CastroCare In Crisis: Medical Help Wanted

In 2009, a group of 30 physicians from Florida toured Cira García, a well-appointed clinic that is run by the government-owned tourism conglomerate the Cubanacán Group and that primarily serves foreigners. The visiting physicians concluded that once the U.S. embargo is lifted, the facility will be overwhelmed by its foreign patients.

It takes little imagination to envision chains of private clinics, located near five-star hotels and beach resorts, catering to the elective needs of North Americans and Europeans. Such a trend might bode well for Canadians seeking to avoid queues in Ottawa for hip replacements or for U.S. health insurance companies looking to cut costs on cataract surgery and pacemakers. However, providing health care to wealthy foreigners would drain physicians, technicians and nurses from Cuba's public system, says Laurie Garrett, a senior fellow for health at the Council on Foreign Relations.

And any such brain drain within Cuba might be dwarfed by a brain drain out into the rest of the world, as Cuban doctors and nurses leave the country to seek incomes that cannot be matched at home. Countries facing gross deficits in skilled medical talent are already scrambling to lure doctors, nurses, lab technicians, dentists, pharmacists and health administrators from other nations, says Garrett.

  • In 2006, the World Health Organization (WHO) estimated that the global deficit of medical professionals was roughly 4.3 million, and the figure can only have grown since then.

  • According to the American College of Physicians, the United States currently has approximately one doctor for every 2,500 patients and a critical shortage of nearly 17,000 doctors.

  • The American Medical Association estimates that there is an especially grave deficit of primary care physicians, with only 304,000 licensed – about 30,000 fewer than needed.

  • In addition, the recently enacted federal health care reform law will put more than 30 million more Americans on insurance or public rolls, thereby dramatically increasing the need for physicians.

    With most U.S. doctors incurring debts of $200,000 to complete their schooling, there is little hope that the acute primary care deficit can be filled anytime soon by talent trained in the United States. Already, U.S. and Canadian medical institutions are trying to fill their human resource gaps through recruitment from Africa, Asia, Eastern Europe and Latin America, says Garrett.

    Source: Laurie Garrett, CastroCare in Crisis: Medical Help Wanted Foreign Affairs, August 2010.

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    First published by the National Center for Policy Analysis, United States

    FMF Policy Bulletin/ 24 August 2010
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