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Universal Health Coverage (UHC): Cuba, Politics, and the Economics of Illness

There is no doubt that with the assistance of technology, great strides have been made in healthcare. As our world has become even more closely connected, universal health interests are of even greater importance, especially when considering the impact of global health threats as seen in the recent Ebola and Zika outbreaks.

 

An Introduction to Universal Health Coverage (UHC)

Recognizing the need for stronger health systems on a global level, the concept of Universal Health Coverage (UHC) was born. UHC was also developed by the World Health Organization (WHO) in consideration of the impact of health outcomes on social and economic development, as well as poverty reduction.  

In the words of WHO, “Universal health coverage is defined as ensuring that all people have access to needed promotive, preventive, curative and rehabilitative health services, of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship when paying for these services.” 

 

The Politics of Health Coverage

Under the WHO Sustainable Development Goal 3, Universal Health Coverage includes access to safe, effective, quality and affordable healthcare. As with any other mandates stemming from international organizations such as WHO, the effectiveness of implementing such changes relies on the governance and reform in-country.  However, healthcare reform globally, including the United States and other developed countries falls far behind this goal.

For Universal Health Coverage to move beyond the conception stage and into practice, health, must be treated as a necessity, not a luxury. This ideology is particularly important in regard to health care expenses for patients.

 

Prevention, Health, and the Economics of Illness

It is easier to prevent people from getting sick than it is to cure people who are ill. Similarly, more money goes into healthcare from those that are sick than those that are healthy.

Why is this? Routine health care visits in combination with regular prevention and wellness outside of the health system, by the patient themselves, reduces the amount of money said patient will generate in health care costs.

Why is this important? Care for chronic, preventable illnesses such as diabetes, obesity, hypertension, etc. is expensive. Unnecessary urgent care visits are also expensive. However, in the eyes of economics, spending is good. Likewise, for those that generate profit from health care expenses, illness generates more money. This does not necessarily mean that health care providers actively want for people to be sick, nor does this mean our system is setup to encourage illness. What it does mean is that illness, at least the cost of health care related to illness, results in economic expenditure. While health and wellness reduces the economic burden of healthcare, it does not pay into the system. This is what we mean by the “economics of illness”.

While Universal Health Coverage is important in relation to health care, there must also be a focus on the health and well-being of populations, in addition to just caring for their illness. While this may not be so popular economically, prevention and wellness is a more sustainable approach to reducing morbidity and mortality than caring for illness alone.

 

Lessons learned from Cuba

While much can be said about Cuba, both negative and positive, there is much to say about the Cuban healthcare system. In fact, the Cuban healthcare system has been recognized by WHO as a model for the world, placed far ahead of that of the United States and other developed countries. Not only is the Cuban healthcare system efficient and effective, but it is one that is operating in a low-resource setting.

What makes the Cuban system so great? Two key component of the effectiveness of the Cuban system are 1) the support of the government in keeping the system strong and 2) a focus on prevention rather than cure. Healthcare in Cuba is free for citizens, yet providers are some of the best trained in the world. At the very least, perhaps we can look to the Cuban healthcare system for tips on how to use prevention to more sustainably provide low cost, high-quality healthcare services and maintain a well-trained health workforce.  

 

For more on the Cuban Health System:

Cuba’s Health Care System: a Model for the World

http://www.huffingtonpost.com/salim-lamrani/cubas-health-care-system-_b_5649968.html

How Cubans Live as Long as Americans at a Tenth of the Cost

https://www.theatlantic.com/health/archive/2016/11/cuba-health/508859/

Fidel Castro’s Health Care Legacy

http://www.commonwealthfund.org/publications/blog/2016/nov/fidel-castros-health-care-legacy

 

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Cartel Mexico: Continued Violence in 2017

Even after a two-year hiatus, the situation of violence in Mexico has continued. For those readers that have returned, thank you. For those who are just reading the “Cartel” series on AnthroPolitique, Welcome. “Cartel” is a series within AnthroPolitique that provides an overview of social, cultural, economic, and political situations surrounding organized crime networks, both present and past.

This week, we will return again to Mexico, taking a look only at the events that have occurred in the month of July 2017. “We are not even halfway through the month”, you may say. Unfortunately, in 2017, violence has left record murder rates in Mexico, with 2,186 murder investigations in the month of May 2017 alone and 9,916 in the first five months of 2017. As of today, July 11th, 2017, the following events have made headlines in relation to the ongoing drug and gang violence in Mexico:

In Mexico, massacre of family underlines surging violence
3 bodies found in condo parking lot in Mexico resort town

 

What does this mean?

