As the transformation of healthcare in the United States continues, it was interesting to read a New York Times article about Cuban healthcare. While food and other basic living conditions are a concern in Cuba, healthcare is not. The government completely funds universal care and the results, as measured by infant mortality, are quite good – 4.0 deaths per 1,000 live births as compared to 5.9 in the United States. We all know that it’s easy to make numbers sing the tune you want, and the New York Times takes great pains to point out the Cuban system strengths: In Cuba, there are a lot of doctors with three times as many physicians per capita in Cuba as compared with its richer neighbor. And they don’t make a lot of money with physician salaries ranging from $45 to $80 per month (and no – that’s not a typo).
Cuba also does a great job in cancer detection with incredibly vigilant screening rates. Early detection allows Cuba to keep these rising costs somewhat under control. Cuban doctors take healthcare directly to the communities with easy to access clinics and home visits being quite common. With the focus on detection and preventive care, outcomes are quite good despite limitations on medical supplies and advanced equipment.
The NYT points out that these results may be skewed slightly by government manipulation of the results, but the point is well taken; an ounce of prevention… And Aetna may have taken a page from the Cuban playbook. They have teamed up with technology startup Heal to bring primary care home visits to patients in California and the Washington DC Metro Area, and now Atlanta markets. Home Healthcare News reports the cost at $149 per visit. Aetna believes that savings can be achieved by removing barriers for care focusing on chronically at-risk patients with multiple conditions. Bringing even more technology, Heal seeks to incorporate devices which can remotely monitor bio-metrics such as blood pressure and glucose levels. Heal is a great prototype as Aetna creates the CVS clinic model which will significantly expand neighborhood access.
With the incredible cost healthcare imposes on our economy, there is a lot of incentive to find improvements. And looking at what works in other countries is a great place to start.