It Never Would Have Happened in Cuba

Yusimi Rodríguez

Blood Bank in Havana. Photo: Caridad

HAVANA TIMES, June 23 – If I hadn’t seen the US film John Q on Cuban television yesterday, perhaps I’d be writing something quite different today on the system of health care here on our island.

The movie’s storyline is that the nine or ten-year-old son of John (played by Denzel Washington), collapses while playing baseball and, after a series of tests, it’s discovered he has an enlarged heart and will need a transplant, otherwise the boy will only have months or weeks left to live, perhaps only days.

The good news is that his blood type is B positive, what quickly raises his name up on the list of patients awaiting donations.  The bad news is that simply to be included on that list his parents will have to pay $75,000, not counting the cost for the care that the boy is receiving in the hospital in the meantime.  The operation itself, if he’s lucky enough that an organ appears on time, will cost a minimum of $250,000 dollars.

The boy’s two parents are employed, so John (Denzel Washington) is convinced that the insurance he had paid for years will cover the costs of the operation their son’s needs.  Soon the hospital administration points out his error: the boy’s condition is not covered.

The couple sells everything that’s marketable, and friends try to contribute with what they can, but it’s not nearly enough.  On top of all this, the boy is going to be released from the hospital, not because he’s improved at all, but because the medical services he had been receiving were not paid.  Faced with his son’s virtual death sentence, John takes drastic measures: he decides to kidnap the surgeon, close off a floor of the hospital and take hostages so that his son is included on that famous list.

Starting from there, this is more or less what I have seen before with this type of plot, where somebody takes hostages to demand something, the hostages go from fear to solidarity with their kidnapper, and the viewers are moved to tears by the story.

And, as always, there’s the element of the curious public who remain outside the hospital trying not to miss anything in “the cause of the moment,” as the situation is described by one of the characters in the movie. Nor is there a lack of the standard political interests, concern for public opinion in the face of elections or journalists trying to squeeze out the maximum juice from the story.

Cuban Kids have their medical attention guaranteed at birth. Photo: Caridad

In fact, it doesn’t matter how the story ends.  There’s something that’s clear after the first half hour of the movie: It is an open and direct criticism of the healthcare system in the United States of America, the most powerful country in the world, where 40 million people live without medical insurance.

If the objective of showing this film on Cuban television was to make Cuban citizens reflect —especially those who dare to criticize the domestic political system and their government about the achievements of the Revolution in the field of public health that is within reach of all our people— then the film achieved that goal. Even before the first half hour of the movie, the first phrase that crossed my mind was, “That wouldn’t have happened here.”

I don’t mean that there wouldn’t have been the risk of the child losing his life on the operating table, procedures of that type are always risky.  Nor am I implying that here there would have been a bunch of compatible hearts waiting for him.  His parents would have had a ton of reasons to be concerned, but if they were in Cuba they wouldn’t have had to sell all their worldly possessions so that their son was included on a list, nor would they have had to think about the expenses of being admitted into the hospital, and less still about the cost of the operation.

Here, medical care is guaranteed for everyone who works, who doesn’t work or who never will work.

Does that mean that Cuba’s health care system is perfect?

No.  Often you go to your neighborhood clinic and there’s no one there to attend to you, or there’s no film to take an x-ray, or in the pharmacy there’s none of the medicine you need.  It’s become common practice for people to bring the doctor some type of gift to guarantee that they’ll be well attended, or so they don’t have to get in the tortuous lines when they go in for a consultation.  People are convinced that they can’t go there with their hands empty, because the doctors also have to live.

Everybody knows that the salaries of doctors are insufficient, and that the majority of them have to chase behind buses the same as anyone of us.  People know that physicians often don’t have the resources to work, that on occasions they go directly from their night shift duty to their regular consultations, that many want to go on medical missions abroad in order generate the income to build a house or to bring back a computer, or things to sell, that many have to extra work outside of their profession to make a living.

Likewise, many of them have abandoned their professions in order to make a living.  We can’t criticize them. We can only give our thanks to those who remain in the field of medicine and carry out their work with the greatest of dedication, with no other interest than that of saving lives, and who suffer when they don’t achieve that.

Despite all this, which would have been the central idea of my comment just a couple days ago,  I can’t avoid continuing to think about the situation of the characters in the movie, and —to repeat to myself— that wouldn’t have happened here.

