"Sicko" Presents False View of Cuba's Health System
by Ryan Balis
Leftist filmmaker Michael Moore claims his latest documentary,
"Sicko," will "rip the band-aid off America's health care industry,"1
which Moore sees as wrongfully dominated by private drug companies and
profit-seeking HMOs.
In part of "Sicko," released June 29, Moore takes a group of
ill 9/11 rescue workers to Cuba for health treatment.2 Though most of
the workers on Moore's two-week sojourn in March 2007 were insured,3
Moore's motive in going to Cuba is to showcase the supposed superiority
of the communist country's "free" national health care and to compare
this to "the misery people are put through on a daily basis by our
profit-based system" in the U.S.4 (The Department of Treasury has opened
an investigation into whether Moore violated the U.S.'s longstanding
embargo of Cuba.)5
As with Moore's previous documentaries, "Sicko" provides a
brash handling of public policy disputes. The film's underlying push is
to, in Moore's words, "ignite a fire for free, universal health care."6
When this premise is examined, the rosy myth of socialized medicine's
achievement in Cuba is crushed.
Cuba's Heath Care System: The Reality
Under the Cuban government's health care monopoly, the state
assumes complete control. Private, non-governmental health facilities,
where ailing citizens could buy treatment, are illegal.7 As a result,
average Cubans suffer long waits at government hospitals, while many
services and technologies are available only to the Cuban party elite
and foreign "health tourists" who pay with hard currency. Moreover,
access to such rudimentary medicines as antibiotics and Aspirin can be
limited, and there are reports that citizens excluded from the
foreign-only hospitals often must bring their own bed sheets and
blankets while in care.8
Despite the reality, Cuba's universal health system continues
to be glorified. "Defenders of Cuba's communist government cite
universal health care and education as 'gains of the revolution,'
claiming the average Cuban is far better off today than under the
dictatorship of Fulgencia Batista," wrote Tom Carter of the Washington
Times.9 Moreover, "The health care system is often touted by many
analysts as one of the Castro government's greatest achievements," says
an updated 2002 State Department report, which rejects the notion that
Cuba's health conditions have significantly improved for most Cuban
citizens since 1958.10
When examining the woeful reality of health care in Cuba,
Moore's and other liberals' drive to establish a 'socially equitable,'
centrally-planned medical system in America should be rejected as a
foolish proposal. Though state-sponsored health care is trumpeted in
Cuba as a basic human right achieved by the revolution, according to
many reports, including those by Cuban defectors, universal availability
of and accessibility to top quality care are fantasies.
Below is a snapshot of reports from those who have witnessed
Cuba's health care system up front. They serve notice of the horrors of
socialized medicine.
Cuba's Health Care System in Practice
Says Canada's National Post, which assessed Cuba and its health
system in a three-part series:
Even the most commonly available pharmaceutical items in
the U.S., such as Aspirin and rubbing alcohol, are conspicuously absent
[in Cuba]... Antibiotics... are in extremely short supply and available
only on the black market. Aspirin can be purchased only at
government-run dollar stores, which carry common medications at a huge
markup in U.S. dollars... This puts them out of reach of most Cubans,
who are paid little and in pesos.11
The same National Post story continues, quoting Jasmin, a nurse
from Moron, Cuba, "We have nothing. I haven't seen aspirin in a Cuban
store here for more than a year. If you have any pills in your purse,
I'll take them. Even if they have passed their expiry date."12
Cuban defector Dr. Leonel Cordova told the New York Times about
his experience practicing in Cuba, "[E]ven if I diagnosed something
simple like bronchitis... I couldn't write a prescription for
antibiotics because there were none."13
Along these lines, Patricia Grogg of the Inter Press Service
writes:
[A] survey carried out in pharmacies late last year [in
2000] by the local [Cuban] magazine Bohemia failed to find 211 of the
medicines included on the official list of products produced to attend
to the health of this Caribbean island nation's population of 11
million... 'They say scarcity of medicine is no longer such a serious
problem, but I've been trying for days to buy aspirin in this pharmacy,
and they always tell me there isn't any,' complained Mara Dolores Pea, a
60-year-old pensioner, outside her neighborhood pharmacy.14
In addition to a limited supply of medicine, according to a
2005 report in the Boston Globe, Cuban health care workers are in short
supply:
A 45-year-old nurse in Camaguey Province said she has
worked without a doctor in her primary-care clinic for more than two
years since the physician was transferred to another clinic to replace a
doctor sent to Venezuela. 'My patients complain every day. They want
me to act as a doctor, but I can't,' she said. 'The level of attention
isn't the same as before.'15
The nurse is alluding to a program in which one-fifth of Cuba's
health care labor supply - some 14,000 doctors and 6,000 health workers
- has been contracted out to work in Venezuela. Under a special
"oil-for-doctors" exchange between Venezuela's Hugo Chavez and Cuba's
Fidel Castro, Venezuelans receive free eye surgery in Cuba. In return
