Cuba vs. the United States on Infant Mortality

By Brian Carnell

Tuesday, February 19, 2002

The primary reason Cuba has a lower infant mortality rate than the United States is that the United States is a world leader in an odd category — the percentage of infants who die on their birthday. In any given year in the United States anywhere from 30-40 percent of infants die before they are even a day old.

Why? Because the United States also easily has the most intensive system of emergency intervention to keep low birth weight and premature infants alive in the world. The United States is, for example, one of only a handful countries that keeps detailed statistics on early fetal mortality — the survival rate of infants who are born as early as the 20th week of gestation.

How does this skew the statistics? Because in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive — and the mortality rate for such infants is in excess of 50 percent — that sequence of events will be recorded as a live birth and then a death.

In many countries, however, (including many European countries) such severe medical intervention would not be attempted and, moreover, regardless of whether or not it was, this would be recorded as a fetal death rather than a live birth. That unfortunate infant would never show up in infant mortality statistics.

It would also solve the problem with no doctors in rural areas.

The medical profession can’t be like every other profession. Not when lives are at stake.

The system is definitely not working. I was one of those people without health care. If I hadn’t finally gotten a contracting job that gave me health benefits, I’d owe $15k to my local hospital for my visit last summer. Instead, I paid $350 and my insurance company picked up the rest of the tab.

If we instituted something like Canada’s system wher would US citizens go to get the treatment they needed, analogously to the Canadians who mow come here for theirs? The Candians have the advantage that most of them live very near the US border. It’s a much longer trip from Peoria to the Cayman Islands to get diagnosis unavailable in the USA now that the nationalized health service is controlling costs in the traditional fashion, by rationing care.

If someone is so worried about “40 million uninsured” then work with the insurance industry to find a way to insure them. The whole history of the 20th Century shows that getting the government involved in it, except at the level of public health services like ensuring sanitation, is the worst thing to do, the kiss of death to any hope of a decent level of health care.

When the Iron Curtain came down, of course, it should have been no surprise to learn that the actual standard of health care in the USSR was abysmal and the ordinary citizen enjoyed nothing like the care the elite did. It’s the same in Cuba.

And when the Castro regime falls the Moores of the world will waltz on to the next shining dream that awaits them.

So I think that a documentary should be made and widely distributed. However, it is a total shame that it’s Michael Moore who will be doing it. He will be irresponsible. He will lie. And if he’s comparing the US to Britain, forget it. The NHS is notorious, though, to be fair, part of the fault does like with Thatcher, who starved the service of funds. I knew an orthodentist who visited Britain (admittedly, this was in the 1980s) with a delegation of colleagues from the US. He said that there were only a handful of periodentists in Britain, that they were based at hospitals and only worked on extreme cases. Everyday orthodenture work was done by general practitioners, with predictably horrendous results. He told me that dentists proudly showed his group photos of their work. He said that, in the USA, the results would’ve been valid causes for law suits.

And Cuba? He has to be kidding. Sure, they have some showpiece programs that are touted all over the world, and Castro probably does more for his populace than your average Latin American dictator. But Cuba? As a model for anything? Why Cuba? Why not Germany or Holland, or a Scandinavian country or Canada (where you only have to wait for elective surgery, a problem that could be solved if they spent a little more of their GDP on health care), or Australia? From what I understand, these have decent health care. The choice of Cuba is ridiculous.

If you want to see a good documentary on health care, though it is dated, there was a Frontline one done by Walter Cronkite, from 1994, I think, just when Clinton was trying to enact a health insurance scheme. It compared the Canadian system with ours, frankly admitting the flaws in the Canadian one but rating it as far superior to our own. It was intelligently done, and just very good. There are some archives of tv programs around the country, including here in NY, or maybe one can order it. But it is dated.

I just wish someone other than Michael Moore would do this thing. They could still be incisive and inject humor. The results may not be as popular with audiences, though. A shame.