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They are also part of the neighborhood. Dr. Rodríguez and her nurse know the 907 people they are responsible for from their consultorio: As I walked with Dr. Rodríguez on the street, neighbors stopped her and asked her about their complaints. This proximity and convenience, and not just the lack of fees, make Cuba’s medical system accessible.

“It helps that the doctor is close, because transportation would be a problem,” Fernández told me.

Home visits are also a chance to reach elderly and disabled people and to coach dysfunctional families, such as those wracked by alcoholism (a common problem), and to work on prevention. During Dr. Rodríguez’s visits to Fernández, for example, they discuss breast-feeding and how to make the home safe for the baby.

“It’s no secret that most health problems can be resolved at the primary-care level by the doctor, nurse or health worker nearest you,” said Gail Reed, the American executive editor of the health journal Medicc Review, which focuses on Cuban health care. “So, there is something to be said for Cuba’s building of a national primary-care network that posts health professionals in neighborhoods nationwide.”

Each consultorio doctor is supposed to see every person in the area at least once a year, if not for a formal physical then at least to take blood pressure.

All this is possible because Cuba overflows with doctors — it has three times as many per capita as the United States — and pays them very little. A new doctor earns $45 a month, and a very experienced one $80.

Source : https://www.nytimes.com/2019/01/18/opinion/sunday/cuba-healthcare-medicare.html

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