CUBA: THE MYTH OF CUBAN HEALTH CARE, MICHAEL MOORE GIVES IT A POWERFUL BOOST
2007-07-13. National Review / Digital, July 30 , 2007,
MICHAEL MOORE has made another piece of pure propaganda. This film,
called Sicko, attacks the American health-care system. You will agree
that there is a lot to attack. But Moore glorifies socialist systems,
which have problems all their own. And perhaps his worst offense is to
glorify Fidel Castro's system, as has been done endlessly for as long as
most people can remember.
Moore hit on an inspired idea: He took a group of sick Amer¬icans to
Cuba, to seek health care. Not only are these unfortunate people
Americans: They are 9/11 rescue workers, heroes. They have been denied
the care they need in America (or so the film alleges), and must get it
As the group is heading to Havana, we hear a song: "I'm on my way to
Cuba . . . where all is happy; Cuba, where all is gay." And it appears
exactly this way in Moore's film. You may remember that, in his previous
film, Fahrenheit 9/11, Saddam Hussein's Iraq was portrayed as a nation
of happy kite-fliers. The same artistry is applied to Sicko.
The Left has always had a deep psychological need to believe in the myth
of Cuban health care. On that island, as everywhere else, Communism has
turned out to be a disaster: economic, physical, and moral. Not only
have persecution, torture, and murder been routine, there is nothing
material to show for it. The Leninist rationalization was, "You have to
break some eggs to make an omelet." Orwell memorably replied, "Where's
the omelet?" There is never an omelet.
But Castro's apologists have tried to create one. Their hopes rest on
three lies, principally: that Castro cares for the sick; that he is
responsible for almost universal literacy; and that he has been a boon
to blacks. Castroite propaganda has been extraordinarily effective,
reaching even to people who should know better. Among the most
disgraceful words ever uttered by a secretary of state were uttered by
Colin Powell in 2001, when he said, "He's done some good things for his
people." The "he," of course, was Cuba's dictator.
It was hard to know which was worse: the "his people," which is
certainly how Castro thinks of Cubans. Or the imagined omelet, the "good
The myth of Cuban health care has been debunked in article after
article, for the last several decades. (Remember that Castro took power
in 1959.) But Michael Moore has given the myth fresh legs, necessitating
another round of such articles. If I had a nickel for every article I've
read entitled "The Myth of Cuban Health Care" . . . But here is another one.
SEPARATE AND UNEQUAL
To be sure, there is excellent health care on Cuba — just not for
ordinary Cubans. Dr. Jaime Suchlicki of the University of Miami's
Institute for Cuban and Cuban-American Studies explains that there is
not just one system, or even two: There are three. The first is for
foreigners who come to Cuba specifically for medical care. This is known
as "medical tourism." The tourists pay in hard currency, which provides
oxygen to the regime. And the facilities in which they are treated are
First World: clean, well supplied, state-of-the-art.
The foreigners-only facilities do a big business in what you might call
vanity treatments: Botox, liposuction, and breast implants. Remember,
too, that there are many separate, or segregated, facilities on Cuba.
People speak of "tourism apartheid." For example, there are separate
hotels, separate beaches, separate restaurants — separate everything. As
you can well imagine, this causes widespread resentment in the general
The second health-care system is for Cuban elites — the Party, the
military, official artists and writers, and so on. In the Soviet Union,
these people were called the "nomenklatura." And their system, like the
one for medical tourists, is top-notch.
Then there is the real Cuban system, the one that ordinary people must
use — and it is wretched. Testimony and documentation on the subject are
vast. Hospitals and clinics are crumbling. Conditions are so unsanitary,
patients may be better off at home, whatever home is. If they do have to
go to the hospital, they must bring their own bedsheets, soap, towels,
food, light bulbs — even toilet paper. And basic medications are scarce.
In Sicko, even sophisticated medications are plentiful and cheap. In the
real Cuba, finding an aspirin can be a chore. And an antibiotic will
fetch a fortune on the black market.
A nurse spoke to Isabel Vincent of Canada's National Post. "We have
nothing," said the nurse. "I haven't seen aspirin in a Cuban store here
for more than a year. If you have any pills in your purse, I'll take
them. Even if they have passed their expiry date."
