¿Free medicine?

Properly repeated a thousand times lie becomes a truth.

Joseph Goebbels

 By: Roberto Camba Baldomar

I was deceived. I reiterated many times that thanks to the Revolution and Socialism Cubans had a free public health system which I believed. It took me years and exile, detecting deception.

No health system is free. It is perhaps the most burdensome of any State; with its large costs of construction, maintenance and repair of health facilities, equipment, supplies, staff salaries, energy, food, medicine ... The basic task of a state is efficiently manage their resources, therefore it is better not to squander administering an inefficient bureaucracy. So it must be clear: in Cuba is not the state that provides these services nor President who pays out of pocket " for free".

To explain how the costs of the health system covered will use a concept for a Marxist, the surplus value that I think can help us understand where will the money go that we produce and will both incorporate the two systems usually cover that in most countries, the tax system and the insurance system, also analyzing the fourth possibility to pay the services directly.

1. Goodwill:

Although this concept was created by scholars of Marxism to criticize capitalism, it is in socialist countries where the surplus reaches higher percentage being lower wages. That part of the money produced that is not rewarded the worker remains as profit of state enterprises for which works the majority percent of workers in the country, and serves as a basis for national income which public health expenditures are extracted , education, social security, military expenses, the state apparatus and contingency reserves, among others.

2. Tributes:

In most countries where private businesses are the majority, the state budget is used to cover the costs mentioned in the previous point is primarily fed by taxes paid by individuals and companies. Tax systems allow to maintain "free" health services to citizens and residents in most European countries, Canada, Japan.

3. Insurance:

By the contract of insurance people pay a (monthly, yearly) bonus, and this guarantees coverage for all expenses agreed in case the preset condition in the policy (death, accident, fire, damage occurs to the property , disease, etc.) insurance is based on mathematical formulas that calculate the risk that the condition occurs, so that in practice all pay for those who need the service agreed. The system of clinics that existed in Cuba before 1959 (eg "La Colonia Spanish") worked as an insurance system. The person paid a small monthly fee and it would guarantee any health services at these clinics. In the US, Medicare, Medicaid and Obamacare are insurance systems.

4. Cash:

The name refers to the time and not the payment. The patient pays only for the health service received at the time you receiveit . In this system the person manages more money, but at higher risk if you get sick because the cost of services is very high.

The difference between these concepts is not who pays - are always workers - but when, how much and how to pay. In the first concept the worker never receives the capital gain, not decide and nobody is accountable for what is used. In the second the worker manages a little more and demands to know what "taxpayer money" is used. In the third the worker will probably endup helping to pay the expense of others, but at least is assured. In the fourth set the perception of "free" disappears.

In almost all countries coexist more than one system. For example, in Canada coexist tax system, the insurance (many employers pay the full premiums or partially as "benefits") and less cash. Contrary to what many people think these systems are not determined by the fact that health is public or private. Many private clinics billed their services to the state, so that the patient perceives as "free".

The price that Cubans have paid for the "free" medicine is too expensive: poverty wages, health propaganda as "conquest of socialism , " medical infrastructure in ruins, exodus of health professionals. It 's time to understand deception and we demand better use of our money.