por admin » Lun Jul 12, 2010 10:33 pm
No hay nada bueno bajo un sistema socialista, absolutamente nada.
Dr. Berdwick y El Fabulosos Sistema de Salud de Cuba. La marcha muerta de la medicina progresiva
A nadie se le ocurra acusar al Donal Berwick del Centro de Medicare y Medicaid con $800 billones a su cargo de ser un admirador del seguro de salud de Cuba.
En este periodico no asustamos a nadie. Y hay pruebas de que el Dr. Berwick es un admirador del servicio de salud Cubano.
Hay que notar que cuando se paso el seguro de salud de Obama, Fidel dijo que era un milagro. Notar tambien que el Dr. Berdwick se ha hecho notorio por acusar al servicio privado de una empresa oscura. Ha admitido su amor por el sistema socializado de medicina de Inglaterra e insiste que un excelente cuidado de salud tiene forzosamente que ser un sistema de redistribucion.
Creemos que en este momento vale la pena revisar el sistema de salud Cubano como lo ha hecho Laurie Garett a senior gellow del Council on Foreign Relatios en la ultima edicion del magazine Foreign Affairs.
El problema del sistema Cubano es que esta al borde del colapso. El sector salud en Cuba ha quebrado al estado y ha llevado a los medicos a abandonar la medicina y el pais. Es ostensiblemente igualdad de naturaleza es radicalemente una realidad desigual con un pequenio numero de clinicas en buen estado que atienden a torustas y a los del partido comunista mientras el pueblo Cubano se atienden en inmundos hospitales sin recursos.
Consideren los hechos expresado por Ms. Garret. Hay 73,000 medicos con licensia para practicar en Cuba. Esto permite a Cuba decir que tiene la mayor cantidad de medicos por paciente en el mundo, con un doctor por cada 170 personas muy por debajo de un medico para 390 personas en US.
Y sin embargo la realidad le gana a las estadisticas. Mas de la mitad de los medicos Cubanos trabajan fuera de la Isla, pagan 66% de impuestos, muchos de ellos se van del pais. Los doctores que se quedan ganan mas o menos $25 al mes. Como resultado, Ms Garrett escribe, ellos con frecuencia toman trabajos como taxistas o trabajan en hoteles donde pueden ganar mas dinero. Y si se va a hablar de la calidad de los doctores que algunos de los pocos que logran venir a US solo pueden trabajar como enfermeros, debido al lenguaje y a las contrastantes diferencias con el entrenamiento y educacion medica.
Y de la realidad del tratamiento medico en Cuba, Ms. Garrett reporta que los pacientes en los hospitales Cubanos deben llegar al hospital con sus propias jeringas, tohallas y sabanas para sus camas. Las mujeres evitan los examenes ginecologicos por temor a la infeccion que puede causarles la falta de limpieza en el equipo de los hospitales. El cancer al utero se ha duplicado en los ultimos 25 anios por que usan el examen Pap que ha fallado en un 30%.
Y para lso admiradores del sistema Cubano que publicitan la baja mortalidad de los ninios, lo que no se sabe es que la mayoria de las muertes ocurren durante el parto o las 48 horas despues del parto debido a la hemorragia uterina o al postparto.
Suena invitador? el anio pasado Margaret Chan, el director general de la organizacion Mundial de la Salud, dijo que Cuba tenia la correcta vision y la correcta direccion. La salud y la politica del estado es vista como un derecho de la gente. En el 2005 un editorialista del NY Times escribio una columna donde decia que si se trataba de salud habia que preguntarle a Cuba. Probablemente a eso se referia Collin Powel cuando dijo que Castro habia hecho algunas cosas buenas por su gente. De verdad?
La verdad es que el socialismo y sus formas relacionadas de comando y control de la tecnocracia trabaja tan bien en el sector salul como en cualquier otro. Lo cual es decir nada. Cuando los Americanos se vayan a otros paises a atenderse por medicos Americanos que se hayan ido del pais, mientras los pobres de US se atiendan en US, talvez la realidad del sistema de salud de Obama se entienda en US y las verdaderas lecciones del sistema Cubano sean aprendidas en US. Talvez tambien seran apreciadas por los amigos del Dr. Berwick.
Dr. Berwick and That Fabulous Cuban Health Care
The death march of progressive medicine.
