Cuban Health – Not Related to Cuban Health Care
I haven’t seen Sicko, but by all accounts it makes the argument that since Cuba’s infant mortality is lower than the US and Cuba’s life expectancy is basically the same, Cuba has a superior health care system, at least considering how relatively poor they are. But, as Matt Yglesias so astutely points out, the debate about health care is about more than just the financing or access.
Why is Cuban life expectancy so long? Is it because they have great coverage, innovative treatments and the best new technology? No, and it has very little to do with a health care system, per se.
I imagine the reasons for Cuba’s admirable life expectancy are pretty similar to Costa Rica’s, which also boasts a life expectancy near that of the the US. This is from the Phillip Longman article that Yglesias calls a classic, but I call it the best article ever written on health care since the Hippocratic oath:
Costa Ricans consume about half as many cigarettes per person as we do. Not surprisingly, they are four times less likely to die of lung cancer. The car ownership rate in Costa Rica is a fraction of what it is in the United States. That not only means that fewer Costa Ricans die in auto accidents, but that they do a lot more walking, and hence they get more exercise. Thanks to a much lower McDonald’s-to-citizen ratio, the average Costa Rican thrives on a traditional diet of rice, beans, fruits, vegetables, and a moderate amount of fried food–and therefore enjoys one of the world’s lowest rates of heart disease and other stress-related illnesses.
In Cuba specifically, the long life expectancies are attributed to not being so god damned fat, from today’s Times
“Because they don’t have up-to-date cars, they tend to have to exercise more by walking,” he said. “And they may not have a surfeit of food, which keeps them from problems like obesity, but they’re not starving, either.”
Dr. Butler has just completed a study that shows it is possible that because of the epidemic of obesity in children, “this may be the first generation of Americans to live less long than their parents.”
Our national affluence is killing us, literally. No amount of expanded health coverage, though certainly a good idea, is going to stop the rise in obesity that allows Cubans to live as long as us, or more accuratley, for us to live as short as Cubans.
The Cuban health care system, though offering low cost or free access to doctors for basic treatments, isn’t so hot, at least not in the ways many health care reformers want to change the american system, or lack thereof:
“But even if I diagnosed something simple like bronchitis,” he said, “I couldn’t write a prescription for antibiotics, because there were none.”
…
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.”
So, if the goal of national health care, or any sort of health care reform, is to make people healthier, than clearly a broader conversation is needed. The effect our health care system, or lack thereof, has on the economy, is a different issue for a different day.
PS – Phillip Longman, in his review of Jonathan Cohn’s Sick, knocks another one out of the park.
PPS – This post is a classic case of Dan Drezner’s recently discovered “phenomenon of reading something that warrants a blog post, procrastinating the actual writing, and then discovering that some other blogger has managed to post your precise feelings on the matter.” I say we call it the Yglesias Law, because he manges to be the culprit rather often.
