January 29, 2007
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January 29, 2007 |
Wellness, longevity take varied paths in U.S., Cuba
By John Dorschner
MIAMI - The average Cuban lives slightly longer than the average American, but the American's healthcare costs $5,711 a year while the Cuban's costs $251. Those are the figures of the World Health Organization. Some experts question the accuracy of the Cuban numbers, but no one doubts the underlying revelation: There is little relationship between the cost of your healthcare and how long you'll live. "Medical care is responsible for only a small portion of the variation in life expectancy," says Gerard Anderson, a Johns Hopkins professor specializing in health policy. "Behavioral factors such as diet and exercise are much more important. The U.S., which spends much more than any other industrialized country on healthcare, is getting little value for much of the spending." These factors have moved to the forefront of the American political discussion as leaders in both major parties work toward solving what almost everyone agrees is a "healthcare crisis," with soaring costs threatening to increase the numbers of the uninsured, which already include 46 million Americans. In such a discussion, Cuba serves as the starkest possible contrast, a completely government- controlled system in which ailing leader Fidel Castro benefits from the best possible care, including consultations with a Madrid surgeon, while many Cubans struggle to get basic treatment. Here are the numbers: The average American has a life expectancy of 77.8 years, as of 2006. The average Cuban lives 78.3 years. Even if the Cuban figure is inflated, no one disputes the statistics from European countries, where people tend to live a year or two longer than in the United States - at about half the healthcare costs per capita. At its highest level, most people agree, the United States has top-quality care. The country offers the latest magnetic resonance imaging, robotic-arm surgeries and drugs to deal with cholesterol, acid reflux and arthritis pain. Americans want the biotech drug to target tumor cells, but many don't get basic preventive screening tests. That's particularly true for the uninsured, who often avoid treatment until their condition sends them to the emergency room. Cuba offers universal healthcare and has twice as many doctors per capita as the United States. The Cuban government did not respond to The Miami Herald's request for comment via telephone or e-mail, but its publications have boasted that the country is one of the world's leaders in healthcare. Ann C. Seror, a professor at Laval University in Quebec, Canada, says Cuba has "achieved a remarkable level of healthcare quality of life for its citizenry." But six Cuban doctors The Miami Herald interviewed - two dissidents still on the island, four now in Miami - say many prescription drugs and even over-the-counter remedies are nearly impossible to get, and patients sometimes have long waits in clinics unless they pay bribes. One irony is that poverty has forced Cubans into a healthier lifestyle. Juan A. Asensio, a University of Miami trauma surgeon and a Cuban American who is certainly no friend of the Castro regime, put it this way: "No McDonald's, and Cubans walk everywhere or ride bikes because they can't afford cars." About one in 10 Cubans are obese, according to the Pan American Health Organization. In the United States, one in three are obese, "increasing risks of high blood pressure, type 2 diabetes, stroke, heart disease and osteoarthritis," according to the Agency for Healthcare Research and Quality. Still, the aging American, no matter his weight, can lay claim to a more comfortable life, with access to everything from Advil to Pepto-Bismol and Viagra - products virtually nonexistent in Cuba. As Nestor Viamonte, a physician who left Cuba in 2003, puts it: "There's a difference between a 75-year-old with quality of life and a 75-year-old without quality of life." --- 2007, The Miami Herald.
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