Someone could argue that our health care isn’t really free, because the money the State uses in health and education is what it takes from our pay checks on the job, with the result being our so very low wages.

Here, medical care is guaranteed for everyone who works, who doesn’t work or who never will work. Photo: Caridad

It’s possible, but like I said before, that right here is guaranteed even for those who have never worked.  Yes, it’s complicated; nothing is black and white.  There might exist people who are much better informed and who could possibly provide data on measures taken to “influence” the statistics on the public health care system in our country, or they might have information about medicines that are in short supply here but are exported to other countries.

I cannot substantiate anything concerning that.  In this instance, I can only guide myself based on what our official national press says, but also from my own experience as a person suffering from asthma since I was a child, from the medical problems of friends and family members with afflictions that are even more serious than mine, and from anyone who has at any time needed medical care.

The movie could have been set in many countries

Most countries in the world could have been used as the location for the movie John Q.  In many countries, people die from simple illnesses for lack of diagnosis.  That’s not the case of Cuba.

What I’m asking is whether the fact of having free health care and education a strong enough argument to stop us from criticizing what we consider worthy of criticism, to stop us from demanding changes, to stop us from standing up for any right that is denied us?

No.  Medical care is one right that should be guaranteed all human beings on the planet, independently of their social condition, economic situation or their political or religious affiliation.  We cannot view free health care as a favor or charity.  If we have to pay for it with our silence, conformism or sell-out attitudes, then it’s not free.

In the United States, 40 million people still lack medical insurance.  This is a pending task for President Barack Obama and for all the citizens of that country, who should fight for that right.  We have already achieved it.  Free health care in Cuba is a right.  Now we must conquer others.


13 thoughts on “It Never Would Have Happened in Cuba

  • July 5, 2010 at 8:51 am
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    Interesting argument about Capitalism, and how wonderful it is to have all the profits you earn in your own pocket. And Health Care of course can always improve under Capitalism because the profit motive will create the self-interest to improve it. Sorry folks, Capitalism doesn’t work that way.

    The profit motive simply gives greedy people an opportunity to take advantage of the less greedy, or less healthy, or less educated. I won’t even bring up race and Class which muddy the waters even further. Instead, I’ll give you a few examples of how the system works for those of us who are not at the top of the heap.

    Our ‘Democratically’ elected Legislature passes a bill, and funds, a Medical Residency Program. The ‘Democratically’ elected Governor – from the minority Party – decides the money may be wasted, and refuses to spend it. The Residency Program never gets started. This same Governor decides a Long-Term care facility for Veterans is too expensive. She unilaterally cuts the size of the facility in half, and ‘Privatizes’ the work-force. Other Public Institutions have Union employees working for a living wage. The new facility has non-union workers many of whom are paid minimum wage [they are ‘unskilled’] and receive no benefits that are not mandated by law.

    The Administrators of these projects receive big salaries so they can be ‘competitive’ with private industry. Who knows, maybe BP will lure them away if they just earn a good living…

    Cuba offers Medical Scholarships to US Citizens. I have written to Newspapers and Politicians and Educators about them. So far, even though we suffer from a terrible shortage of Doctors, going to a Communist country for an education is a no-no.

    The primary similarity I see between Cuba and the US is the appalling ignorance one people has of the other. In that, they seem to have true equality!

  • June 27, 2010 at 5:55 pm
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    ‘Castro brothers personal farm’

    Oh my… this is Fox News quality material! 😉

  • June 25, 2010 at 2:54 am
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    Let me just be more clear Greg, Cuba is not socialist or communist

    The system in Cuba just seem to be the Castro brothers personal farm.

  • June 24, 2010 at 10:08 pm
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    Greg I think you are misunderstanding my statement
    When I say before the system in place now is State monopoly capitalism
    I was referring to Cuba’s system.

    This is a question that always intrigue me. What is the real economical system of Cuba now?

    The two that come closest to it are
    Slavery and State monopoly capitalism

    Let me explain myself

    People are pay very little as you know therefore they are working almost for free, what they get is not even sufficient for them to buy food to eat! and they get this “free health” and “free education” but in the end they actually pay for it will the very very low wages they will earn for the rest of their life!
    They price to pay for the individuals is too high! Because they have to support all the lazy ones that do not want to study or work etc so there you have it.
    Slavery!

