22 September, 2009 — Black Agenda Report
The U.S. health care jungle fares badly when compared to health care systems in other wealthy, capitalist countries. However, even western Europe and Canada can learn a great deal from the examples of Cuba and Venezuela, where health care is a human and constitutional right and the wellbeing of the people is central to the national mission. Now, that’s real socialized medicine.
‘Instead of closing public hospitals, as is happening across the US, Cuba and Venezuela are building them.’
With all of the solidly compelling facts supporting advocates for a single payer healthcare system in the US, it might be hard to conceive of better healthcare models than those they cite. When citing examples of better systems these advocates generally confine comparisons to healthcare in Europe and Canada. One reason is that they don’t acknowledge the direct relationship between a revolution on one hand and healthcare as a human right on the other. If this relationship were accepted it could not be denied that the real models for universal healthcare are in Cuba and Venezuela.
In the US most activists (vs. revolutionaries) take a piecemeal approach to the social ills and injustices afflicting society. Meaning, the fight for healthcare is treated as something separate from the fight for housing/shelter or the environment, which is separate from the fight for living wages and job security, which is also separate from the fight for quality public education, as is separated from the struggle for fair trade or a really democratic system that puts people before profit. These disconnections between the people’s issues is ultimately what preserves the place of healthcare profiteers.
This is not to disparage the admirable advocates for a single-payer system or ignore that we have a great deal of work cut out for us. Private interests have such pervasive control over the political machine and control over the most powerful media that the vision and revolutionary will of the people has been stifled. Activists for single-payer are up against a collective learned helplessnessthat appears right now to be prevailing against the movement for universal healthcare in the US. Learned helplessness, a technical term in psychology, refers to a condition in which a human being or animal has learned to behave helplessly, even when the opportunity for it to help itself exists.
‘Activists for single-payer are up against a collective learned helplessness.’
Legislators and the Obama administration have dishonestly convinced so many that for no good reason a single-payer system is not possible, while at the same time saying that it is the only thing capable of addressing the healthcare crisis in this country. They pretend to respect and respond to citizens concerned about too much government control over people’s healthcare. When in reality they are dancing to the tune of capitalists infecting the healthcare industry like cancer.
As a result there are positive examples available in the healthcare debate not being used because of liberal’s fear of red-baited. Red-baiting (when not ignorance) is essentially why single payer advocates spend energy giving reassurances that what they want is not the same as the ‘socialized healthcare’ boogie monster. However, people need the unadulterated truth, which is that SOCIALIZED HEALTHCARE IS NOT A BAD THING. Universal healthcare advocates in the US should let the public know there is nothing inherently wrong with a socialized healthcare system. In fact to effectively eradicate the plethora of health issues plaguing the most underprivileged sectors of society, a socialized system is an indispensable necessity.
There are several factors that make Cuba and Venezuela’s example superior to any in Europe and Canada. In actuality the healthcare systems in England, France and Canada are all based on economies that depend on neo-colonial exploitation. It will be interesting to see how these systems will fare once all the oppressed and exploited (‘third world’ or ‘underdeveloped’) countries of the world successfully wrench control of their land, natural resources and labor and achieve a just economic self-determination.
The governments of Canada and in Europe, whose healthcare systems are criticized by right wing opponents to healthcare reform, are all allies of the US, while Latin American countries like Cuba, Venezuela, and Bolivia are posited as political adversaries. It is Cuba and Venezuela that by example are transforming the symbol of revolution from one of a militant with a gun to that of a young woman or man with a stethoscope. Cuba and Venezuela’s approach to healthcare is decidedly more proactive and humane.
‘Cuba and Venezuela are transforming the symbol of revolution from one of a militant with a gun to that of a young woman or man with a stethoscope.’
Article 25 of the Universal Declaration of Human Rights, adopted and proclaimed by the General Assembly of the United Nations in 1948, asserts that ‘Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.’
In accordance with this declaration, both Cuba and Venezuela regard healthcare as a human right, not a privilege and have enshrined it as such within their constitutions.
Article 50 of the Cuban Constitution states:
‘Everyone has the right to health protection and care. The state guarantees this right:
– By providing free medical and hospital care by means of the installations of the rural medical service network, polyclinics, hospitals, preventative and specialized treatment centers
– By providing free dental care
– By promoting the health publicity campaigns, health education, regular medical examinations, general vaccinations and other measures to prevent the outbreak of disease. All the population cooperates in these activities and plans through the social and mass organizations.
It is becoming common knowledge that Cuba provides healthcare to all its citizens completely free of charge. Additionally and according to the World Health Organization Cuba’s healthcare is among the highest quality in the world. Unfortunately the full potential of what Cuba can achieve in healthcare is severely hindered by a pervasive US blockade, affecting Cuba’s ability to acquire medical supplies it needs and its ability to share freely with the world the many breakthroughs in healthcare it has achieved.
This island nation is now collaborating with Venezuela to follow the same path. Venezuela’s Bolivarian revolution had to halt a corrupt process of privatization that was plaguing its healthcare system and, through a national referendum, adopted a constitution making the State responsible for ensuring universal access to healthcare. Article 83 states ‘Health is a fundamental social right, an obligation of the state, which guarantees it as part of the right to life.’ Like Cuba, Venezuela is now undertaking an aggressive program that is changing the course of healthcare internationally.
‘Cuba’s healthcare is among the highest quality in the world.’
