[News] Venezuelan Healthcare System

[Anti-Imperialist News]

Health Care and Democracy: A Look at the Venezuelan Healthcare System

http://upsidedownworld.org/main/content/view/1925/1/

Written by Caitlin McNulty
Thursday, 25 June 2009


Barrio Adentro ClinicThe right to health care is guaranteed in the  
Venezuelan Constitution, which was written and ratified by the people  
in 1999.  Through implementing a state-funded social program called  
Barrio Adentro, or inside the barrio, free comprehensive health care  
is available to all Venezuelans. Beginning in June 2003 through a  
trade pact with Cuba, Venezuela began to bring Cuban doctors, medical  
technology, and medications into rural and urban communities free of  
charge in exchange for low-cost oil. The 1.5 million dollar per year  
program expanded to provide a broad network of small neighborhood  
clinics, larger regional clinics, and hospitals which aim to serve the  
entire Venezuelan population. (1) Chavez has referred to this new  
health care system as the "democratization of health care" stating  
that "health care has become a fundamental social right and the state  
will assume the principal role in the construction of a participatory  
system for national public health." (2) In Venezuela, not only is  
health care a right; it is recognized as an essential for true  
participatory democracy.

Some of what characterizes this movement towards health care for all  
includes popular participation, preventative medicine, and evaluation  
of community health issues. Western medicine typically operates in a  
top-down fashion. Doctors treat symptoms, and often fail to evaluate  
the larger picture of community health issues or teach prevention. (3)  
In a private for-profit system, there is little incentive to prevent  
costly illnesses. In Venezuela, however, Barrio Adentro began  
constructing clinics within neighborhoods where many had never been to  
a doctor. Through this program, a community can organize to receive  
funding to build a clinic and bring in doctors. The community is  
responsible for creating health committees, the members of which go  
door to door to assess the specific health issues of their community.   
Doctors who live in the communities also make house calls. (4) People  
participate in the process of serving the health needs of the entire  
population.


The extensive health program is also being used to train a new  
generation of Venezuelan doctors. The training program takes place  
within the clinic system itself and relies heavily on experiential  
learning. The program seeks to build a new relationship between doctor  
and patient based on the values of service, solidarity and compassion.  
Doctors participating in the training program are coming from the  
communities they are learning in and serving, building on their  
intimate knowledge of the communities to provide truly compassionate  
and personalized care.  Using popular forums, medical professionals  
are able to respond to the needs of the community and offer education,  
treatment and consultation addressing unique public health issues.(6)


Although the system began by focusing exclusively on preventative  
health, it has expanded to include emergency health services, mental  
health services, surgeries, cancer treatment, dental care, access to  
optometrists as well as free glasses and contact lenses, support  
systems for those with disabilities and their families, as well as  
access to a large variety of medical specialists. They have succeeded  
in taking an under funded, corrupt public health care system and  
changing not only the quality and accessibility but also the mentality  
of those working there. Instead of a for-profit industry  
systematically denying access to large sectors of the population,  
health care in Venezuela is seen as a basic human right. No one is  
turned away, and no one is denied care. In Venezuela, they treat whole  
person, not simply their illness, and money stays where it belongs-  
outside of the health care system.(7)

During my time in Venezuela, I developed a cough that went on for  
three weeks and progressively worsened. Finally, after I had become  
incredibly congested and developed a fever, I decided to attend a  
Barrio Adentro clinic. The closest one available was a Barrio Adentro  
II Centro de Diagonostico Integral (CDI) and I headed in without my  
medical records or calling to make an appointment. Immediately, I was  
ushered into a small room where Carmen, a friendly Cuban doctor, began  
questioning me about my symptoms. She listened to my lungs and walked  
me over to another examination room where, again without waiting, I  
had x-rays taken. Afterwards, the technician walked me to a chair and  
apologized profusely that I had to wait for the x-rays to be  
developed, promising that it would take no more than five minutes.  
Sure enough, five minutes later he returned with both x-rays  
developed. Carmen studied the x-rays and informed me that I had  
pneumonia, showing me the telltale shadows. She sent me away with my  
x-rays, three medications to treat my pneumonia, congestion, and  
fever, and made me promise to come back if my conditioned failed to  
improve or worsened within three days.

I walked out of the clinic with a diagnosis and treatment within  
twenty-five minutes of entering, without paying a dime. There was no  
wait, no paperwork, and no questions about my ability to pay, my  
nationality, or whether, as a foreigner, I was entitled to free  
comprehensive health care. There was no monetary value connected with  
my physical well-being; the care I received was not contingent upon my  
ability to pay. I was treated with dignity, respect, and compassion,  
my illness was cured and I was able to continue with my journey in  
Venezuela.

