09/02/13 - WLRN (Florida) - Why We Can't Blame Cuba For Our Doctor Shortages
By TIM PADGETT
Millions of angry Brazilians have taken to the streets this summer to
demonstrate against their government and political class. And right now
we're seeing a vivid example of why: the controversy over Brazil's
recruitment of 4,000 Cuban doctors to work in its remote regions.
Brazilian doctors are up in arms, insisting the Cubans aren't trained well
enough to practice medicine in Brazil. Brazilian President Dilma Rousseff's
administration says the Cuban docs are needed because Brazil's are too
elitist to serve patients in poor rural areas. And U.S. politicians
complain the plan reflects Brazil's "complicit blindness," as the
Cuban-American congressional caucus puts it, toward communist Cuba's
But making Cuba the issue in this dispute misses the point -- and ignores a
problem that plagues not only Brazil but Florida and the U.S.
It's true that Cuban medical training is no longer regarded as exemplary.
And as the Miami Herald's Andres Oppenheimer points out this week, exported
Cuban doctors are virtual slaves since the Cuban government pockets more
than 90 percent of the money foreign countries pay them. (They'll get
$4,000 a month in Brazil). What's more, Cuba's continuing cholera epidemic
makes its doctors-for-international-hire service -- 40,000 Cuban health
workers are stationed abroad, earning Cuba $6 billion a year -- look more
cynical than charitable.
Even so, the fact that Brazil has to import those physicians says more
about its flaws than it does about Cuba's. Brazil is now the world's sixth
largest economy, yet it has only 1.8 physicians per 1,000 people compared
to 6.7 in cash-starved Cuba, according to the World Health Organization.
That's one reason (among many) for the Brazilian protests, which in turn
compelled Rousseff to create the Mais Médicos (More Doctors) program that
invited the Cuban physicians, who started arriving this week.
That doctor shortage is a symptom of how fecklessly Brazil's leaders have
neglected science education and rural healthcare, despite the country's
decade-long economic boom and its constitutional guarantee of medical
services. That doctor shortage is a symptom of how fecklessly Brazil's
leaders have neglected science education and rural healthcare, despite the
country's decade-long economic boom and its constitutional guarantee of
medical services. Says Debora Rosenn, a São Paulo native and Miami
photographer who has led Brazilian ex-pat demonstrations here this summer,
"If there aren't enough doctors in rural Brazil it's because the government
has provided almost no medical infrastructure there."
But before Americans, and especially Floridians, scold Brazil, we should
consider our own looming and inexcusable physician shortage. Florida, in
fact, might as well be Brazil. When the state legislature approved a
medical school at Florida International University in 2006, it pointed out
that Miami was then the nation's second largest metropolitan area without a
public medical school. Florida needed to license 2,500 new physicians
annually to keep up with demand, yet it graduated only 500 medical students
The situation hasn't improved much today: 16 Florida counties still have
fewer than seven doctors per 10,000 residents compared to 22 per 10,000 for
the U.S. as a whole. But don't think the country isn't in trouble, either.
According to the Association of American Medical Colleges, the U.S. is
staring at a shortage of 100,000 physicians by 2020. The problem will be
especially acute in poor rural pockets. Not coincidentally, the
Philadelphia Inquirer recently reported that the number of medical
scholarships offered by the federal government's National Health Service
Corps has dropped from 6,159 in 1981 to 250 today.
I of course wouldn't suggest we alleviate the U.S. shortage by recruiting
Cuban doctors (though it's always amused me how U.S. pols like those in the
Cuban-American caucus vilify the quality of Cuban docs who work abroad but
then suddenly extol their skills when they defect). But railing at Cuban
doctors doesn't fix our problem, either -- just as recruiting them won't
solve Brazil's problem.
Brazil has apparently decided that a Cuban doctor out in the Amazon is
better than no doctor at all out in the Amazon. But that's a lame
healthcare policy -- and Florida and the U.S. need to be mindful of that
CUBA-L FAIR USE NOTICE
This server contains copyrighted material the use of which has not always been specifically authorized by the copyright owner. We are making such material available in our efforts to advance understanding of Cuba's political, economic, human rights, international, cultural, educational, scientific, sports and historical issues, among others. We distribute the materials on the basis of a 'fair use' of any such copyrighted material as provided for in section 107 of the US Copyright Law. In accordance with Title 17 U.S.C. Section 107. The material is distributed without profit. The material should be used for information, research and educational purposes. For more information go to: http://www.law.cornell.edu/ uscode/17/107.shtml.