Cuban Health Care

Michael Moore's latest travesty of truth -- Sicko -- premiered at Cannes and will receive a full release soon. After watching it, many people will be convinced that the Cuban health care system is better than America's. The NY Times says that it ain't so, especially if you are a commoner:

“Actually there are three systems,” Dr. Cordova said, because Cuba has two: one is for party officials and foreigners like those Mr. Moore brought to Havana. “It is as good as this one here, with all the resources, the best doctors, the best medicines, and nobody pays a cent,” he said.

But for the 11 million ordinary Cubans, hospitals are often ill equipped and patients “have to bring their own food, soap, sheets — they have to bring everything.” And up to 20,000 Cuban doctors may be working in Venezuela, creating a shortage in Cuba.

Elsewhere, British magazine The Prospect has an eyewitness account:

Healthcare and education are supposed to be the redeeming graces of the regime, but this is questionable. There are a large number of doctors, but, according to most Cubans I know, many have left the country and the health system is in a ragged state—apart from those hospitals reserved for foreigners—and people often have to pay a bribe to get treated. Michael Moore, the American film director, who has recently been praising the system should take note of the real life stories beneath the statistics. I went into a couple of hospitals for locals on my latest visit. In the first, my friend told me not to say a word in case my accent was noticed, as foreigners are not allowed in these places. I was appalled by the hygiene and amazed at the antiquity of the building and some of the equipment. I was told that the vast majority of Cuban hospitals, apart from two in Havana, were built before the revolution. Which revolution, I wondered; this one seemed to date from the 1900s.

And Jane Galt disputes the notion that Cuban infant mortality rates are lower than those in the U.S. as well, and reminds us that there are three kinds of lies: lies, damn lies, and statistics.

Very interesting article on Cuban v. American infant mortality shows one of the trickiest aspects of using statistics: making sure you're not comparing apples to oranges.

The reason this is so difficult is that often statistics which sound like they're the same thing actually aren't. For example, comparing rape statistics. Most of us think of rape as being forcible intercourse with an unwilling victim. However, there are studies that have included such things as statutory rape (which may be appalling, but isn't what we're trying to get at, which is the rate at which people are sexually assaulted), "rapes" in which the victim never struggled or said no, but merely reported later that she was uncomfortable, or other definitional expansions that make it hard to establish valid comparisons with other studies that focused on forcible intercourse.

In this case, the article points out that while Cuba seems to have a lower infant mortality rate than America, this appears to be because extremely low-weight births for which American doctors perform heroic intervention (and thus get recorded as a live birth in America, followed by a death a few hours later), get reported as stillbirths in Cuba. So it's very important, when you see a statistic, to ask yourself if the two numbers are really comparing the same thing.