The equipment that doctors have to work with is either antiquated or
nonexistent. Doctors have been known to reuse latex gloves — there is no
choice. When they travel to the island, on errands of mercy, American
doctors make sure to take as much equipment and as many supplies as they
can carry. One told the Associated Press, "The [Cuban] doctors are
pretty well trained, but they have nothing to work with. It's like
operating with knives and spoons."
And doctors are not necessarily privileged citizens in Cuba. A doctor in
exile told the Miami Herald that, in 2003, he earned what most doctors
did: 575 pesos a month, or about 25 dollars. He had to sell pork out of
his home to get by. And the chief of medical services for the whole of
the Cuban military had to rent out his car as a taxi on weekends.
"Everyone tries to survive," he explained. (Of course, you can call a
Cuban with a car privileged, whatever he does with it.)
So deplorable is the state of health care in Cuba that old-fashioned
diseases are back with a vengeance. These include tuberculosis, leprosy,
and typhoid fever. And dengue, another fever, is a particular menace.
Indeed, an exiled doctor named Dessy Mendoza Rivero — a former political
prisoner and a spectacularly brave man — wrote a book called ¡Dengue! La
Epidemia Secreta de Fidel Castro.
When Castro seized power, almost 50 years ago, Cuba was one of the most
advanced countries in Latin America. Its infant-mortality rate was the
13th-lowest in all the world, ahead of even France, Belgium, and West
Germany. Statistics in Castro's Cuba are hard to come by, because honest
statistics in any totalitarian society are hard to come by. Some kind of
accounting is possible, however: Cuba has slipped in infant mortality,
as it has in every other area (except repression). But its
infant-mortality rate remains respectable.
You might suspect a story behind this respectability — and you are
right. The regime is very keen on keeping infant mortality down, knowing
that the world looks to this statistic as an indicator of the general
health of a country. Cuban doctors are instructed to pay particular
attention to prenatal and infant care. A woman's pregnancy is closely
monitored. (The regime manages to make the necessary equipment
available.) And if there is any sign of abnormality, any reason for
concern — the pregnancy is "interrupted." That is the going euphemism
for abortion. The abortion rate in Cuba i
s sky-high, perversely keeping
the infant-mortality rate down.
Many doctors, of course, recoil at this state of affairs. And there is
much doctor dissidence on the island. Some physicians have opened their
own clinics, caring for the poor and desperate according to medical
standards, not according to ideology or governmental dictates. The
authorities have warned that, in the words of one report, "new
dissidences in the public-health sector will not be tolerated." Anyone
trying to work outside of approved channels is labeled a
counterrevolutionary or enemy agent.
Furthermore, the shortage of doctors on the island is acute — which is
strange, because there are abundant Cuban doctors. Where are they?
They're abroad. In fact, a standard joke is that, in order to see a
Cuban doctor, a Cuban must contrive to leave the island.
In his film, Michael Moore speaks of the "generosity" of Castro's health
programs. What he means, in part, is that Castro has long sent doctors
overseas on "humanitarian medical missions." These missions are an
important part of the dictator's self-image, and of his image at large.
Cuban doctors go to such "revolutionary" countries as Chávez's
Venezuela, Morales's Bolivia, and Mugabe's Zimbabwe. The missions are
lucrative for Castro, bringing him about $2.5 billion a year.
Yet they are somewhat risky for him, too. The Cubans abroad are
vigilantly watched, and the regime seldom sends unmarried doctors: They
want wives and families back home, as hostages. Still, the Cuban doctors
defect, and do so by the hundreds. They make a run for it in every
country in which they serve, in any way they can. For example, doctors
in Venezuela flee into Colombia; others try a friendly embassy, or start
yelling in some international airport, during a transfer. Many of the
doctors' stories are heart-stoppingly dramatic. And when they have
secured asylum, they tell the truth, about Cuban medicine both at home
One of the things that sicken them, about their foreign service, is that
they see what Cuba can provide: in equipment, in medications, in
personnel. And yet this bounty is not available to Cubans (ordinary
Cubans). It is sold to foreigners, to keep Castro's regime in business.
