From SiCKO to SALUD: The Truth About the Cuban Health Care System

At this rate, SiCKO director Michael Moore and CNN's Dr. Sanjay Gupta will make themselves sick over whose facts are right regarding health and health care in the United States versus Cuba, where Moore took three 9/11 workers for treatment.

Lost in the uproar is a fundamental and irrefutable observation: Despite its poverty, Cuba makes health care available to all its citizens, scoring comparably with the U.S. on many health indicators at a fraction of the cost. On average, Cubans live about as long as we do, and their infant mortality rates are actually lower. They have the lowest AIDS rate in all the Americas, with ambulatory care in their communities for HIV-positive people.

They have more doctors serving them, too: about one doctor for every 220 citizens, even with nearly 25,000 posted abroad in 60 countries. About half of these physicians are working in community-based health care, concentrating on the basics of prevention and early diagnosis. And they and the nurses who work with them actually make house calls. This I know from the personal experience of being based in Cuba for about two decades now. The nurse will knock at the door if you've missed an immunization for your baby, forgot to get your mammogram or Pap smear, or if there's an elderly person who needs their blood pressure checked regularly. They know the community because they live there. And it helps to have clinics in the neighborhoods, accessible and free.

Despite all the problems in Cuba -- and there are problems with outdated equipment, hospitals in need of repair, etc. -- a Gallup poll conducted last December revealed that 96% of Cuban citizens said they had regular access to health care, no matter who they were or what their income. That's a pretty high score for any poll.

There must be some lessons we can take home from this Cuban experience as we look for serious reform to reshape our own health care. Number One seems to be: No matter how poor a society or community, it's possible to guarantee people access to health care and improve their health if you make it a real priority.It's time we got over the political barriers and had the wisdom and courage to look to good examples wherever we can find them.