Different River

”You can never step in the same river twice.” –Heraclitus

March 16, 2005

Free Health Care in Cuba

Filed under: — Different River @ 10:16 pm

(Welcome, Grand Rounds XXVI readers!
See also this post on Misdiagnosis of Persistent Vegetative State.)

Cuba may have problems, they say, and Fidel Castro may be a dictator, but at least Cuba has excellent, free health care available to everybody. Or so they say. Here is a sample of these claims.

From “The Cuban Experience”:

The Cuban health care system is respected around the world, and is literally decades more advanced than any system found in Latin America. For this reason, the Cuban system serves as a model for Third World developing nations.

Before the Revolution, most people could not afford proper medical care. In the rural areas there were few doctors and in the big cities, only the upper classes could afford health care.

All of this has now changed.

And from an advertisement for a lecture in San Francisco, promoting a bill to make California’s health care as good as Cuba’s:

  • Cubans have universal access to free health care (provided by the government).
  • Althrough [sic] Cuba is a developing country, Cubans live as long or longer than Americans
  • Cuban babies survive as well as American babies
  • Cuba spends half of much on health care, (as a percentage of its GNP), as the US, but provides health care to all its citizens
  • “Health Tourists” go to Cuba from other countries for medical treatments because of Cuba’s high quality, low cost health care.

No one should believe these claims, because Communist countries never provide better services than free countries (except maybe for alcohol), and they notoriously lie about their achievement on all fronts, especially economic and scientific. But lots of people believe this stuff about Cuba anyway. I wish I knew why.

As a technical matter, the health care in Cuba isn’t free; there is a 12% payroll tax all Cubans pay. (This is similar to what is being proposed for California.) But that really is only the beginning of what’s false in the above statement, particularly the “decades more advanced” claim.

Here are some pictures from the Hospital Clínico Quirúrgico Joaquin Albarran in Havana, which Fidel Castro called “one of the most modern and best ones in the country” — which for Cuba might be true, but which undermines all the grandiose claims for it.

Go to that link to see all the pictures, but here are a few to get your started:

Toilet in Cuban hospital Patient beds Cockroaches on floor in patient area

If you read Spanish, there’s an extensive article here.

(Hat tip: Captain’s Quarters.)

UPDATE: There’s another excellent article on this topic here.

Scott Peterson Sentenced

Filed under: — Different River @ 4:33 pm

Scott Peterson was sentenced to death today for the murder of his wife Laci and their unborn fetus.

If he is actually executed, he will not be deprived of food and water, since that long and painful method of execution is “cruel and unusual punishment.” On the contrary, he will be entitled to a “last meal” of pretty much whatever he wants, before being executed quickly and (perhaps) painlessly.

Thus we see that a convicted murderer has rights that a disabled, but innocent, patient does not have.

If you did not need a feeding tube, would you want food and water?

Filed under: — Different River @ 2:42 pm

If you did not need a feeding tube, would you want to be given food and water to prolong your life? That is, if you didn’t need a feeding tube, would you want to food an nutrition provided by “natural means”? There’s a judge in Florida who says “No.”

Much of the debate over Terri Schaivo has centered around the assumption that she cannot obtain nutrition and hydration except through a feeding tube. But what if she could obtain nutrition and hydration by “natural means,” that is, through procedures known to medical science as “eating” and “drinking”? In that case, would it still be justified to end her supply of food and drink and let her die of starvation and dehydration? The answer, according to Judge Greer, is yes, and furthermore it’s probihited to find out if she could eat or drink. And, so, Judge Greer has issued an order prohibiting giving Terri “food and water by natural means.”

I’ve told this to enough people in person to know that you’ll probably think I’m either making this up, or completely crazy, since no one would order such a thing. So, here’s a copy of the actual court order signed by Judge Greer. It’s a PDF file (meaning you need Adobe Reader or equivalent to read it) containing a scanned image of the court document, including the judge’s signature.

After a paragraph reviewing the motion to allow natural feeding and another paragraph citing some procedural rules, and determining that they “are asking for an experimental procedure” the order concludes:


ORDERED AND ADJUDGED that Respondents’ Emergency Expedited Motion for Permission to Provide Theresa Schiavo with Food and Water by Natural Means is DENIED.

DONE AND ORDERED in Clearwater, Pinellas County, Florida, this 8 day of March, 2005.

This just has not just ordered removal of a “feeding tube” — he’s ordered complete removal of food and water, given by any means.

He has determined that “providing food and water by natural means” is an “experimental procedure.” There are millions of people around the world who are given “providing food and water by natural means.” Some get it put in their mouths by other people without their express consent (e.g., babies), some with their consent (e.g., double-arm-amputees), and — Judge Greer would be shocked to discover — some even perform this “experimental procedure” on themselves. But Judge Greer feels that there’s no justification for subjecting Terri Schiavo to this procedure. After all, there’s been no evidence present in court that she ever ate or drank before becoming incapacitated, is there? So we don’t know if she’d want it…

(Why is it “experimental” anyway? Well, I guess the FDA never approved “eating and drinking,” so what else could they be but “experimental”?)

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