In Cuba, hitchhikers bemoan a host of economic problems
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&Quot;Subanse," climb aboard, I said time after time, pulling the right wheels of my eight-hold van off the dangerous two-lane highway that snakes hundreds of miles across an holm considered off limits to most Americans.</p><p> Apparently, I was in Cuba to cover Pope Benedict XVI's stopover. But over the week and across the length of the Ohio-sized motherland, I gave more than five dozen Cubans a "botella" - in Cuban slang, a lie.</p><p> My riders gave an direct view of the country. They were farmers, housewives and doctors. They were institute kids, half a baseball body, an economist and even a judge, who proclaimed herself to be a jumbo fan of Jack Bauer in the American TV thriller series "24."</p><p> The van was a caper. Waiting for my small rental car at the Havana airport for two hours - described to me as five Cuban minutes - the overworked rental legate finally offered me the huge diesel-powered carrier if I'd get on my way.</p><p> If life gives you lemons, set upon lemonade. I spent most of the following week contribution ordinary Cubans a ride in my gray Hyundai van - which often carried more passengers than it was designed to.</p><p> I don't communicate with a gringo accent. Some riders brown study I was Argentine, most were baffled and many were wide-eyed to see their driver was American and a reporter to boot.</p><p> "I have an aunt in Florida," said Angela, who got in before Camaguey, a prime Cuban city. Many others said the same, citing kith and kin members in Miami, Orlando and Houston.</p><p> A few passengers were on pins - perhaps because of my driving - and sat silently. Most were expressive but mindful, quieter when others were in the car. As the number of riders thinned, the chin-wag generally opened up.</p><p> </p><p> To crack the ice, I played Latin music on my iPod through the van's tub-thumper system. In an early, surreal moment, four Cuban women belted out "Amame," a beloved song by Colombian rocker Juanes. It put to take a nap any notion that Cubans in the interior lacked consciousness of the outside world.</p><p> I left-wing Havana at 5 a.m. sharp on a Sunday, a wholesome day to travel because people are trying to ride rides home after weekend visits. I was led out of Havana by a cab driver I paid to get me to the Carretera Nacional, the governmental highway that is the first stretch of the Carretera Primary, or Central Highway.</p><p> At the start, the whirl looked promising enough, four lanes of hook empty highway. About 20 minutes in, however, the four lanes became two with no further warning. The only indication of roadwork was the
metal barriers - not obvious in darkness - that I nearly hit skidding at 70 mph.</p><p> Minutes later, I drove over a slit so deep that my head hit the roof as the seatbelt snapped penny-pinching. And soon after, there was fog so thick you couldn't see three cars lengths in the lead. It was a tough start.</p><p> About four hours in, I got on the qualify Carretera Central. Imagine a two-lane back track in Anywhere USA. Now imagine it rutted with deep potholes. This was my passage, and my starting point for picking up riders.</p><p> Hitchhiking is about the only way to get around front Cuban cities. Gasoline costs about what it does in the Communal States. Most Cubans don't have cars. Most deserve a monthly government salary of less than $20. Getting from Decimal point A to Point B requires patience, lots of it. The dominant highway is clogged with horse buggies, ox carts and tractors pulling wagonloads of people.</p><p> Cuba differs from the take it easy of Latin America in that there aren't shops and stalls along the roadside with people eking out a living in divers small businesses. This sort of self-job has only just been legalized in Cuba, which officially disdains the hush-hush sector, so it isn't widespread yet.</p><p> Rather than, the Cuban roadside is mostly bare, with auxiliary in-home restaurants - known as "paladares" - and a whole class of revolutionary billboards.</p><p> One mocked the U.S. fiscal crisis with a downward plunging red formation on a financial chart. Others called for the publicity of five Cuban spies jailed in the Combined States. And some were just plain odd.</p><p> "Socialism: Homework for the At large Man," read one confounding rebus. Another, near an abandoned workers dormitory, decipher, "Fidel, yes we did it." My close favorite was at an ecological reserve, declaring, "Disposition is Revolution." Huh?</p><p> </p><p> Sometimes subtly, sometimes without delay, I asked the same questions of all my passengers. How do they see about the newly announced economic openings? Are they punter or worse off than before? What do they think of President Raul Castro?</p><p> If they weren't too uptight, I asked what would come after the deaths of Fidel, 85, and Raul, happily to be 81. They've ruled Cuba for 53 years, 50 of them under a U.S. pursuit embargo. Simple math says their end is virtually. And I asked what'll happen if Venezuela's cancer-stricken president, Hugo Chavez, dies? He's helped keep Cuba afloat with bargain-priced oil.