[toomuchtodo]

http://www.wired.com/2010/04/cuban-health-lessons/

"Despite a 50-year trade embargo by the United States and a post-Soviet collapse in international support, the impoverished nation has developed a world-class health care system. Average life expectancy is 77.5 years, compared to 78.1 years in the United States, and infant and child mortality rates match or beat our own. There’s one doctor for every 170 people, more than twice the per-capita U.S. average.

Not everything is perfect in Cuba. There are shortages of medicines, and the best care is reserved for elites. But it’s still a powerful feat. “In Cuba, a little over $300 per person is spent on health care each year. In the U.S., we’re spending over $7,000 per person,” said Drain, co-author of Caring for the World and an essay published April 29 in Science. “They’re able to achieve great health outcomes on a modest budget.”"

[mudil]

"There are shortages of medicines, and the best care is reserved for elites."

Nice healthcare system!

[toomuchtodo]

Please explain how that's any different than the US when you can't afford medicine or care? It makes little difference whether the shortage is due to no physical supply vs not being able to afford it. If you can't get healthcare, you can't get it.

http://www.nerdwallet.com/blog/health/2014/03/26/medical-ban...

“In 2013 over 20% of American adults are struggling to pay their medical bills, and three in five bankruptcies will be due to medical bills. While we are quick to blame debt on poor savings and bad spending habits, our study emphasizes the burden of health costs causing widespread indebtedness. Medical bills can completely overwhelm a family when illness strikes,” says Christina LaMontagne, VP of Health at NerdWallet. “Furthermore, 25 million people hesitate to take their medications in order to control their medical costs. Unfortunately this can lead to even worse financial outcomes as preventative treatments are not rendered and patients end up using expensive ambulance and ER care as their health worsens.”

[mudil]

I am an anesthesiologist. I worked in some of the best hospitals in the country in residency (UCSF and Harvard's BWH), and I worked in Detroit and I work now in a small Catholic hospital. And I can tell you that quality of care poor get is the same as rich ones get.

Then I also grew up in Soviet Union, where supposedly great healthcare was developed. And I can tell you they had a horrible health care like they have it in Cuba today.

If Cuban health care is so great, where is their great health research and studies? When did they publish the last time in Lancet on in NEJM? Where is that?

[mentalhealth]

And I can tell you that quality of care poor get is the same as rich ones get.

That's because you're an anesthesiologist, and you see the acute cases which have already been admitted to the hospital. Poor people don't receive comparable long-term care. They don't receive comparable followup care after procedures. They can't afford lifesaving medication, they can't afford physical therapy, and they can't afford psychiatric care. They're denied for transplants, and many surgeons won't accept them as patients because their recovery stats are so much lower due to the aforementioned lack of followup.

All of this, without even mentioning the increasing number of specialty surgeons that operate on a cash-only basis, or the poor who don't go to the doctor simply because they cannot afford to. There's no comparison between the care that the rich and poor receive in this country, except possibly once they're unconscious in the OR.

[toomuchtodo]

> If Cuban health care is so great, where is their great health research and studies? When did they publish the last time in Lancet on in NEJM? Where is that?

Cuba invests heavily in cancer research.

"Even in times of economic hardship, the Cuban Government has remained constant in its political and financial support for biotechnology. In the last 20 years it invested around one billion US dollars in research and development. Today, the Cuban biotech industry holds around 1200 international patents and markets pharmaceutical products and vaccines in more than 50 countries. Exports are soaring and generate yearly revenues of several hundred million dollars."

http://www.who.int/features/2013/cuba_biotechnology/en/ http://investmentwatchblog.com/cuba-develops-anti-cancer-tre...

http://www.medicalnewstoday.com/articles/255830.php

[mistermumble]

What does getting basic primary care to the population (vaccinations, preventive care, well baby care) have to do with how many research papers get written?

I have worked in one of the top medical schools in the US, with world-class researchers, and know that there is very little there that is directly applicable to a population of rural farmers and impoverished city dwellers.

[smacktoward]

As opposed to the U.S., where the best care is reserved for the people who can afford to pay for it out of pocket.

Elites, in other words.

[dragonwriter]

The US system -- despite being the mist expensive per capita in the world -- has both of those features, too; sure, the rationing method in the USA is different (rather than a formal elite with special access, we have pay-to-recieve and an elite defined by the ability to pay -- but there's still limited supply and the best care going only to the elite.

[ceejayoz]

The US has shortages of medicines, too. http://www.accessdata.fda.gov/scripts/drugshortages/default....