Well first, it does not appear that either direct or indirect cartel violence has shied away from targeting families, religious leaders, students, and other innocent bystanders, in addition to any others that may be directly involved. What these particular headlines represent is the targeting of innocents – those that have either resisted the violence or are in some way linked indirectly to the events that have ravished Mexico since the crackdown on drugs under former President Felipe Calderon in 2006. While the rates of murder soar in Mexico, what is more, alarming is the number of “disappearances” that have continued since the disappearance of 43 students in September 2014.

As a glimpse of hope, I would like to highlight another article from the Los Angeles Times this week titled “One Mexican town revolts against violence and corruption. Six years in, its experiment is working”.

Inspired by this Cheran town example, next week we will take a look at how violence and terror from cartel conflict can be countered by breaking the link between crime, drugs, and politics.

 

For more information and alerts on Criminal Violence in Mexico, take a look at the Council on Foreign Relations (CFR) Global Conflict Tracker: https://www.cfr.org/global/global-conflict-tracker/p32137#!/conflict/criminal-violence-in-mexico. Note that the current conflict status has been noted as “unchanging”.  

Balancing Russia in Ukraine: U.S. Policy One Year following 2014 Annexation of Crimea

palm flag crimeaWith continued Russian control of Crimea over a year after the February 2014 annexation of the peninsula, the U.S. must decide whether or not to take further action in the conflict. On March 10, 2015, a hearing will be held by the United States Senate Committee on Foreign Relations regarding “U.S. Policy in Ukraine: Countering Russia and Driving Reform”, following a similar hearing in the House Committee on Foreign Affairs on March 4, 2015. Russia’s appropriation of Crimea from Ukraine has forced U.S. policy decisions to be made regarding U.S. positioning in the Ukrainian crisis.

What will be significant about the upcoming hearing is not whether the United States will become involved in the Ukrainian crisis against Russia. Instead, the question will be the extent to which the U.S. will back the torn state against Russia. While we no longer live in a bipolar U.S. versus U.S.S.R world, tension between these two states will continue as long as power balancing is in play. Referring back to a 2011 writing on Russia and Soft Balancing, which on Russia’s status in a post-Cold War world in relation to the U.S., it is important to note that while Russia has declined as a bipolar power, Russia holds significant influence in our multipolar world as a balancing power. Russia’s annexation of Crimea from Ukraine, a sovereign state, demonstrated that Russia’s strength is very much present in the international community.

Even with a ceasefire in place, more than an estimated 6,000 people have been killed in conflict since the Russian annexation of Crimea. Idealistically, the U.S. role in Ukraine should focus on protecting Ukrainian civilians from the violence that has emerged since annexation. This sentiment has been voiced by many since the beginning of the conflict in light of the thousands that have been displaced, injured, and killed due to the conflict. However, one substantial fact exists: war is costly. In this delicate position, too much pressure on Russia can result in further armed conflict. Furthermore, involvement in Ukraine does not appeal to immediate interests of the US. Such intervention would result in significant military expenditure on the part of the U.S. in or to successfully expel Russia from Crimea – and Russia is prepared to fight.

This is not to say that Ukrainian opposition groups will be left without U.S. support. U.S. foreign policy plays a careful hand at providing indirect support to groups opposing “enemies” of U.S. interests. In this case, the U.S. will continue to provide backing of groups as a means of countering Russia, but not to the extent of implicating a U.S.-Russian war over Crimea. Although it is objectionable that humanitarian interests are still ignored in our era of globalism, tomorrow’s hearing will be indicative of how the U.S. will maintain this careful balance as a countering power to Russia in the post-Cold War rivalry.

Introducing “AnthroPolitique”

Dear Reader,

I would like to thank you in advance for taking the time to stop AnthroPolitique. To help familiarize you with what you will find as you browse, I would like to provide you with a brief introduction which will include a bit about my background.

My name is Leighann Eileithyia Kimble and I am the founder of Logrando Juntos, Inc., an organization focused on providing education, ESL, and childcare resources to those in underprivileged communities. As a growing organization, we seek to provide assistance and support to individuals in every corner of the world.

In a separate role, I am Executive Assistant to Dr. M. Rashad Massoud, Director of USAID Applying Science to Strengthen and Improve Systems Projects and Senior Vice President of the Quality & Performance Institute at University Research Co., LLC (URC). In this role, I lead various administrative tasks, ranging from scheduling and travel planning, to event hosting for major organizations. This position has allowed me to not only host, but to participate in individual meetings involving organizations such as WHO, CDC, and the Embassy of the Republic of Georgia.

I hold a MA in International Relations from Webster University and a BA in Anthropology, International Relations, and Asian Studies from Mary Baldwin College. My research experience and passion lies in International Relations, Humanitarian Affairs, Anthropology, and Latin American Studies.

In short, this blog will be open to a variety of topics ranging from international relations and anthropology to public health and policy. I invite you to contribute your own comments and views as you read, and to keep an open mind should you come across an entry, comment, or idea that is different from your own.

Happy reading!

– Leighann E. Kimble, MA

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