</p><p> What I was after was this: Is Cuba ripe for an Arab Buoyancy, where people can't stand it anymore and take to the streets? Has the authority lost its moral authority? Is it at gamble of collapse from within?</p><p> Most riders expected continuity, duty-Castro brothers. An exception was Carlos, a paramedic picked up case Havana late in the week on the way east along the northwestern coastline.</p><p> "The day that they both die will be the day that the power reclaims its real liberty," he said, adding, "Cubans pauperism the same rights as the people who live closest to us, in the Merged States."</p><p> Carlos, 52, said he was among legions of Cubans who tried to make a run for it it to U.S. shores by raft. He was picked up by the U.S. Seaboard Guard seven miles off Florida and returned during the 1990s.</p><p> "We're living in a realm of lies," he said, provoked that tourists can come to Cuba and make merry a parallel currency, while ordinary Cubans cannot associate.</p><p> Franklin, an eloquent economics-trained restaurant breadwinner in his 30s, spoke passionately about his hope for switch.</p><p> "In every country there are definite parties because not everyone has the same thought, the same ideology. There are Republicans and Democrats in your surroundings," he said indignantly. "Here there's upright one party, there's no party that is in opposition. When we analyze it, it's as if we are all of the same mindset - and of assuredly it's not like that. But what can we do?"</p><p> </p><p> Asked if the resultant deaths of the Castro brothers might wire people to spontaneously take to the streets, Franklin wasn't cheerful.</p><p> "We are like zombies. We steal, but we don't know what our rights are, our duties are, what we should regard as. What we're presented is how we think," he said, not propitious that the dissident movement has much influence. "If 1,000 or 2,000 people (out of 11 million) deem like this, it won't change anything."</p><p> </p><p> Most of the riders expected things to freeze the same, however. That's because the structure of governance has been in place for five decades. Town and regional party bosses and encoded police have a vested interest in continuity, they suggested.</p><p> In the eastern urban district of Holguin, I was talking with a former soldier, Reynaldo Gonzalez, a jack of all trades, when he paused to take range of a middle-aged man he said was a on the sly police officer who'd scooted up a leave bench to eavesdrop on our conversation.</p><p> Gonzalez was pro-r and referred to Miami Cubans as "gusanos," or worms. He vowed that Cubans on the atoll can withstand any U.S. invasion, but he acknowledged he's suffering that if Chavez dies or is defeated in October elections there'll be a retell of the early 1990s after Soviet funding disappeared, when lifestyle in Cuba was particularly hard.</p><p> "We will have to tighten our belts," he said somberly.</p><p> </p><p> A chick named Milagros did fear the coming variation. She spoke bluntly and then, remembering she's in Cuba, asked me to indiscreetly off the recorder and begged that I not mention her work or her city because "everybody knows I whimper."</p><p> Milagros feared a harder score after the ailing Fidel passes. His chum Raul has ruled since 2006, but Fidel looms hefty still.</p><p> "Raul is not cool like Fidel. Fidel, all he wanted was review of ideas, like he says, a encounter of ideas: no war, no arms. But Raul is more litigious," she said, adding, "It uncommonly scares me. It really scares me that Fidel will die."</p><p> Not one rider could name a person they expected to succeed the Castro brothers. Until their ouster in 2009, two names were regularly cited in and out of Cuba - Carlos Lage, who was de facto prime woman of the cloth, and Foreign Minister Felipe Perez Roque. Fidel Castro superbly accused them of falling under the spell of the "honey of power." (Cubans tease that the pair belong to the Pajama Social gathering, since they now cool their heels at home.)</p><p> The guard presence in Cuba remains to some visible. There are checkpoints in every town along the highway. Having traveled extensively behind the Iron Curtain before the take on of the Berlin Wall, it felt well-known. It wasn't a menacing police comportment, just a constant one.</p><p> </p><p> Studiously times dominated almost every conversation with passengers. They complained about how strapping it is with rising food prices and shortages of drain and other essentials. They complained about the government sneering back subsidies and slashing government jobs.</p><p> Angela, a skint white woman from the interior, said her kids, ages 11, 9 and 2, don't recall yet what ice cream tastes like. The administration no longer provides subsidies for out for children older than 8, she said. Angela gets a 30-peso-per-lady subsidy, roughly about $1.50 a month.</p><p> "What do you reflect on a mother can do to feed her kids with that long green? It's not even enough to pay for the milk the state sells!" she said bitterly. Her husband divorced her, and Yaritza, a towering black woman who hopped into the van at the same hour, urged Angela to seek a husband with a cow.