    As for State monopoly capitalism
    Anything in Cuba has to be paid for. (Even the so call “free services” like education and health) where do you think that money comes from? The state does not create wealth. People’s work do!
    So with the state fixing prices and not allowing any competition and using the police and the customs service to control what people can import into the country or export. They have absolute control of everything.
    So then again there you have it.
    Cuba system is top down because of both explanations above. The top hierarchy set everything up so that they direct from their ivory tower the system to very bad effect on the people at the bottom of the pyramid.
    Those Cubans, those at the bottom are the ones for whom this system was build and they are worst of.
    Now they are even poorer than before the revolution, and they do not even have the freedom to express it!

    I do not understand how the international left can not see that the Cuban system is a really bad example. One that simply shows Stalinist socialism is bad for every one.

    I do not think socialism can be improve. You always end up with this kind of system were not everyone in society is included.

  • June 24, 2010 at 8:02 pm
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    Oh, and I’m not arguing that Cuba isn’t broken, no least of the reasons being the blockade and 50 yrs of imposed war… Broken by the bureaucracy and coordinator class that is too afraid to act lest they fall under some other bureaucrat ducking for cover. Only when there is a participatory process governed by the stake holders on the ground, one where decisions are not undermined by the party time and time again, will there not be incredible gaps throughout all of provisioning in Cuba.

    But you’ll never see me working with the immoral ignorance of capitalism. There is no debate, it is direct democracy within socialism or barbarism.

  • June 24, 2010 at 7:51 pm
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    Julio, you obviously don’t understand and system of political economy when you say that we are in state-capitalism. Even all the Austrians give some role to the state in a market system to regulate and break up monopolies. There are so many contradictions within the political economy of capitalism that you’re bouncing around within it’s “logic” is so ignorant that I could hardly begin to illuminate you in such a forum.

    Read more Hayek, he’s the only honest and hard working purist Austrian or what in the u.s. is called “libertarian” scholar of political economy. You have to actually read his original works, read his struggles to show equilibrium in markets (he ended up with a bunch of caveats that never occur), to show how they can avoid monopolism.

    The reason, as predicted by Lenin and Marx, that markets end up within a capitalist state, is because markets accrue more power and wealth into fewer and fewer hands… So the market players reflect the centralization of power in the state, and the state and market makers HAVE to cross polinate. Thus market-capitalism is very unlikely to allow democracy to work.

    I’m not at all duped by the Cuban propaganda. I have a very realistic look on Cuba, to the point that some of my more elite cuban friends, who like me a lot, don’t like to have me around, out of paranoia. But that also doesn’t make me blind, to what I’ve seen first hand in the hospitals and with Cuban friends who were sick… Including one of the top professors of medicine in the country gettin sick while I was there, vs. a lowly regular nobody who was sick at the same time. And I would say the the lowly centro habana man got better care because he really needed it. The system is there when it’s life or death. Which is the same here in Canada.

    And every system has costs on the population. That goes without saying, and you arguing on that basis makes your whole stance much less than serious.

  • June 24, 2010 at 5:59 pm
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    Greg, please provide link to the article you are referring as for monopoly
    I can show that the system in place now is State monopoly capitalism
    The worst king of capitalism possible.
    And to top these all personal liberties have been taken away.

    With regards to the medical care and the quality they get. I will tell you that if you listen to their propaganda machine it all looks wonderful.
    You have to see the system working to see that is not.
    If it is so wonderful then why does the regime refuse to let news people near the hospital facilities etc?

    There is different levels of medical care. One for the top hierarchy and the military and security apparatus and another for foreigners paying with hard currency and yet another for the rest of Cubans. This last one is the one that suffers from all the scarcities they blame on Embargo.
    The reality is that they can not really afford to pay for all of these services for everyone. They need Cubans to become more productive and unfortunately for them this is not happening.

    I know of many stories of people that had to do miracles just to get the X-Ray film that will be use on them or a family member! The same with medicine that it is usually sent by family abroad.
    So there you have it. It is a broken system, this broken system is intending to pass as the triumph of the revolution!
    On the other hand let me address again the fact that this whole system is paid for by the Cubans themselves. The state resources dedicated to it come from as Yusimi was saying the very very low wages paid to them!
    So this is not really a free service. They are actually been tax and they do not even know it!
    Additionally there is this lack of fiscal accountability.
    Ask any Cuban functionary how much they expend per person in this health care system or also on the so call “free education”. Let us know what they say. I suspect none can answer those questions.