for these medical services, Cuba receives 90,000 barrels of discounted
oil per day.16
Ordinary Cubans have suffered as a result. "Blackouts,
shortages of consumer goods and other problems persist," wrote Gary Marx
of the Chicago Tribune.17
Indira A.R. Lakshmanan of the Boston Globe wrote:
The system has suffered setbacks... since the cutoff of
Soviet aid some 15 years ago, with hospitals and clinics in need of
renovation and equipment, pharmaceutical costs soaring, and patients
saying they must bring bedclothes, food and fans to hospitals. But
complaints about a lack of medical personnel are new, dating to the
cooperation with Venezuela that some observers disparagingly call the
oil-for-doctors program.18
Lourdes Garcia-Navarro of National Public Radio reported:
[S]peaking privately... some Cuban patients and doctors say
the system has been feeling the strain of treating the Venezuelans in
their home country and on the island. Doctors say that there's a
shortage of trained specialists. Most Cuban doctors now they say become
general physicians and forego specialized training because what is
needed in Venezuela are community doctors. Patients in Cuba complain
that their hospitals are stretched and they're not getting the same
standard of care they're used to.19
Finally, the Chicago Tribute reported in 2005:
At least one nurse involved in the eye operations said
Cuban physicians are sacrificing quality for quantity as they hurry to
complete as many operations as possible. The nurse said the number of
eye operations at her hospital has soared from about 15 to more than 120
daily, and many patients fail to receive important preoperative tests,
she said. The surgeries are performed round-the-clock... 'Nobody is in
agreement with this, but they say that you have to do it without
discussion,' the nurse said. 'The patients are being mistreated.'20
Despite shortages of medicine and care, especially since the
exchange agreement with Venezuela, not all Cubans suffer. "In Cuba
there exists TWO health care systems,"21 explains U.S. Rep. Ileana
Ros-Lehtinen (R-FL), who fled Cuba with her family to the United States
when she was seven years old.22 "[O]ne [care system is] for tourists, as
well as Communist Party officials, and another for Cubans, who are
forced to take with them even the most basic necessities when visiting a
Cuban hospital; even aspirins are scarce."23
Reports on therealcuba.com, a privately-run website that
contains anecdotes, including ghastly images, of suffering anonymous
Cubans cut off from the rich foreign-only facilities. As explained on
the website,24 the horrors of socialized medicine are not, in fact,
evenly or universally experienced:
Castro has built excellent health facilities for the use of
foreigners, who pay with hard currency for those services. Argentinean
soccer star Maradona, for example, has traveled several times to Cuba to
receive treatment to combat his drug addiction. But Cubans are not even
allowed to visit those facilities. Cubans who require medical attention
must go to other hospitals that lack the most minimum requirements
needed to take care of their patients.25
Are Cuba's health care woes the result of the longstanding U.S.
economic embargo? Not a chance, according to a group of 18 exiled Cuban
doctors. The doctors made their personal views clear in a joint letter
in 1997:
We remain mystified as to why people of ordinarily good
will and faith would seek to find fault with the United States for the
disastrous situation inside Cuba, while failing to direct the blame
squarely where it belongs - at the feet of Fidel Castro, who continues
to rule our country with an iron fist after 38 years in power.26
The exiled doctors continued:
We, who have only recently emerged from the belly of the
beast, can categorically and authoritatively state that our people's
poor health care situation results from a dysfunctional and inhumane
economic and political system, exacerbated by the willingness of the
regime to divert scarce health resources to meet the needs of the
regime's elite and foreign patients who bring hard currency.27
# # #
Ryan Balis is a policy analyst at the National Center for
Public Policy Research
Footnotes:
1 Michael Moore, "Statement in Response to Bush
Administration's Investigation of 'Sicko,'" Michaelmoore.com, May 10,
2007, available at
http://www.michaelmoore.com/words/mikeinthenews/index.php?id=9780 as of
June 1, 2007.
2 Janon Fisher, "Moore's 'Sicko' Stunt," New York Post, April
15, 2007, available at
http://www.nypost.com/seven/04152007/news/worldnews/moores_sicko_stunt_worldnews_janon_fisher.htm
as of June 1, 2007.
3 Monisha Bansal, "Nurses Praise Michael Moore's 'Sicko,'"
Cybercast News Service, May 22, 2007, available at
http://www.cnsnews.com/ViewCulture.asp?Page=/Culture/archive/200705/CUL20070522a.html
as of June 1, 2007.
4 Michael Moore, "An Update from Michael Moore (and an
Invitation to His Film Festival)," Michaelmoore.com, July 7th, 2006,
available at
http://www.michaelmoore.com/words/message/index.php?messageDate=2006-07-07
as of June 1, 2007.
5 For a copy of the Treasury Department's letter to Moore, see
"Uncle Sam Probes Michael Moore," The Smoking Gun, May 10, 2007,
available at
http://www.thesmokinggun.com/archive/years/2007/0510071moore1.html as of
June 1, 2007.
6 Michael Moore, "A Letter from Michael Moore: 'Sicko' is Socko
in Cannes!," Michaelmoore.com, May 23, 2007, available at
http://www.michaelmoore.com/words/message/index.php?messageDate=2007-05-23
as of June 1, 2007.