By BRET STEPHENS
Heaven forbid that anyone accuse Donald Berwick—lately of Harvard, newly of the Centers for Medicare and Medicaid Services, with $800 billion under management—of being an admirer of Cuba's health-care system. In the matter of CastroCare, progressives of Dr. Berwick's stripe are rarely at a loss for superlatives. But suggest that ObamaCare is a step in the Cuban direction, and these same people will accuse you of rank scare-mongering.
We don't scare-monger in this paper. And for the record, nothing in Dr. Berwick's published record indicates he has ever praised the Cuban system.
But note that when the health-care bill became law in March, Fidel Castro emerged from semiretirement to praise it as a "miracle." Note also that Dr. Berwick has made himself notorious by warning of "the darkness of private enterprise," admitting his "love" for Britain's socialized National Health Service, and insisting that "excellent health care is by definition redistributional."
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Reuters
A patient waits to be examined at the Ramon Pando Ferrer ophthalmology hospital in Havana.
.Without imputing a mutuality of views, then, it's worth noting a certain mutuality of respect. So it's a good time to check in on the state of the Cuban health-care system. That's just what Laurie Garrett, a senior fellow at the Council on Foreign Relations, does in the current issue of Foreign Affairs magazine.
Lest anyone mistake Ms. Garrett as a raving opponent of the Cuban system, she praises Cuba for offering "an inspiring, standard-setting vision of government responsibility for the health of its people." Cuba's (reported) success in reducing the incidence of child mortality and tropical diseases, she adds, is "laudable."
Just one problem: The system is in an advanced state of collapse. It is bankrupting the state and driving doctors out of the medical field and the country. Its ostensibly egalitarian nature disguises a radically inegalitarian reality, with a tiny number of well-appointed clinics catering to paying medical tourists and senior Party apparatchiks while most Cubans take their chances in filthy, under-resourced hospitals.
Consider the facts as laid out by Ms. Garrett. There are 73,000 physicians licensed to practice in Cuba. This allows Cuba to boast of having the best doctor-patient ratio in the world, with one doctor for every 170 people, as opposed to one for every 390 in the United States.
Yet reality belies the statistics. Slightly more than half of all Cuban physicians work overseas; taxed by the Cuban state at a 66% rate, many of them wind up defecting. Doctors who remain in the country earn about $25 a month. As a result, Ms. Garrett writes, they often take "jobs as taxi drivers or in hotels," where they can make better money. As for the quality of the doctors, she notes that very few of those who manage to reach the U.S. can gain accreditation here, partly because of the language barrier, partly because of the "stark differences" in medical training. Typically, they wind up working as nurses.
As for the quality of medical treatment in Cuba, Ms. Garrett reports that hospital patients must arrive with their own syringes, towels and bed sheets. Women avoid gynecological exams "because they fear infection from unhygienic equipment and practices." Rates of cervical cancer have doubled in the past 25 years as the use of Pap tests has fallen by 30%.
And while Cuba's admirers love to advertise the country's low infant mortality rate (at least according to the Castro regime's dubious self-reporting) the flip-side has been a high rate of maternal mortality. "Most deaths," Ms. Garrett writes, "occur during delivery or within the next 48 hours and are caused by uterine hemorrhage or postpartum sepsis."
Sound inviting? The number of ostensibly serious people—Michael Moore not being one of them—who think so is nothing short of astonishing. On a visit to Cuba last October, Margaret Chan, the director general of the World Health Organization, said that Cuba "has the right vision and the right direction. Health is a state policy and state is seen as a right of the people." In 2005, one prominent New York Times editorialist headlined a column "Health Care? Ask Cuba." Health care was probably also what former Secretary of State Colin Powell had in mind when he noted that "Castro has done some good things for his people."
Now, to repeat, Dr. Berwick is nowhere on record endorsing Cuban-style health care. And ObamaCare, with its million flaws, is not CastroCare.
But it remains the case that for all those for whom "free" health care has been, as Teddy Kennedy once put it, the cause of their lives, the Cuban system has been a touchstone—proof, supposedly, that socialized medicine is, as Dr. Berwick has said, the only "just, equitable, civilized and humane" answer when it comes to addressing the dilemmas inherent in health-care delivery.
The truth is that socialism and related forms of command-and-control technocracy work as well in the health-care market as they do in every other. Which is to say, not at all. When better-heeled Americans start flying to offshore medical centers for their facelifts and bypasses (performed by expat American doctors) while poorer folk make do in ObamaCare's second tier, then perhaps the real lessons of the Cuban system will begin to sink in. Even, perhaps, among Dr. Berwick's progressive friends.