30 November 2016

The Atlantic: How Cubans Live as Long as Americans at a Tenth of the Cost

Many consider it more than decent. After a visit to Havana in 2014, the director-general of the World Health Organization Margaret Chan called for other countries to follow Cuba’s example in health care. Years before, the World Health Organization’s ranking of countries with “the fairest mechanism for health-system finance” put Cuba first among Latin American and Caribbean countries (and far ahead of the United States).

Cuba has long had a nearly identical life expectancy to the United States, despite widespread poverty. The humanitarian-physician Paul Farmer notes in his book Pathologies of Power that there’s a saying in Cuba: “We live like poor people, but we die like rich people.” Farmer also notes that the rate of infant mortality in Cuba has been lower than in the Boston neighborhood of his own prestigious hospital, Harvard’s Brigham and Women’s. [...]

The difference comes back to the basic fact that in Cuba, health care is protected under the constitution as a fundamental human right. The U.S. protects unlimited firearms and freedom from quartering soldiers but does not guarantee health care. Instead we compromise, taking inefficient and expensive half-measures to rescue people in serious peril. [...]

It’s largely done, as the BBC has reported, through an innovative approach to primary care. Family doctors work in clinics and care for everyone in the surrounding neighborhood. At least once a year, the doctor knocks on your front door (or elsewhere, if you prefer) for a check-up. More than the standard American ritual of listening to your heart and lungs and asking if you’ve noticed any blood coming out of you abnormally, these check-ups involve extensive questions about jobs and social lives and environment—information that’s aided by being right there in a person’s home.

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