Moore expands on his intention for "Sicko" in an interview with
Entertainment Weekly: "What I'm suggesting is the elimination of private
health insurance, which is a much bigger thing. I don't know any
politicians who are going to take that stand, which is too bad. I don't
know many liberals who can take that stand. They want to reform the
system and put Band-Aids on the system. The system needs to be scrapped
and we need to invent something here that will benefit all Americans."
See Daniel Fierman, "Ready for Moore?," Entertainment Weekly,
June 1, 2007, p. 28, available at
http://www.ew.com/ew/article/0,,20035285_20035331_20040352_3,00.html as
of June 1, 2007.
7 Glenn Woiceshyn, "Canada's Healthcare System is Bad
Medicine," Capitalism Magazine, March 31, 2006, available at
http://www.capmag.com/article.asp?ID=4618 as of June 1, 2007.
8 For example, see Isabel Vincent, "For Cubans, a Bitter Pill,"
National Post (Canada), July 4, 2004, p. A11, available at
http://www.cubaverdad.net/references/for_cubans_a_bitter_pill.htm as of
June 1, 2007; "Health Care in Cuba: Myth Versus Reality," The Cuban
American National Foundation, available at
http://www.canf.org/Issues/medicalapartheid.htm as of June 1, 2007;
Anthony DePalma, "Michael Moore's Math," New York Times, May 27, 2007,
available at
as of June 1, 2007; Fred Thompson, "Paradise Island," National Review
Online, May 2, 2007, available at
http://article.nationalreview.com/?q=OWNhNzA2YmY3NTNjZjZhNjE1NmZjMDFkOTdjN2Q4ZmE=
as of June 1, 2007. See also blog entry by "Jose," Moorewatch.com, May
4, 2007, available at
http://www.moorewatch.com/index.php/weblog/comments/1624/ as of June 1,
2007; "Hospital Clinico Quirurgico,"
http://www.therealcuba.com/Page10.htm as of June 1, 2007.
9 Tom Carter, "Report Doubts Cuba Better under Castro,"
Washington Times, p. A13.
10 "Zenith and Eclipse: A Comparative Look at Socio-Economic
Conditions in Pre-Castro and Present Day Cuba," Bureau of Inter-American
Affairs, U.S. State Department, February 9, 1998, revised June 2002,
available at http://www.state.gov/p/wha/ci/14776.htm as of June 1, 2007.
11 Isabel Vincent, "For Cubans, a Bitter Pill," National Post
(Canada), July 4, 2004, p. A11, available at
http://www.cubaverdad.net/references/for_cubans_a_bitter_pill.htm as of
June 1, 2007.
12 Ibid.
13 Anthony DePalma, "Michael Moore's Math," New York Times, May
27, 2007, available at
as of June 1, 2007.
14 Patricia Grogg, "Health Cuba: Nearly 80 Percent of Medicines
Produced Locally," Inter Press Service, March 19, 2001, available at
http://www.aegis.org/news/ips/2001/IP010312.html as of June 1, 2007.
15 Indira A.R. Lakshmanan, "Help for Venezuela Strains Cuban
Health Care," Boston Globe, August 2005, available at
http://www.iht.com/articles/2005/08/25/news/doctors.php as of June 1, 2007.
16 Ibid.; Lourdes Garcia-Navarro, "Medical Care Draws Cuba,
Venezuela Closer," All Things Considered, National Public Radio,
November 24, 2005.
17 Gary Marx, "Chavez Seeing to Cuba's Revival," Chicago
Tribune, November 27, 2005, p. 3.
18 Indira A.R. Lakshmanan, "Help for Venezuela Strains Cuban
Health Care," Boston Globe, August 2005, available at
http://www.iht.com/articles/2005/08/25/news/doctors.php as of June 1, 2007.
19 Lourdes Garcia-Navarro, "Medical Care Draws Cuba, Venezuela
Closer," All Things Considered, National Public Radio, November 24, 2005.
20 Gary Marx, "Chavez Seeing to Cuba's Revival," Chicago
Tribune, November 27, 2005, p. 3.
21 "Michael Moore's Cuba Problem," Miami Herald Blog, May 10,
2007, available at
http://blogs.herald.com/cuban_connection/2007/05/michael_moores_.html as
of June 1, 2007.
22 Victoria Stuart, "Ileana Ros-Lehtinen: Opening Doors in
Congress and the Community," Florida International University Magazine,
Spring 2000, http://news.fiu.edu/fiumag/spring_00/alumni2.html as of
June 1, 2007.
23 "Michael Moore's Cuba Problem," Miami Herald Blog, May 10,
2007, available at
http://blogs.herald.com/cuban_connection/2007/05/michael_moores_.html as
of June 1, 2007.
24 Please note: Although therealcuba.com website includes some
photographic documentation of its claims, much of its information is not
sourced.
25 "Hospital Clinico Quirurgico,"
http://www.therealcuba.com/Page10.htm as of June 1, 2007.
26 "Defecting Cuban Doctors Blame Castro for Cuban Health
Crisis," CubaNet, April 14, 1997, available at
http://www.cubanet.org/CNews/y97/apr97/14e9.htm as of June 1, 2007.
27 Ibid.
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