For example, in 2003, five years after Hugo Chavez was elected president, the Venezuela-Cuba collaboration created for Venezuelan citizens what is known as Misión Barrio Adentro (Mission Inside the Neighborhood) as a humanitarian effort undertaken in Caracas. Since then, the mission ‘has grown into a national public health program committed to wiping out the healthcare deficit through a partnership of the Venezuelan Ministry of Health, the Cuban Medical Mission in Venezuela, and the Office of the Pan American Health Organization in Aruba, the Netherlands, and Venezuela. Barrio Adentro began by necessity after too few Venezuelan doctors responded to calls to join a government campaign to provide care to underserved populations in impoverished neighborhoods. Because the Venezuelan medical community showed insufficient response, the government turned to Cuba, which is renowned for its medical missions, and has doctors volunteering in 69 countries in Africa, Latin America, and the Caribbean.’
Venezuela’s oil wealth is used to finance this direct healthcare and an array of other social programs known as social missions. Barrio Adentro is providing free medical services to the population. In 2005 alone, the state-owned oil company invested $5 billion in the social missions, adding to the regular budget of the Ministry of Health.
Obama has treated US citizens to smoke and mirror pronouncements that he ‘will not sign a (healthcare) plan that adds one dime to our deficit either now or in the future. Period.’ This is to buttress the false premise that a tight budget is an obstacle to public healthcare provisions. It is to get the public to accept that such a thing would require more from taxpayers. Again, the disconnection between other major issues and universal healthcare in the US is used to cloud the public’s reasoning.
‘44.4% of US tax dollars were allocated this year to military spending and the cost of past wars, while only 19.7% went to healthcare.’
US military spending for fiscal year 2009 rose to $515.4 billion, rising to $651.2 billion once emergency discretionary and supplemental spending is added. These figures exceed the military spending of the next 15 countries combined. In case you want to make sure this isn’t a typo or that you’re misinterpreting what is written, let me rephrase. What the US spends on its military (inappropriately called ‘defense’, since the US is always invading and occupying) exceeds the combined totals of the next 15 highest military spending nations. It is a no brainer that the Federal government could take a sliver of this (let’s say 10%) and have more than enough to establish a universal healthcare system and even export services to poorer countries free of charge, as does Cuba. According to the Friends Committee on National Legislation, 44.4% of US tax dollars were allocated this year to military spending and the cost of past wars, while only 19.7% went to healthcare.
And don’t forget that, as BAR’s Bruce Dixon has often pointed out in his analysis on the issue, a more efficient and sensibly administered single payer system would cost less than what is currently spent on healthcare, create millions of jobs and boost the economy. This is merely a question of accessibility in its crudest sense.
Venezuela and Cuba on the other hand not only seek to make healthcare accessible for all but to organically connect this with community organizations and associations, such that the doctors and healthcare professionals work hand in hand with the people themselves for solutions to eradicate versus mitigate disparities. Eradication and prevention of pervasive health issues confronting the society are intrinsic to their mission. All over Venezuela and particularly in the poorest communities free clinics have been established and staffed by at least one doctor who is often Cuban and these clinics are networked to several free Integral Diagnostic Centers (much like mini-hospitals) fully equipped with ex-ray and sonogram machines, trauma care, dental facilities, beds, pharmacies and more. These are the bedrock of Barrio Adentro.
In addition this approach recognizes and includes extenuating issues that worsen negative health factors, like nutrition, clean drinking water and environment, and risky behavior, etc. The lesson from Cuba and Venezuela is simply that they are on a mission. It is not only about free care but also imbuing healthcare workers with a revolutionary spirit and integrity that makes them militants in a struggle that touches those most in need. It is about empowering people to assert that they have a human right to healthcare and that a government truly based on freedom and democracy is obligated to facilitate it.
‘It is about empowering people to assert that they have a human right to healthcare.’
The US government always spouts rhetoric about freedom, even when talking about healthcare systems, making privatization synonymous with freedom. What does the freedom to read or write whatever you like, mean to a person who cannot read nor write. By the same token, what does the freedom to go to any hospital or doctor mean to those who are not health literate or who are condemned to health hazardous environments and living conditions?
Cuba spends less than $1 billion on defense and Venezuela about 1.6 billion. Instead of closing public hospitals, as is happening across the US, Cuba and Venezuela are building them. Both countries are the proof of not only what socialized healthcare is capable of but also what a privatized system beholden to capitalism is incapable of. It is because their systems have the support of a people’s state that makes their accomplishments possible, revealing that achieving anything like it within the US capitalist society is a steeply uphill battle as long as profit is prioritized over people.
The Washington DC based People Before Profit Community Healthcare Project has arisen from the inspiration of these revolutions in healthcare. This project is itself a revolution in the sense that it goes beyond advocacy. We are not looking for the government to do for us. We are attempting to be the change we want to see. PBPCHP participants become transformed ideologically to put people before profit, just as Cuban doctors do. To put the underprivileged who need care before the development of their careers.
Harriet Tubman, Franz Fanon and Ernesto Che Guevara are used as icons so that people associate the pursuit of the human right to healthcare with resistance to capitalism and to inextricably connect it to revolution. In addition to being freedom fighters, Tubman was a nurse, Fanon a doctor of psychology, and Che a medical doctor.
As with Cuba’s international missions, the masses in the US must become instilled with an individual will to sacrifice for the collective good.
To truly realize revolution, it cannot be thought unreasonable to take another’s life or sacrifice your own. Powerful and ruthless interests make the stakes that high. This is why a gun or an armed militant were traditional revolutionary symbols. Such symbols will always present difficult questions of weighing strategies and tactics against principles. But the indispensability of addressing the fundamental needs of the masses is purely a matter of principle.
So there are those today who, internalizing a new form of self-sacrifice, are transforming their revolutionary symbols from guns and armed militants to stethoscopes and healthcare workers.
Netfa Freeman is the director of the Social Action & Leadership School for Activists at the Institute for Policy Studies and an organizer for the People Before Profit Community Healthcare Project. He can be contacted at netfa(at)hotsalsa.org.