Today on the announcement of the Supreme Court decision upholding the Affordable Care Act's constitutionality, I dug back in the files for this image. I made this photo while visiting the Cardiovascular Center in Vedado in 2003. This is a cardiologist and a lab technician performing a coronary angiogram in the cardiac catheterization laboratory there. I am a retired cardiologist who did such procedures in my career and I had the privilege of meeting one of the leaders of this facility in Havana. The capabilities of the physicians in Cuba were superb, the specialty training had been done in a hospital in Spain. I spent the better part of a day visiting and talking shop with many of the doctors who worked there. The doctors major complaint was the scarcity of information. They all felt that it was difficult to stay abreast of advances in their field of specialization. Almost all of their supplies were cleaned and re-used. In more advanced countries, most all of the supplies and instruments are disposable. Catheters and other things were cleansed, sterilized and re-used. The time to dispose of something was when it no longer worked. In spite of these shortcomings people were getting good care and it did not cost them anything. The availability of good front line care and public health has benefited the people in lessening disease and it reduces the cost of health care by avoiding unnecessary procedures. There are still many scarcities though and now there are some costs for drugs and things like that. Still the people can find a clinic and a provider anytime and can get some sort of treatment. It is an interesting contrast to the US system, like in most things the best way lies somewhere between the two....and, it is possible to provide everyone with health care regardless of their ability to pay.
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