Local Execs Study National Health System
Cuba had been on Scott Mertie’s bucket list for years. When he finally had a chance to visit this past January as part of a person-to-person cultural exchange, the president of Kraft Healthcare Consulting, LLC soon recognized it should be on the bucket list of other healthcare executives, as well.
What started as a personal desire to tour the country rapidly turned into professional interest. As a communist society, the healthcare system is 100 percent government run. “Their quality of healthcare is considered very good,” Mertie noted. “Their life expectancy is among the longest in the Americas.” Although quick to add he isn’t advocating for socialized medicine in the United States, Mertie said it is intriguing to see how Cuba has set up their healthcare delivery system in an affordable manner.
Mertie approached Caroline Young, president of the Nashville Health Care Council, to tap into her expertise in creating meaningful foreign trade missions. The result is a Kraft Healthcare-led delegation to Cuba next month to study the successes and challenges of a community health system that has an emphasis on prevention and to learn more about the country’s robust physician education programs.
With room for 24 attendees, the delegation quickly filled up. In addition to Young and former U.S. Senate Majority Leader Bill Frist, MD, who has also signed on to attend the trip, Mertie will be joined by healthcare executives representing a cross-section of the industry ranging from providers, facility operators and developers to HIT and revenue cycle management experts.
Although travel from the United States is still limited, there has been some lessening of restrictions over the last few years for Americans. Mertie explained Insight Cuba, which is facilitating the tour planning and meetings in Havana, is one of only a handful of companies that have a contract with the U.S. Department of the Treasury to put together cultural exchanges, such as the Oct. 9-12 Nashville delegation.
During the trip, the Nashville executives will tour the Latin American School of Medicine in Havana, one of the country’s largest medical schools. Mertie noted Cuba produces a large number of physicians to work at home and abroad. “They export a significant number to third world countries for humanitarian reasons,” he noted. “You think of Cuba as being ‘taboo’ and in their own little world … but that’s just to America. They aren’t closed off to other countries.” The Middle Tennessee group also will have an opportunity to engage in informal conversations with students and professors, he added.
Much of the trip’s focus will be on how the country restructured their health system over the last 55 years. “After the revolution in ’59, they put in a national healthcare system,” noted Mertie. “Then in the early ‘80s, they really put an emphasis on preventive care … pushing screenings, health and wellness ... things we’re just now starting to do here 30 years later.”
Mertie added Cuba’s community medicine program is tiered with the catchment area getting larger as acuity rises. “They have a family doctor unit, which is what we’d think of as a primary care physician,” he noted. That physician would be located within a neighborhood or cover a small geographic area. “In general, physicians there see about 1,000 patients a year. In America, it’s more like 2,000-2,500 per year.”
If care needs exceed the capabilities of the neighborhood physician, then a patient would go to a polyclinic, which covers multiple family doctor units. For inpatient needs, regional hospitals care for patients in a polyclinic cluster.
“As with most of the world outside the United States, they do not have the long-term care nursing home environment like we do in this country. It’s the family’s responsibility to care for grandma or grandpa,” Mertie said.
However, he continued, there are grandparent homes that serve as a day option for seniors to allow other family members to work. The local group plans to visit one of the facilities designed for seniors. Mertie hopes the delegation will also have a chance to visit a community mental health clinic, which he said operates much in the same manner as in the United States.
Additionally, the trip includes meetings with physicians and executives with a polyclinic and pharmacy, plus a tour of a large hospital and presentation by representatives from the Ministry of Health. The group will also enjoy a general overview of the economic picture of Cuba, including how healthcare has been integrated in the past and present, and attendees also will have the opportunity to experience some of the country’s cultural landmarks.
“I think the biggest thing we want to bring back is to learn what they are doing from the perspective of what causes them to have a longer lifespan than most other countries, and how they are doing it in an affordable manner,” Mertie concluded.
RELATED LINKS:
Healthcare delegation to Cuba info
New England Journal of Medicine article on the Cuban Healthcare System
