Bloodletting - Life, Death, Healthcare
a film by Lorna Green

In memory of her Aunt Sydney, who died due to lack of adequate health care.

Review by Joan Marie Malerich, 6/30/2004

About the Writer: Joan Marie Malerich, Universal Single-Payer Health Care Advocate, who has had healthcare insurance for only two of last 12 years. Malerich has studied Cuban issues for two years and visited Cuba September of 2003. She also educated US students about the Latin American School of Medicine (LASM) in Cuba. September of 2000, Cuba offered 500 free medical school scholarships to American students who could not afford the cost of US medical school. There are currently about 90 Americans students studying free in Cuba. The students must make a moral commitment to return to the US at the end of their studies and practice in underserved areas. Currently, President Bush is trying to put an end to this great opportunity via his absurd increased travel-ban restrictions, which are part of his and Colin Powell’s "Commission for Assistance to a Free Cuba," all bottled-up in 500 pages of insanity.

Bloodletting: Life, Death, Healthcare is an inspiring documentary that awakens one to the reality of the plummeting healthcare system in the United States. The visual techniques and the music play off one another and are very effective in setting the tone. The comparisons of Cuba’s humanitarian healthcare system to the United States’ profit-driven system drive home the fact that better healthcare in the US is possible and should be mandated.

Green’s weaving in and out of her family’s healthcare problems and the experts’ facts and testimonies molds reality with truth. Bloodletting documents a healthcare crisis that daily devours more and more working people in the United States, the "richest" country in the world. The viewer ponders: If a third-world country, under a 42 year US embargo, can make healthcare a priority and serve all of their people, why can’t the US provide quality care for ALL of its people?

The film begins in California with rap music playing, people scurrying, and the mighty Dow Jones drumming its economic beat. Irony and reality set the scene at a healthcare rally in Oakland, CA., as an uninsured home-healthcare worker makes her pitch, while the police arrest nonviolent demonstrators.

Using frequent-flyer miles and a borrowed camera, Green starts her journey to Cuba to search for answers about the complexities of healthcare administration and treatment. Is Cuba’s system as complex as the US? What drives the Cuban healthcare system, and does it succeed in serving the people?


Green, an African-American describes a county where 60% of the 12 million multi-ethnic population are of African decent. Dr. Elsira Fernandez, pediatrician, states, "Education and healthcare are the greatest achievements of the Revolution."-- won January 1, 1959. Cuba has an infant mortality rate lower than the United States and a life span into the late 70s, same as the United States. (Cuba’s rates represent the whole country, while in the US the rates vary between wealthy areas and poor minority areas.) Cuba’s literacy rate is 95%. (If not counting the severely mentally impaired, the rate is 100%). There are no homeless. Green goes beyond the statistics and makes a reality check showing people full of life and vitality. It is said that the Cubans move with a love song.

Green spends four weeks following the US Healthcare and Trade Union Delegation, a group of American and Canadian healthcare workers who travel to hospitals and clinics with medicines for which the US embargo prohibits sale to Cuba. When Cuba was hit with Dengue Fever in the early 1980s, 300,000 fell sick within days. Though Panama had the medicine, the US made it and forbade Panama to sell the life-saving treatment to Cuba. After searching, Cuba was able to purchase the medicine from Japan; but, the shipping cost was higher and the delivery time longer. The result: Cubans, including children, died. The viewer begins to question why the US is so blatantly hostile to Cuba and its healthcare system? Could it be that those who control the US economics do not want the Americans to see the accomplishments of a benevolent and successful healthcare system?

The complicated made simple: Sonia Ruiz-Valdez, a social worker, says that when it comes to healthcare, money is not an issue. She speaks about a boy who needed blood. They announced it on the radio. The next day people with the boy’s blood type were lined up to give their blood. A child’s life was saved.

Doctors free to practice: Steve Thornton, American Union Organizer, is awed by the dedication of the healthcare teams. He states it is "driven by determination to serve people," to make sure the country is strong and healthy. Thornton describes his visit to a neighborhood healthcare center: It has 582 patients, covered six blocks, has a map and chart of all patients, and the doctor knows their patients and their needs. The US dollar entered the Cuban market after the fall of the Soviet Union. Cuba turned to tourism as a means of funding the free healthcare and free educational systems. As a result, doctors often earn less than a tour guide. Thornton seems to allow his capitalist perspective label this as a big problem. However, Sonia Ruiz-Valdez, a nurse and social worker, states, "No matter what we are lacking, we keep making doctors and nurses."

The elderly respected, Gomez Gendra Senior Center, a typical facility: Thornton found the number of staff amazing. Ruiz-Valdez explains that a multi-disciplinary staff, called ELEMAG, composed of a geriatrician, licensed psychologist, nurse and social worker work with the family doctor. Ruiz-Valdez says old people should be with people who love them, "who are sweet to them,"...the "elderly feel good with us. They’re reborn. It’s like a flower that blooms when we water it." This is a shock to the American viewer, who is all too familiar with the horror stories of nursing homes and elderly care in the US, especially for the poor.

The most vulnerable, mentally ill, treated with dignity: Green takes us to the Havana Psychiatric Hospital. Thornton comments that before the Revolution, it was more like a house of horrors. A Cuban explains that before the Revolution, Africans and elderly were often placed in the psychiatric hospital, even though they were normal. Before the Revolution, the US was a major player in the Cuban economic system. Since the Revolution, the psychiatric care has been innovated. Dance and music therapy techniques are used.