  • June 24, 2010 at 6:54 am
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    Yusimi, that was a great article. It raises very painful questions, and I hear your cry for the suffering of our must vulnerable citizens, the children.
    However, the realities of the Health Systems are such, that there is not a country on earth where the health resources are enough for the needs demanded. In the Cuban case, the Goverment determines where, how and when to use those resources, and lets face it, some recipients are lucky and others are less than please, no way to “fix” this. In the case of other countries, the resources are determined by their own people and what they can demand of their goverments by means of legislation and also augmented by private citizens organizations. One system is a fixed hand-out at the whim of bureaucrats, the other one, even thou painful and unfair a lot of times, has at least a chance to evolve and grow.
    Free, unlimited and equally distributed medical care is an utopia, no matter where and how much we try.
    Over the years, hand-outs, welfare, brings complacency. Struggle, fight, freedom of choise, brings progress.

  • June 24, 2010 at 5:26 am
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    Generally, Cubans don’t know how good they have it. Of course there are problems, and the coordinator class offends the intentions of Guevara and keeps real self-driven impetus and self-management suppressed.
    I think Cuba only spends $330 per person on health care, including dentistry, per year. They can do this because they really, truly value human beings before capital, and because they focus on preventative care.

    Some friends of mine, when I was there, were enjoying relaxation that no other country gives its sick… 3 months off after a major illness, and 2 months off for his wife to care for him. Having all the basics provided for them, they have some of the most advanced culture of any small city I’ve ever been to, because a huge mass can afford to be nearly full time artists. Free vacations at world class resorts, incredibly cheap, world class beverages, you can get 15 cent cocktails in central Habana. Free world class education, an intellectual culture the likes of which I’ve never come across in all my travels, etc. etc.

    Cubans, need to stop griping and start building on the treasure trove of what they DO have, and get the momentum back up to speed from the initial revolutionary stage. The gains have been huge in just 50 years (thanks to Guevara mostly IMO) – from two thirds illiteracy (at least), probably one of the highest infant mortality rates in the world, unemployment of up to %75 in the off cane season (el tiempo muerto), etc., etc. Communism has been good for Cuba, no one can look at the facts and argue against that.

  • June 24, 2010 at 5:09 am
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    Julio, study Canadian health care and read Parecon: Life After Capitalism. Read up on remuneration based on effort and sacrifice, also say proportionate to stake and balanced rotation of roles. To see how you build incentive for hard work and innovation, without the corruption of markets, which even Hayek admitted, tend towards monopoly, or the leveraging of wealth for more (asymetrical) control of wealth (and discourse).

  • June 23, 2010 at 9:50 pm
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    This article is just Cuban propaganda. How many 8-year-olds are getting heart transplants in Cuba these days? My guess is none. Meanwhile, people die every day in Cuba because the “health care” system doesn’t have basic medicines and equipment. Hell, I know a person whose mother died because the ambulance didn’t have enough gas to get to the hospital. Cuba is a mess, from top to bottom. It’s time for the people here to admit it.

  • June 23, 2010 at 8:01 pm
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    How very true. In Canada we have free health care.The fact that people die in the streets in the USA or insurance companies employ workers to find loopholes to deny coverage is a shame. The people need to wake up. Populations are aging and health care is more needed. I believe that universal free health care is a right. The USA got it wrong(big surprise).In the USA healthcare is a business like selling shoes or food.
    No wonder the sun is setting on their empire. Their economy is in ruins and they wonder why.It is because all around them people are dying.

  • June 23, 2010 at 7:42 pm
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    Yeap Yusimi you got this right
    I will be one to write this

    “Someone could argue that our health care isn’t really free, because the money the State uses in health and education is what it takes from our pay checks on the job, with the result being our so very low wages.”

    Now your reply is
    “It’s possible, but like I said before, that right here is guaranteed even for those who have never worked.”

    My question then is do you think this is fair? Is it fair the lazy and the ones that does not want to move the country or himself forward be given this benefit? Is it fair to you who push to improve yourself and your life to be dragging all the lazy ones? Every society has them. We have them here in the US too. It is sad to see how many are living from welfare instead of working and learning new things.

    Why are we to support such laziness?

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