gift, is universally expected. Be assured that I was opposed to this from the ‘get-go’. My belief is that this is the surgeon’s job as my wife once had a job in Cuba and her mother still has a job as an engineer and neither of them was ever ‘tipped’ for doing their jobs. Moreover, on behalf of the fatherland, my mother-in-law has served on two international missions as well as put up with all the crap just living in Cuba demands. She has never earned more than 25 cuc a month in Cuba. Other than childbirth, this was her first time overnight in a Cuban hospital. I am of the mind she had a free one coming. BUT, I was overruled on the whole tipping question as well as the amount. I am also told that while people who are unable to tip and buy pizzas and sodas are still treated, they are last in line for everything. There is no comparison between the ‘comforts’ of a US hospital stay and what I witnessed in this Havana hospital. It’s said to be worse outside of Havana. But you are correct in echoing that the surgery went well and that is ultimately most important.

  • You may get the brightest and whitest sheets by tipping but the the actual medical care will be the same with or without the tips. Also, if it wasn’t for the American embargo there may have been far more white and bright sheets. My husband, a Canadian, was in a Cuban hospital and I was very grateful for the well trained and caring medical staff.

  • My wife has just had spinal surgery in Australia, where we are citizens and supposedly entitled to free health care. Our total out of pocket expense was the equivalent of $120,000.00 US dollars. I have been to Cuba three times, and I have visited the hospital in Havana twice. Having had the benefit of comparing both systems, we now hope to migrate to Cuba one day.

  • So because you CHOSE to bribe the surgeon and pay off the staff with pizzas and cokes, that means that health care isn’t free? Bottom line is reflected in your admission that “despite these physical conditions, the two hour surgery thankfully went well.”

  • I would say that health care in Cuba is expensive indeed. The confiscatory nature of Cuban communism means that the vast majority of its citizens labor is taken by the state. In return the state provides (in theory) the basic requirements of life (food, medical care, housing) With the inificient Cuban system and the deplorable infrastructure on the Island, it wold appear that the average citizen is not getting there money’s worth.

    I have a feeling Makodude that you would not put op with that kind of care should you encounter it in the states.

  • Guess what the Total cost of surgery and 3 days care
    in a US hospital would be? A “tad” more than linens, towels and doctor tips

  • Well ,I don’t know in the USA, but in Spain if you are an illegal immigrant the treatment would be none i,f you don’t have the money to pay for it, and last ofmonth an illegalinmmigrant didn’t receive the treatment for tuberculosis screening as a result he died, this is the stark reality and getting worse and worse

  • A very interesting story, Moses. Thank you for sharing it with us. Best wishes to your mother-in-law for a full and speedy recovery.

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