Ruiz-Valdez sums up the Cuban healthcare philosophy: "Health is most important thing. Without health you have nothing. If you don’t have health, you can’t work. If you don’t have health, you can’t study. If you don’t have health, there is no development (for the People) in a country. Health is a fundamental factor for a human being." It is this philosophy that led to the control of diarrhea, infectious diseases, and malnutrition that killed children before the Revolution, when the infant mortality rate was over 60% and Africans often died in their 40s.


Flickering shots of the living dead dancing in the streets jolts the viewer back to reality of life for a growing population of Americans. Green very effectively reflects the depression and repression of the people in the streets. The people appear to be locked into a death song.

Green weaves between the healthcare experiences of her family (mother and brother) and commentary by healthcare experts. Greens mother, Evelyn Sheppard, age 62, has been a pre-school teacher for 32 years. She has asthma and high-blood pressure. Before the HMO took over, she had good healthcare benefits. However, the HMO cost over $400 a month, half of her pay. She had to drop it, which meant paying for medicine and office visits out of her pocket. As many older people do, she tried cutting back on her medication, which led to more problems. Her height of desperation was resorting to cutting an abscess off of her finger, what she calls her "kitchen surgery." Joseph, Greens brother, developed dental problems requiring a root canal. Joseph worked himself up from an assembly person to a forklift driver/material manager at a furniture plant. His pay was $10 an hour, not enough to meet minimal living requirements in California. The root canal was over $2000. When the dentist drills, one can fill the painful drilling away of healthcare for the average person in the US. Joseph went to the management to represent himself and other employees for better healthcare coverage. He was laid-off, which was the company’s way of firing him for daring to ask for what the employees deserved and needed to survive. He has more dental problems. As a last resort, he goes to the county hospital. He waits hours before being led into an office, where his tooth is yanked out. The shots of Joseph spitting blood draw the viewer into a depressing reality. Joseph is a strong person, but Green captures his moments of desperation and feeling of being isolated from humanity. Lorna states, "Falling on hard times because you ask for more healthcare benefits is crazy, but watching your brother’s life get ruined because of it and watching him go from my couch to my mother’s to nothing is worse."

Green lines up an interesting and convincing group of healthcare experts--doctors, nurses, single-payer advocates. Their key point is, profit is more important than people in the US healthcare system.

  • Nora Roman, RN, San Francisco General Hospital: For-profits limit your care to maximize profits. Even if tests, medicines, surgery are approved by the doctor, they often are denied treatment by the bean counters.

  • Melinda Paras, Alameda County Medical center: "It’s a systematic way in which people are killed, in which people are deprived of their ability to work and live well.... Healthcare is so much about morality. It’s one thing to talk about privatizing and the production of widgets, but were talking about something that involves life and death for people." (Paras also points out that seven million people in California do not have health insurance. Seven million is almost three-quarters of the Cuban population, where ALL are insured.)

  • Rachel Kagan, Alameda county Medical Center, Oakland, CA: Portion of people who have no jobs and healthcare insurance is becoming a national phenomena.

  • Dr. Lorca Rossman: Physicians are leaving medicine. Freedom to practice medicine as they see fit is being curtailed. Due to getting the run around, people come in late. People with coughs are diagnosed with TB weeks after they should have been treated. "Any society as rich as ours has an obligation to provide the basics--food, shelter and decent healthcare for its people."

  • Jerome McCochran, RN, Kaiser Permanente: $300 million profit at Kaiser Permanente, and they are still crying about losing money. Managed care does not want to take care of working-class people, people of color, unemployed. They would rather NOT SEE them. Managed care became short-cut care. The practitioner does not ask a lot of questions because if you ask a lot of questions you’re going to have to treat. Becomes a way of saying, no, you’re not going to get the cardiologist or endocrinologist because you came in with a headache. They are saying that all of these other contributory factors as far as we’re concerned we didn’t hear them and we’re not going to treat them.

  • Frances Payne, Single-Payer initiative activist: Strategy of for-profits is to get money from healthy people and treat as few as sick as have to treat. 96% of people who lose their jobs lose their healthcare too. This radically changes the quality of their lives.

  • US Census Bureau: 70% of uninsured work every day.


The contrasts between the Cuban and the US healthcare system are clearly defined. Cuba has a love affair with humanity, while the US has a love affair with profits. Cuba serves the most vulnerable, the US pushes the most vulnerable (children, elderly, mentally ill) off the cliff, out of sight. Cuba has a single-payer (the government) system with a clear vision, while the United States complicates issues with a multi-payer system and has a narrow vision of being obligated to serve only the privileged. Cuba makes the connection that a healthy workforce is important to build the country, while the US replaces unhealthy workers who complain with workers (healthy or unhealthy) who will honor the code of silence and transform their human qualities to machine functions. Cuba has an innovative and creative system that incorporates music and dance with its advanced medical technology, while the US repressively turns to increasingly expensive drugs, which can create more complications requiring more drugs, which, in turn, creates more profit.

I highly recommend this informative and insightful film. Bloodletting: Life, Death, Healthcare takes on the challenge of visually awakening the American public to the plight of the United States’ healthcare system and motivates the viewers to act before they become further entrenched in a system that does not work. The US is the only country in the industrialized western world that does not have a universal health care system. As Green clearly illustrates, if Cuba, a third-world country, afflicted with the US embargo and travel ban, can succeed in treating all of its people in a humane and effective manner, the US healthcare system could and should do the same. Green’s intensity, both personally and professionally, pushes the viewer out of the armchair and into the arena of action.

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