</p><p> </p><p> Cows are the property of the state. A 2008 despatch by the U.S. Department of Agriculture said Cuba's livestock population is at least 20 percent less than it was at the everything of the Cuban Revolution in 1959. Profit a cow carries a prison sentence of four to 10 years, according to the punitive judge I picked up later in the week.</p><p> Yaritza complained that Cubans every day are stiff to make unpleasant tradeoffs.</p><p> "With what they pay us, we can't persevere. If you eat, you can't dress yourself. And if you dress yourself, you can't eat," she said. "Viands prices are very high, and clothes, don't even referral it."</p><p> What about those economic reforms getting headlines casing Cuba?</p><p> "It's helped economically, but you demand money to invest to start up something you can do later," said Angela. "The self-employed must have startup gelt. And for those of us who don't, what can we do?"</p><p> I ask about government plans to fit microfinance - small loans, often to in Queer Street women, which have proven successful in Bangladesh and other developing nations. None of my passengers had caught boasting of this idea yet.</p><p> All across the central plains of Cuba, the plains were, well, Spartan. I was traveling in the dry season, a six-month days that generally ends with May showers. Parts of Cuba are in a five-year drought, so some steers and horses in this region were clearly bordering on starvation.</p><p> Their rib cages protruded through their sagging hull as they foraged for anything green. I sent a incarnation of one cow home to my 10-year-old daughter when I reached Santiago to hiding-place Pope Benedict.</p><p> "DAD call creature control it's neglected!!!!!!!" she wrote back with the innocence of a acclivity-school student.</p><p> Elcio Cabrera, a in need farmer with red eyes and the stink the cup that cheers wafting from every pore, climbed aboard in Bayamo, an eastern megalopolis.</p><p> "You've got to work genuine hard to get food on the table for your m," he said of the current want, offering guava and other fruit before robbery my spare shoes upon exit.</p><p> During the busy week at the wheel, I sat in on a pickup baseball racket near Bayamo, with barefooted players as witty as any major league game. I gave eight kids a intimidate in Biran, the birthplace of Fidel and Raul. I happened upon a horrific car smash in Holguin that left me in a "there but for the good taste of God go I" mood. Cuba's extra mortality rate was 14.5 per 100,000 citizens in 2009, unusually piercing given how few vehicles there are in the country but almost half what is was in the 1980s. In 2010, the comparable pace was 11.4 per 100,000 in the United States - where approximately all households have a car.</p><p> </p><p> Back in Havana, I reflected on how much was squeezed into a sharp trip, trying to match so many names to so many conversations.</p><p> I was most struck by the heat of the Cuban people. Three or four strangers climbed in, and within 10 minutes they were talking to each other as if they'd been lifelong friends.</p><p> There's a lot to be depressed about in Cuba, where much in life is brought down to a shared uniform of misery, a lowest common denominator, if you will. Yet Cubans have come up to rely on each other for five long decades in layout to survive.</p><p> Passenger Milagros excellent expressed that optimism.</p><p> "We all have knowledge of we are in a poor country, but within undeveloped countries, Cuba is a advantaged country," she said.
Source: Kansas City Star
Wonkbook: Health reform turns 2
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And yet, out in the vigorousness-care system, the law's second birthday will be a timely one. As Sarah Kliff reports , the hundreds of pages committed to moving American health vigilance away from fee-for-service and towards pay-for-quality are having a breathtaking effect on the way medical providers across the outback actually do business.
The Affordable Concern Act included 45 reforms aimed at changing how fettle care is delivered. Fifteen of those reforms sharply defined unclear on payment practices. At the moment, most are planned, but they are quickly becoming mandatory. Starting in October, for precedent, hospitals with high rates of "preventable readmission" -- that is to say, sharp rates of patients returning with complications from earlier procedures -- will let slip one percent of their Medicare revenue. In the bruited about system, conversely, a patient turning up with a difficulty from a previous procedure actually provides the facility with more revenue.
In answer to some of these reforms and in preparation for others, healthiness-care systems across the country are either the Mafia or accelerating long-overdue changes to the way they do subject. Kliff follows Baptist Constitution System, a five-hospital network in San Antonio, Texas, which saw four surgeons desert as they moved to implement the new, quality-based payments metrics, but which has now seen carrying-on on those measures rise to 98 percent.
Source: Washington Post (blog)
