Lo these many years since the Russian Revolution and the collapse of the Soviet Union, the New York Times is still doing public relations for Communism. The most recent example — I find it almost unbelievable — is Nicholas Kristof’s January 18 Times column “Why Infants May Be More Likely to Die in America Than Cuba” (accessible here on Outline). Kristof writes:
Cuba has the Medicare for All that many Americans dream about.
“Cuba’s example is important since for decades ‘health care for all’ has been more than a slogan there,” said Dr. Paul Farmer, the legendary globe-trotting founder of Partners in Health. “Cuban families aren’t ruined financially by catastrophic illness or injury, as happens so often elsewhere in the neighborhood.”
“Cuba has the Medicare of All that many Americans dream about” may be true in a sense, but this is so old and so lame. Kristof’s column is based on Cuba’s low infant mortality rate as reported. He acknowledges the gauzy veil of Cuban health care statistics yet he fails to get at the essential problems they raise. He is a fool for Communism. He promotes what Jay Nordlinger aptly derided as “The myth of Cuban health care” in his 2007 NR column on Michael Moore’s Sicko.
Jay noted that “Cuba’s infant-mortality rate remains respectable,” but put it in the context that Kristof failed to provide. Jay noted, for example, “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 is sky-high, perversely keeping the infant-mortality rate down.” See also Katherine Hirschfeld’s case study below. The word “abortion” doesn’t appear in Kristof’s column.
We have written a lot about the myths of Cuba’s health care system over the years. I collected some useful material in the 2010 posts “Useful idiots, PBS edition” and “Useful idiots, PBS edition: Ray Suarez responds.” PBS was working on behalf of the enactment of Obamacare at the time.
In working on those 2010 posts I came across the work of University of Oklahoma Professor of Anthropology Katherine Hirschfeld. Professor Hirschfeld conducted ethnographic field work in Cuba on the health care system for 10 months in 1997. She experienced the effects of Cuban health care first hand. Then a 29 year-old doctoral student, she was hospitalized in May 1997 with dengue fever in Santiago. She learned that doctors were expected to keep the outbreak quiet. And she was sent to a secret ward where an armed guard stood before her door.
In a paper on her field work in Cuba, Professor Hirschfeld noted some of the difficulties: “Formally eliciting critical narratives about health care would be viewed as a criminal act both for me as a researcher, and for people who spoke openly with me.”
Professor Hirschfeld’s increased awareness of Castro’s tyranny caused her to ask a question that evidently did not occur to Kristof: “[T]o what extent is the favorable international image of the Cuban health care system maintained by the state’s practice of suppressing dissent and covertly intimidating or imprisoning would-be critics?”
Professor Hirschfeld’s book is Health, Politics, and Revolution in Cuba Since 1898. Professor Hirschfeld discovered that Castro has been cooking the books on his health care system. In her paper “Re-examining the Cuban Health Care System: Towards a Qualitative Critique” (Cuban Affairs Quarterly Electronic Journal, July 2007), based on her field work, Professor Hirschfeld provided this case study bearing on the subject of Kristof’s column:
Case #1: Reproductive Choice
The Cuban Ministry of Health [MINSAP] expects physicians to structure their clinical interventions to achieve the Ministry’s annual health goals. As with other sectors of the economy, MINSAP sets statistical targets that are viewed as the equivalent of production quotas. The most carefully guarded of these health targets is the infant mortality rate. Any doctor who had an unusually high rate of infant deaths in his or her jurisdiction would be viewed as having failed in a number of critical respects.
One of the family doctors I worked with in Havana was quite politically militant and took these health goals very seriously. One day during my clinic observations I observed her scheduling an ultrasound for a pregnant woman.
“What happens if an ultrasound shows some fetal abnormalities?” I asked. “The mother would have an abortion,” the doctor replied casually. “Why?” I queried.
“Otherwise it might raise the infant mortality rate.”
Suffice it to say that Kristof seems not to have bothered himself with a call to Professor Hirschfeld before composing his monument to stupidity.
Via James Freeman/Wall Street Journal (“Cubans are ruined financially long before they ever develop a catastrophic illness or injury. In 2015 Fred Dews of the Brookings Institution reported that ‘the take home salary for most Cubans is around $20 a month.’ More recently, the CIA World Factbook placed its estimated per capita income below that of Venezuela and just ahead of Nauru”).