Tag Archive for: doctors

Emilio Arteaga: How Socialism Revives Slavery in the West Today (Part 1)

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Yesterday, the slave trade in the West focused on unskilled labor, but today, Cuban socialism has revived slave practices for decades — albeit with professionals. It has done so through the “export of services.” Under the guise of “humanitarianism” or “solidarity,” it openly and systematically exploits its workers, “in collaboration with private companies, governments, and international organizations,” according to the NGO Archivo Cuba. In this hemisphere, forced labor is condemned as a practice similar to slavery.

It is not surprising to think that if Christianity, with the British abolitionist movement at the forefront, truncated the practice in much of the world, it is socialism that will bring it back. The Cuban author José Martí, as early as the 19th century, recognized this ideology as “the future slavery.”

Doctors, nurses, medical technicians, teachers, sports coaches, musicians, sailors, architects, geologists, tobacco workers, construction workers — Cuba has state-owned companies that exploit the services of all of them, mostly by sending them temporarily abroad on “internationalist missions,” according to Archivo Cuba.

“They are exported like merchandise for two or three years in unusual secret agreements with governments or companies. From 55% to 75% of exported services are in the health sector; Cuba and its allies dedicate a lot of propaganda to glorifying the practice and concealing its darker aspects. These provide the Cuban dictatorship with enormous income and symbolic capital (prestige, influence, goodwill) that translates into countless political benefits, including votes in international organizations,” the organization stated.

Emilio Arteaga was part of these “missions” in South America and Africa. His story offers a stark picture of the semi-slave-like conditions that thousands of Cubans still endure today. From his exile in Spain, where he arrived after a harrowing journey, he shares his testimony with us.

You were part of contingents in Bolivia, Angola, and Namibia. What did and does Cuban health care professionals do to enlist in these “missions”? What is life like for a doctor in Cuba, and what are its challenges?

What makes a doctor in Cuba enlist in a mission is, basically, economic necessity. The rest can be a mix of various motivations that vary from person to person, but to a lesser extent. In Cuba, the salary is so low that for a little more money (which represents a tiny percentage of what the governments of the countries you go to pay you), people enlist. The life of a doctor in Cuba is complicated and difficult. They are the first eyewitnesses to the suffering of a people. Literally. I say this considering that they must respond to the health needs of a population without medicines, without diagnostic tools, without basic supplies and resources to care for a patient, and from a health care system on the verge of collapse.

In a country with several chronic systemic polycrises — encompassing all aspects of daily life: health, social, and financial — doctors are yet another component of this social fabric, already severely damaged anthropologically, and without direct access to foreign currency. They receive their salaries in highly devalued Cuban pesos.

And in this scenario, they have no option for employment other than through a single employer: what I call the Castro-Feudal state.

The Cuban Medical Services Marketing Company (CSMC, S.A.) is the state-owned company designated to “market and manage” the export of medical, academic, and other services, both within Cuba and abroad. It negotiates contracts with foreign governments, organizations, and companies for the deployment of Cuban health care personnel and the provision of external medical services. What is the recruitment and enrollment process for doctors to participate in these missions? What was it like in your case?

The process to enroll in the mission begins at your workplace.

There, you must have the approval of the “factors,” as your union and official political organizations like the Union of Young Communists or the Communist Party of Cuba, among others, are called under communism.

In addition, you must demonstrate professional competence and good overall work conduct to the workplace administration.

In my particular case, it was influenced by the fact that CSMC, S.A. had to provide psychiatrists to the Collaboration Department, and at that time, the vast majority of my colleagues were quite old and didn’t want to leave.

There was also motivation from people close to me — family, friends, and colleagues — and even some patients. They all told me, “It will be good for you to get a change of scenery because you’re going to burn out here,” given how bad the situation is on the island.

So I decided to enter the selection process. We still didn’t really know what lay ahead.

In the preparation before leaving Cuba for the country where you’ll be sent to serve, you have to go through several courses and training sessions. Some are related to the field of medicine in general, others to the culture, language, and characteristics of the place or region where you’ll end up.

