Sejelek-jeleknya sosialisme, paling tidak sistem itu
membawa kebaikan pada dua hal, yaitu jaminan kesehatan
masyarakat dan pendidikan untuk semua warganegara. 
Dan kesehatan serta pendidikan berbanding lurus dengan
perolehan medali Olimpiade.

Salam,
RM

--------------------------------------------------------------------------------

January 12, 2005
OP-ED COLUMNIST 
Health Care? Ask Cuba
By NICHOLAS D. KRISTOF 
 
ere's a wrenching fact: If the U.S. had an infant
mortality rate as good as Cuba's, we would save an
additional 2,212 American babies a year. 

Yes, Cuba's. Babies are less likely to survive in
America, with a health care system that we think is
the best in the world, than in impoverished and
autocratic Cuba. According to the latest C.I.A. World
Factbook, Cuba is one of 41 countries that have better
infant mortality rates than the U.S.

Even more troubling, the rate in the U.S. has worsened
recently.

In every year since 1958, America's infant mortality
rate improved, or at least held steady. But in 2002,
it got worse: 7 babies died for each thousand live
births, while that rate was 6.8 deaths the year
before.

Those numbers, buried in a recent report from the
Centers for Disease Control and Prevention, didn't get
much attention. But they are part of a pattern of
recent statistics dribbling out of the federal
government suggesting that for those on the bottom in
America, life in our new Gilded Age is getting
crueler.

"America's children are at greater risk than they've
been in for at least a decade," said Dr. Irwin
Redlener, associate dean at the Mailman School of
Public Health at Columbia University and president of
the Children's Health Fund. "The rising rate of infant
mortality is an early warning that we're headed in the
wrong direction, with no relief in sight."

It's too early to know just what to make of the
increase in infant mortality in 2002 for American
babies. Reliable data for 2003 and 2004 are not out
yet. Sandy Smith of the Centers for Disease Control
says that the statisticians are pretty sure there was
not a further deterioration in 2003, but that it's too
soon to know whether there was an improvement or just
a leveling off at the higher rate.

Singapore has the best infant mortality rate in the
world: 2.3 babies die before the age of 1 for every
1,000 live births. Sweden, Japan and Iceland all have
a rate that is less than half of ours.

If we had a rate as good as Singapore's, we would save
18,900 babies each year. Or to put it another way, our
policy failures in Iraq may be killing Americans at a
rate of about 800 a year, but our health care failures
at home are resulting in incomparably more deaths - of
infants. And their mothers, because women are 70
percent more likely to die in childbirth in America
than in Europe.

Of course, deaths in maternity wards occur one by one,
and don't generate the national attention, grief and
alarm of an explosion in Falluja or a tsunami in Sri
Lanka. But they are far more frequent: every day, on
average, 77 babies die in the U.S. and one woman dies
in childbirth.

Bolstering public health isn't as dramatic as spending
$300 million for a single F/A-22 Raptor fighter jet,
but it can be a far more efficient way of protecting
Americans.

For example, during World War II, the employment boom
meant that many poor Americans enjoyed regular health
care for the first time. So even though 405,000
Americans died in the war, life expectancy in the U.S.
actually increased between 1940 and 1945, rising three
years for whites and five years for blacks.

True, infant mortality and many other American health
problems are largely intertwined with poverty, and
experience suggests that neither the left nor the
right has easy solutions for intractable poverty. But
some of the steps the government is now taking or
talking about - like cutting back further on
entitlements, particularly those giving children
access to health care - would aggravate the situation.
Last year, a study by the Institute of Medicine, a
branch of the National Academy of Sciences, estimated
that the lack of health insurance coverage causes
18,000 unnecessary deaths a year. 

As readers know, I complain regularly about the
Chinese government's brutality in imprisoning
dissidents, Christians and, lately, Zhao Yan, a New
York Times colleague in Beijing. Yet for all their
ruthlessness, China's dictators have managed to drive
down the infant mortality rate in Beijing to 4.6 per
thousand; in contrast, New York City's rate is 6.5.

We should celebrate this freedom that we enjoy in
America - by complaining about and working to address
pockets of poverty and failures in our health care
system. It's simply unacceptable that the average baby
is less likely to survive in the U.S. than in Beijing
or Havana. 



The New York Times 


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