A prior post referenced criticism of the Cuban health system from Christopher Sabatini, an adjunct professor at Columbia University’s School of International and Public Affairs and director of Global Americans, a research institute focused on the foreign policy of human rights and social inclusion.
Although he recognized that there have been health-care advances in Cuba with Cuban life-expectancy the second-highest in Latin America and that Cuba justifiably is proud of its medical education and sending its physicians to other countries, Sabatini said “advanced health care is flagging” in Cuba with “the health system used by average Cubans in crisis” and hospitals “generally poorly maintained and short of staff and medicines.”
Sammy Almashat, a M.D. and M.P.H. researcher with Public Citizen’s Health Research Group, a nonpartisan, nonprofit organization, in a letter to the Washington Post takes issue with Sabatini. Almashat asserts that “Sabatini’s sweeping critique of Cuba’s health-care system was strikingly bereft of evidence and relied entirely on scattered anecdotes from a few reports to support his claims. This is not surprising given that the evidence overwhelmingly contradicts his analysis.”[1]
Whereas Sabatini claimed that Cuba’s advanced health care is “flagging,” Almashat says “Cuba has cutting-edge research centers in fields such as genetic engineering and neuroscience, and academic journals in all major medical specialties. According to the organization Medical Education Cooperation with Cuba, Cuban doctors have performed more than 6,000 liver, kidney and heart transplants. Cuba’s biotech sector also has long been a leading exporter of pharmaceuticals.”
Almashot also disputes “Sabatini’s claim of a Cuban physician shortage as Cuba has far more physicians per capita than the [U.S.], which does suffer from a shortage of primary-care physicians. Cuba’s physician workforce includes more than 20,000 specialists in more than 60 fields, almost as many specialists per capita as the [U.S.] has in physicians overall.”
Even assuming that Almashat’s factual assertions are well founded, he overstates his criticism of Sabatini.
First, Sabatini’s article obviously was not intended as a thorough examination of the Cuban health system. Instead, he mentioned the system as only one of five so called “myths” about the alleged greatness of the Cuban system.
Second, Sabatini claimed that Cuban “advanced health care is flagging,” which is directed to the health care actually delivered to patients. The existence of Cuban medical research centers, academic journals and manufacturing and exporting pharmaceuticals does not rebut Sabatini’s assertion. The claim that Cuban doctors have performed 6,000 liver, kidney and heart transplants, on the other hand, again if true, suggests at least a qualification to Sabatini’s statement.
Third, Sabatini did not claim there was a general shortage of Cuban physicians, but rather that Cuban hospitals generally were “short of staff,” without specifying what kind of staff. Thus, Almashat’s citation of the number of Cuban physicians per capita and the number of Cuban specialists does not meet the point made by Sabatini.
This commentary is merely based upon a close reading of the article and the letter. I do not have any independent knowledge or data to confirm or deny the assertions of either author. The conflict of these two authors instead suggests that while there is much to admire in the Cuban medical system, it is not without problems. It is neither heaven nor hell.
I, however, do believe, on the basis of news reports that Almashat correctly observes that Cuba has a large number of qualified primary-care physicians while the U.S. “does suffer from a shortage of primary-care physicians,” a problem that is projected to become worse, for example, in the State of Minnesota with an aging population, especially in rural parts of the state.
I, therefore, wonder whether the U.S. and Cuba could come to an agreement for Cuba to provide primary-care physicians to the U.S. This may well require revisions in state medical qualification standards, but given the recent legalization of health-care providers other than physicians, as an outsider I think this should not be an insurmountable problem.
I also suggest that Sabatini and Almashat confer and collaborate on a joint article about the Cuban medical system. I suspect that they would find a lot of agreement.
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[1] Almashat, Letter to Washington Post: Cuba’s health-care system remains cutting-edge, Wash. Post (April 8, 2016). Almashat also has written a more general article about the Cuban health-care system. Almashat, The Cuban Health System at the Dawn of Détente, Huff. Post (Mar. 23, 2016).