May 24, 2017


Putting lipstick on a pig is a term used by many, generally in reference to someone who may be trying to make something or someone look appealing or attractive when it quite clearly will not work, or will only deceive the dumbest of people. 

A friend sent me an article written at the end of March in Wired Magazine by Sara Zhang titled “Why some students are ditching America for medical school in-Cuba”. It is important to note that Wired is a noted liberal magazine and Ms. Zhang, a known science writer, a Neurobiologist graduated in Harvard University that became a journalist. Other than the “catchy” headline that article does not present anything new, but a repeat of the liberal rhetoric that tries to sell Cuba’s healthcare system as something it is not, as if putting “lipstick on a pig” would change the fact that it remains a pig. The idea that healthcare in Cuba has to be one to imitate, is laughable if not for the reality of the Cubans that depend of that service.

This is not to say that our system, a mix of overregulation, insurance industry and government control is adequate by any means. But writing that a totally government run program works better is a liberal fantasy. The data mentioned in the article came from Cuba and not independent sources, enough said. The statement that Dr’s do mostly primary care in their houses and treat patients like family ignores reality. Physicians in Cuba study what the Castro’s order; graduate in numbers useful to them so they are able to barter their services to foreign countries in exchange for hard currency and or products. These contracts are done between governments, providers have no say, their travels are mandated, not voluntary and they receive the fees that the dictators desire, with no other options available. These actions would be deemed akin to modern day slavery, if not for the fact of the successful Cuba’s propaganda. Physicians make a salary of $50 to a $100 dollars a month, many giving up their studies to work in the tourism industry.

The primary care Dr.’s cited have a basic medical education that is in general worse than our average nurses and they supplement their meager salary by asking their patients/family? for extra goods or monies to get prompt and better care. Hospitals are a disaster, with the exception of the ones dedicated to the elite and tourists. The idea that education and healthcare are free, so often repeated, can only be believed by the “dumbest of people”. Does the finance come from Mars? Nothing is free, in this particular case it is paid by the population that work in a country that is run, as private property, by the Castro’s and elite who dispense the “free” stuff in exchange for their labor. Any difference from the so often criticized company’s like The United Fruit, or the US southern plantations? Last but not least, Ms Zhang blames the barely effective embargo, as the cause of the lack of appropriate medicines and technology for the majority, ignoring that these are exempt from the restrictions and are also available from other countries.

Foreign students do receive free education, but they better expect harsh conditions and a mediocre at best learning. This is why many of them, conveniently not mentioned by the author, leave and at times even revolt as it happened recently. I have been fortunate enough to travel to attend medical meetings abroad and had the opportunity to talk with many of our Cuban colleagues. I found them, admitting that only their best travel, knowledgeable and when able to talk without fear honest enough to admit their lack of resources, appropriate education and, it might interest Ms. Zhang, they all blamed the system, never mentioning the Castro gang, but no one mentioning the embargo.

The things you will see, my dear Sancho!

Fernando J. Milanes, MD