This past year, a family friend was not so lucky. At the age of 56,  
she was going back to school and was uninsured. She came down with  
what she thought was a severe case of the flu, and as her condition  
worsened she decided not to see a doctor because of the cost. She died  
at home in bed, losing her life to a system that did not respect her  
basic human right to survive. Her death is not an isolated incident.  
Over 18,000 United States residents die every year because of their  
lack of prohibitively expensive health insurance. The United States  
has the distinct honor of being the "only wealthy industrialized  
nation that does not ensure that all citizens have coverage".(8)  
Instead, we have commodified the public health and well being of those  
live in the US, leaving them on their own to obtain insurance. Those  
whose jobs do not provide insurance, can’t get enough hours to qualify  
for health care coverage through their workplace, are unemployed, or  
have "previously existing conditions" that exclude them from coverage  
are forced to choose between the potentially fatal decision of  
refusing medical care and accumulating medical bills that trap them in  
an inescapable cycle of debt. And sometimes, that decision is made for  
them. Doctors often ask that dreaded question; "do you have  
insurance?" before scheduling critical tests, procedures, or  
treatments. When the answer is no, treatments that were deemed  
necessary before are suddenly canceled as the ability to pay becomes  
more important than the patient’s health.(9)

It is estimated that there are over fifty million United States  
residents currently living without health insurance, a number that  
will skyrocket as unemployment rates increase and people lose their  
work-based health care coverage in this time of international  
financial crisis.(10) Already this year, 7.5 million people have lost  
work-related coverage. Budget cuts for the state of Washington this  
year will remove over forty thousand people from Washington Basic  
Health, a subsidized program which already has a waiting list of  
seventeen thousand people.(11) As I returned to the US from Venezuela,  
I was faced with the realization that as a society, the United States  
places a monetary value on life. That we make life and death judgments  
based on an individual’s ability to pay. And that someone with the  
same condition I had recently recovered from had died because,  
according to our system, her life wasn’t insured.

Many in the United States fear that people would abuse a free health  
care system, causing overcrowding and a compromised level of care.  
Others claim that a single payer system would limit the freedoms of  
both doctor and patient. These claims, propagated by the corporate  
media in the United States, are a hollow attempt to keep those in the  
US from organizing to demand single payer health care. Primary care  
and preventative medicine are seen as the first steps towards  
sustainable universal health care, keeping people out of costly  
hospital stays, tests, and treatments down the road.  Socializing the  
costs of medicine keeps costs low by preventing expensive treatments  
and health problems. It is difficult to understand how much quality,  
free health care means until you find yourself in a position of  
vulnerability and need. I felt a sense of security traveling in  
Venezuela that I do not feel in the United States; in Venezuela, there  
is a safety net ready to catch you when you fall. People in the US  
must ask themselves, as a country, where our values lie and how we  
have not only let people slip through the cracks but worked to  
systematically exclude them. Do we believe that insurance corporations  
and the medical industrial complex should be profiting from denying  
care and keeping sick people from receiving treatment? Or do we  
believe that care should be separate from an individual’s ability to  
pay? As a nation, we must embrace our humanity and value life over  
profits.

Notes:

1 Wilpert, Gregory. Changing Venezuela The History and Policies of the  
Chavez Government. New York: Verso, 2006.

2 "Mision Barrio Adentro." Mision Barrio Adentro. 02 June 2009  
<http://www.barrioadentro.gov.ve/>.

3 Wilpert, Gregory. Changing Venezuela The History and Policies of the  
Chavez Government. New York: Verso, 2006.

4 "Mision Barrio Adentro." Mision Barrio Adentro. 02 June 2009  
<http://www.barrioadentro.gov.ve/>.

6 "Mision Barrio Adentro." Mision Barrio Adentro. 02 June 2009  
<http://www.barrioadentro.gov.ve/>.

7 ibid

8 "Insuring America's Health: Principles and Recommendations -."  
Institute of Medicine. 02 June 2009 <http://www.iom.edu/?id=19175>.

9 "PR-2000-43/ WORLD HEALTH ORGANIZATION : ASSESSES THE WORLD'S HEALTH  
SYSTEMS." 02 June 2009  
<http://www.who.int/inf-pr-2000/en/pr2000-44.html>.

10 "Census Revises Estimates of the Number of Uninsured People —  
Center on Budget and Policy Priorities." Center on Budget and Policy  
Priorities. 02 June 2009 <http://www.cbpp.org/cms/?fa=view&id=245>.

11 "PR-2000-43/ WORLD HEALTH ORGANIZATION : ASSESSES THE WORLD'S  
HEALTH SYSTEMS." 02 June 2009  
<http://www.who.int/inf-pr-2000/en/pr2000-44.html>.


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