And this brings up a point concerning Castro's apologists: If they must
concede that Cuban health care is a shambles, their fallback position is
that it's all the fault of the American "embargo." And yet Cuba has no
problem taking care of people in other countries, for show and profit.
Moreover, American trade with Cuba in medical goods is virtually
unfettered, and American humanitar¬ian aid is considerable.
THE PRESENCE OF HEROES
Above, I spoke of doctor dissidence — and a particularly painful aspect
of Moore-like myth-making is that some of the most courageous, most
admirable, and most persecuted people on the island are doctors: men and
women who have rebelled against health-care injustices and injustices in
general. Oscar Elías Biscet is possibly the most noted of such people.
He is in one of Castro's most wretched dungeons. Michael Moore would not
even think of taking his cameras to it (and, in any case, he would not
Biscet, like so many of the human-rights figures, happens to be
"Afro-Cuban." And, as Mary Anastasia O'Grady of the Wall Street Journal
has pointed out, the regime is especially vicious toward such figures,
because they are supposed to be grateful for all the Revolution has done
for them. Dr. Mendoza, who wrote about dengue, is also Afro-Cuban. So is
Dr. Dariel "Darsi" Ferrer.
He has managed to stay out of prison, somewhat miraculously — perhaps
because there has been a fair amount of international attention on him.
Ferrer operates the Center for Health and Human Rights. In 2005, he
penned a statement called "Health Authorities and the Complicity of
Silence." Though he has avoided prison, the regime has subjected him to
terrible abuses, including actos de repudio, or acts of repudiation.
These are those lovely episodes in which mobs are unleashed on your
home, family, and friends.
Hilda Molina Morejón is another doctor-dissident — a stunning case. She
was the country's chief neurosurgeon, the founder of the International
Center for Neurological Restoration. She was also a deputy in the
National Assembly. In the early 1990s, however, the regime informed her
that the neurological center would start concentrating on foreigners,
who would bring their hard currency. She objected, resigning her
positions and returning the medals that Castro had awarded her. Then
came actos de repudio and all the rest of it (but not prison). She has
been forbidden to leave the island, and is banned from practicing
medicine. She manages, despite the circumstances, to speak out.
"Live not by lies!" said Solzhenitsyn. "Live not by lies!" And yet Cuban
Communism and its enablers have lived by them for a half-century.
Totalitarians always depend on these lies. Robert Conquest, the great
scholar of the Soviet Union, remembers a health official telling him, in
private, that many hospitals lacked even running water. Yet public
assertions were much different. And there have always been
Potemkin-style visits, such as Moore's. He is simply more talented than
most of the others.
Once Communism collapses in Cuba — or if it does — will there be a
reckoning? When I was growing up, East Germany was presented to me, by
misguided teachers and professors, as a fine social democracy. Earlier
this year, a movie called The Lives of Others won an Academy Award. It
told some of the truth about East Germany. What will future generations
make of Sicko, particularly its portrait of Cuba?
In the meantime, the movie will do a lot of harm, cementing the myth of
Cuban health care, among other myths. Castro's health minister, José
Ramón Balaguer, is well pleased. "There's no doubt that a documentary by
someone of Michael Moore's stature will help the world see the deeply
humane principles of Cuban society," he said. You wonder, sometimes — in
the face of constant and powerful myth-making — whether articles in
magazines, and the daring and anguished testimonies of Hilda Molina et
al., and the cries of an entire society, can make a dent.
I have an indelible memory, from the mid-1980s. Armando Valladares was
at Harvard, speaking to students. He had emerged from 22 years in the
Cuban gulag, and had written the memoir Against All Hope. (Valladares is
often called the Cuban Sol¬zhenitsyn.) In the Q&A, the kids spouted at
him the usual line about Cuba: health care, literacy, and blacks. They
had been carefully taught it by their teachers. And Valladares answered,
in essence, "It's all untrue — a pack of lies. But even if it were true:
Can't a country have those things without dictatorship, without tyranny,
without gulags, without torture — with freedom?"
There is no omelet. There never is. But even if there were — so what?