Americans Are Learning Medicine the Cuban Way

But then her boyfriend saw a blurb in a church newsletter that appeared to assuage her growing worries. It was a unique offer to study in Cuba, the impoverished nation 90 miles from Florida that is internationally known for its training and use of doctors. She applied through the Interreligious Foundation for Community Organization in New York, a group whose mission is to "increase minority participation in medicine" and therefore increase the doctor-patient ratio for underserved areas.

Cuba began educating American medical students after members of the Congressional Black Caucus met with Fidel Castro in 2000. Congressman Bennie Thompson of Mississippi told Castro about areas in his district that suffer from extreme doctor shortages. The Cuban president responded by promising scholarships for 500 Americans to attend medical school in Cuba, under the umbrella of the Latin America School of Medicine. To qualify, the students would have to show aptitude and a commitment to work in underserved communities in the United States. Since then, 34 have graduated, and more than 160 are currently enrolled.

The Bay Area, it turns out, is something of a hub for the Cuba school of thought, where Cuba-trained students, unencumbered by the massive debt that plagues grads from US medical schools, have the luxury to do the kind of medicine that Cuba instructs — family medicine. The island's medical schools focus on nutrition and other preventative approaches. Cuba also is well known for its focus on the "social determinants of health."

The Cuban experience also may provide important lessons for our current health-care crisis. With a fifth of our per capita GDP, Cuba has health statistics comparable to those of industrialized nations. In the shabby, eroding, and commodity-deprived neighborhoods of Old Havana, Cubans also enjoy a better doctor-patient ratio than Americans: 59 doctors per 10,000 people compared to 26 for us.

Cuban life expectancy also matches that of the United States, its infant mortality rate is lower, and the island's HIV/AIDS transmission is among the lowest worldwide. Cuba's aggressive health-care delivery system also costs much less — around $200 per capita annually, compared to our $7,000. And it provides timely and primary care for every citizen — near universal accessibility. To the Cuban government, health care is a right.

This fact highlights a gap in the health-care reform initiative proposed by Congress and President Obama. Those currently without insurance, who will receive coverage with the bill, will feel the lack of family practitioners as basic care continues to be undervalued in favor of more profitable types of medicine.