Chavez’s socialist medicine dream may be liability

CARACAS,  (Reuters) – Osmar Herrera is the kind of  Venezuelan that President Hugo Chavez had in mind when he  launched his flagship health program eight years ago: sick,  impoverished and in need of a break.

But Herrera’s predicament today illustrates how the  socialist leader’s biggest social spending experiment fell off  the tracks and may become a liability in next year’s election.

When the 60-year-old Herrera first started coughing up  blood earlier this year, he sought help near his house at one  of thousands of “barrio adentro” health centers that Chavez has  built in poor neighborhoods, paid for with oil money.

Hugo Chavez

Near collapse, Herrera was punted from one institution to  another until eventually ending up in the thoracic ward of a  run-down public hospital three hours from his home. He adores  Chavez but laments his inability to provide hospitals in his  area with the equipment they need to treat pneumonia.

“They should have it too, so that some people don’t have  more than others, so that everyone is at the same level,” he  whispered from his bed in a spartan, eight-patient room.

While the president, who is undergoing treatment for  cancer, is whisked away to Cuba for chemotherapy as a pampered  guest of its revolutionary leader Fidel Castro, frustration at  home is mounting over marathon waits at crumbling hospitals and  shortages of basic medicines and supplies.

The “barrio adentro” program — “within the neighborhood”  in Spanish — began in 2003 with an ambitious promise to grant  free health care to the most needy. Initially, the government  built small primary care modules in Caracas’ many slums,  staffed by Cuban doctors. The centers later mushroomed all  across the country.

In subsequent stages, the government talked of building  rehabilitation and diagnostic centers with technology imported  from allies Cuba and China. It would also erect new hospitals  in poor areas and refurbish existing ones.

The goal was widely applauded and the program’s early  success boosted Chavez’ popularity. Several years on, however,  only a small percentage of the projects have been completed and  traditional hospitals have been starved of cash as the  government pours money into the alternative system.

A self-styled revolutionary and populist, Chavez has framed  the health debate as a struggle of the downtrodden against the  elite. He is counting on his health and housing programs and  discount food and clothing stores to win votes in the 2012  election, seen as a close race against the opposition.

Nobody knows how much “barrio adentro” costs due to  notoriously opaque fiscal accounts. Jorge Diaz, a health policy  researcher, estimates the overall budget for public health  reached 9 percent of gross domestic product in 2004, up nearly  500 percent from 1998 and above the 2 percent historical norm.

State oil company PDVSA, which invests some of its revenue  from the OPEC country’s vast oil revenues in Chavez’ social  initiatives, says it invested $650 million on “barrio adentro”  last year and $6.36 billion from 2003-2010.    Meanwhile, maternal and child health indicators have  deteriorated and health coverage has not improved, according to  research by Diaz at the Central University of Venezuela’s  Center for Development Studies.

The country now has three parallel services with no  coordination between them: “barrio adentro”, traditional public  hospitals and private clinics. Surveys show Venezuelans are  increasingly losing confidence in the two public options and  turning to private care despite the cost.

Even Chavez declared in 2009 that there was a medical  “emergency” after reports that 2,000 of the 6,700 “barrio  adentro” modules had been abandoned.
“To summarize it in the simplest way, I would say this has  been a rip-off,” Diaz said. “It started as an electoral bait  with some health benefits but it turned into a fraud, not only  for health reasons but a fraud of the national treasury.“

The gap between the idea and reality couldn’t be starker  than at the dilapidated Jose Ignacio Baldo public hospital in  Caracas’ low-income west side.

The pediatric care unit was “temporarily” closed in 2007  for renovations supposedly funded by “barrio adentro”. Four  years later, it remains an empty shell in a yard overgrown with  weeds but otherwise no signs of life. Five weathered billboards  advertise projects awarded to contractors that never got done.

Doctor Maria Yanez, a kidney specialist, threw her hands in  the air when asked recently how this was possible. “We have no  idea what has been done with so much money,” she said. “A  barrel of oil is at $107, for example, and a ton of money has  entered the country.”

The 500-bed hospital with peeling paint and leaky ceilings  is running at about 30 percent of its capacity. The one X-ray  machine doesn’t work and many of its underpaid doctors have  bolted the country in search of a better life elsewhere.

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