At the same time, you have to pass the so-called “Party Courses.” These are taught at the Provincial Schools of the Communist Party of Cuba (PCC).

I wasn’t a communist militant, but to get my graduation certificate, I had to pass these courses. They were like a kind of summary of the subjects of Marxism and Fundamentals of Political Knowledge. I particularly enjoyed and made fun of that group of “professors.” They lived in a parallel reality, as if they were unaware of the real and pressing problems on the island.

Since 2019, international organizations have denounced the Cuban regime for committing human trafficking under conditions of slavery, especially through its “medical missions.” How did you personally experience these conditions?

Several conditions were common in Bolivia, Angola, and Namibia, the three countries where I worked.

One of them was the total absence of individual freedom, limitations on movement, and the requirement to submit to absolute control and constant monitoring by State Security agents or the political police, who are stationed in each country to “accompany” those participating in the missions. Furthermore, other doctors also lent themselves to monitoring their colleagues.

This constant monitoring I’m referring to also includes the control and digital espionage of all your communications and social media.

You couldn’t interact or maintain close relationships with anyone outside the mission. Nor with natives of the countries where you were, and much worse, with free Cubans already residing there. The regime’s representatives were terrified of the latter.

AUTHOR

Yoe Suarez

Yoe Suárez is a writer, producer, and journalist, exiled from Cuba due to his investigative reporting about themes like torture, political prisoners, government black lists, cybersurveillance, and freedom of expression and conscience. He is the author of the books “Leviathan: Political Police and Socialist Terror” and “El Soplo del Demonio: Violence and Gangsterism in Havana.”

EDITORS NOTE: This Washington Stand column is republished with permission. All rights reserved. ©2026 Family Research Council.

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Who Should Choose? Patients and Doctors or the FDA? by Doug Bandow

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Good ideas in Congress rarely have a chance. Rep. Fred Upton (R-Mich.) is sponsoring legislation to speed drug approvals, but his initial plan was largely gutted before he introduced it last month.

Congress created the Food and Drug Administration in 1906, long before prescription drugs became such an important medical treatment. The agency became an omnibus regulatory agency, controlling everything from food to cosmetics to vitamins to pharmaceuticals. Birth defects caused by the drug Thalidomide led to the 1962 Kefauver-Harris Amendments which vastly expanded the FDA’s powers. The new controls did little to improve patient safety but dramatically slowed pharmaceutical approvals.

Those who benefit the most from drugs often complain about the cost since pills aren’t expensive to make. However, drug discovery is an uncertain process. Companies consider between 5,000 and 10,000 substances for every one that ends up in the pharmacy. Of those only one-fifth actually makes money—and must pay for the entire development, testing, and marketing processes.

As a result, the average per drug cost exceeds $1 billion, most often thought to be between $1.2 and $1.5 billion. Some estimates run more.

Naturally, the FDA insists that its expensive regulations are worth it. While the agency undoubtedly prevents some bad pharmaceuticals from getting to market, it delays or blocks far more good products.

Unfortunately, the political process encourages the agency to kill with kindness. Let a drug through which causes the slightest problem, and you can expect television special reports, awful newspaper headlines, and congressional hearings. Stop a good drug and virtually no one notices.

It took the onset of AIDS, then a death sentence, to force the FDA to speed up its glacial approval process. No one has generated equivalent pressure since. Admitted Richard Merrill, the agency’s former chief counsel:  “No FDA official has ever been publicly criticized for refusing to allow the marketing of a drug.”

By 1967 the average delay in winning approval of a new drug had risen from seven to 30 months after the passage of Kefauver-Harris. Approval time now is estimated to run as much as 20 years.

While economist Sam Peltzman figured that the number of new drugs approved dropped in half after Kefauver-Harris, there was no equivalent fall in the introduction of ineffective or unsafe pharmaceuticals. All the Congress managed to do was strain out potentially life-saving products.

