Health Care Crisis, pt4: The health-care revolution workers deserve

By David Hoskins

Washington, DC chapter of FIST

Workers inside the United States are suffering at the hands of a capitalist health-care system.

A six-country study performed by the Commonwealth Fund found that the United States scored “particularly poorly on its ability to promote healthy lives, and on the provision of care that is safe and coordinated.”

A 2008 study published in Health Affairs journal analyzed the health systems of 19 countries. The study found that the United States had the highest rate of preventable deaths before the age of 75. The study concluded that as many as 101,000 deaths a year could be prevented by ensuring that all patients receive quality care in a timely manner.

The human face of under-investment in public health care came to light with the recent circulation of a video by ACLU lawyers showing 49-year-old Esmin Green writhing on the floor and then dying in a Brooklyn psychiatric emergency waiting room, where she had been waiting for 24 hours to be seen by a doctor.

Socialized medicine offers hope to workers

Right-wing politicians regularly call every government attempt at expanding access to health care “socialized medicine,” as though that’s a bad thing. This is generally a mischaracterization meant to derail even modest attempts at reform. Despite the right-wing’s pejorative use of the word, however, real socialized medicine remains workers’ greatest hope of health-care justice.

Socialized medicine is a medical care system that is publicly financed and government administered. Hospitals and clinics are government operated with doctors and nurses working as public employees.

The Soviet Union established the early benchmarks for socialized medicine’s achievements following the 1917 Bolshevik Revolution. After World War II, a number of European capitalist countries adopted some of the features of socialized medicine because of the intense competition between the two social systems that became the Cold War.

Soviet health care was a comprehensive system that provided factory clinics, industrial hygiene programs, neighborhood polyclinics, and local hospitals at no cost to the patient. The Soviet health-care system was recognized for the great strides it made in battling infectious diseases—such as tuberculosis and typhus fever, which had periodically ravaged workers and peasants in czarist Russia.

A 2006 OECD report found that post-Soviet Russia’s move to a more market-based, insurance-driven system has proven disastrous, with declining life expectancy and dramatic increases in deaths from preventable diseases.

The Cuban Revolution in 1959 made possible a complete overhaul and rebuilding of the medical system in that country along socialist lines.

In 1960 revolutionary physician Che Guevara outlined the aims of Cuban health care in his essay “On Revolutionary Medicine.” Since that time Cuba’s system has developed into a pinnacle of achievement in socialized medicine.

Article 50 of Cuba’s Constitution establishes free health care as a right of all citizens. World Health Organization statistics demonstrate the superiority of socialized medicine. Cuba’s infant mortality rate of five deaths per thousand live births is lower than the United States, where there are seven deaths per thousand. Cuba has twice as many physicians per capita as the United States and its life expectancy is 16 years higher than the average in its region.

Socialized medicine in Cuba has accomplished all this while spending just $251 per capita on health care, compared to $7,129 per capita in the United States. Cuba has protected the integrity of its health-care system even while enduring a punitive economic blockade by the United States.

A 1997 American Association of World Health report titled “Denial of Food and Medicine” outlines the difficulties deliberately imposed by the United States on Cuba’s health system.

In 1992 the U.S. Congress passed the so-called Cuban Democracy Act. It is little more than an attack on Cuba’s socialized health-care system, which the World Health Organization had praised in 1989 as a “model for the world.”

The act imposed a ban on subsidiary trade with Cuba that severely constrains Cuba’s ability to import medicine and equipment from third-country sources. Shippers are discouraged from delivering medical equipment to Cuba by a provision in the act prohibiting ships from loading or unloading cargo in U.S. ports for 180 days after delivering cargo of any type to Cuba. Licensing and other restrictions severely restrain even charitable contributions to Cuba.

Despite these inhumane attacks, Cuba has managed to exceed the United States on key health indicators while sending thousands of its own doctors to provide medical care to the world’s poor and oppressed.

“¡Salud!,” a recent film highlighting Cuba’s accomplishments in health care, estimates that this small country has approximately 28,000 health professionals now providing care in 68 countries. Cuban doctors and nurses serve the poorest of the poor in countries like Honduras, Haiti and Guatemala. Another 21,000 international students are studying free of charge in Cuba’s medical schools on the condition that they provide care to underserved populations in their country of origin.

Workers and oppressed people living in the United States would be well served by a socialized medicine system similar to Cuba’s. If the crisis in U.S. health care has demonstrated anything, it is that capitalist health care places private health industry profits before patient care in a way that threatens the lives of many thousands each year and leaves many more in suffering and pain.


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