After all, a company won’t make money selling a medicine that doesn’t work. And putting out something dangerous is a fiscal disaster. Observed Peltzman:  the “penalties imposed by the marketplace on sellers of ineffective drugs prior to 1962 seem to have been enough of a deterrent to have left little room for improvement by a regulatory agency.”

Alas, the FDA increases the cost of all medicines, delays the introduction of most pharmaceuticals, and prevents some from reaching the market. That means patients suffer and even die needlessly.

The bureaucracy’s unduly restrictive approach plays out in other bizarre ways. Once a drug is approved doctors may prescribe it for any purpose, but companies often refuse to go through the entire process again to win official okay for another use. Thus, it is common for AIDS, cancer, and pediatric patients to receive off-label prescriptions. However, companies cannot advertise these safe, effective, beneficial uses.

Congress has applied a few bandages over the years. One was to create a process of user fees through the Prescription Drug User Fee Act. Four economists, Tomas Philipson, Ernst Berndt, Adrian Gottschalk, and Matthew Strobeck, figured that drugmakers gained between $11 billion and $13 billion and consumers between $5 billion and $19 billion. Total life years saved ranged between 180,000 and 310,000. But lives continue to be lost because the approval process has not been accelerated further.

Criticism and pressure did lead to creation of a special FDA procedure for “Accelerated Approval” of drugs aimed at life-threatening conditions. This change, too, remains inadequate. Nature Biotechnology noted that few medicines qualified and “in recent years, FDA has been ratcheting up the requirements.”

The gravely ill seek “compassionate access” to experimental drugs. Some patients head overseas unapproved treatments are available. The Wall Street Journal reported on those suffering from Lou Gehrig’s disease who, “frustrated by the slow pace of clinical drug trials or unable to qualify, are trying to brew their own version of an experimental compound at home and testing it on themselves.”

Overall, far more people die from no drugs than from bad drugs. Most pharmaceutical problems involve doctors misprescribing or patients misusing medicines. The deadliest pre-1962 episode involved Elixir Sulfanilamide and killed 107 people. (Thalidomide caused some 10,000 birth defects, but no deaths.) Around 3500 users died from Isoproterenol, an asthmatic inhaler. Vioxx was blamed for a similar number of deaths, though the claim was disputed. Most of the more recent incidents would not have been prevented from a stricter approval process.

The death toll from agency delays is much greater. Drug analyst Dale Gieringer explained:  “The benefits of FDA regulation relative to that in foreign countries could reasonably be put at some 5,000 casualties per decade or 10,000 per decade for worst-case scenarios.  In comparison … the cost of FDA delay can be estimated at anywhere from 21,000 to 120,000 lives per decade.”

According to the Competitive Enterprise Institute, among the important medicines delayed were ancrod, beta-blockers, citicoline, ethyol, femara, glucophage, interleukin-2, navelbine, lamictal, omnicath, panorex, photofrin, prostar, rilutek, taxotere, transform, and vasoseal.

Fundamental reform is necessary. The FDA should be limited to assessing safety, with the judgment as to efficacy left to the marketplace. Moreover, the agency should be stripped of its approval monopoly. As a start drugs approved by other industrialized states should be available in America.

The FDA’s opinion also should be made advisory. Patients and their health care providers could look to private certification organizations, which today are involved in everything from building codes to electrical products to kosher food. Medical organizations already maintain pharmaceutical databases and set standards for treatments with drugs. They could move into drug testing and assessment.

No doubt, some people would make mistakes. But they do so today. With more options more people’s needs would be better met. Often there is no single correct treatment decision. Ultimately the patient’s preference should control.

Congress is arguing over regulatory minutiae when it should be debating the much more basic question: Who should decide who gets treated how? Today the answer is Uncle Sam. Tomorrow the answer should be all of us.

Doug Bandow

Doug Bandow is a senior fellow at the Cato Institute and the author of a number of books on economics and politics. He writes regularly on military non-interventionism.