<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>WildUtah</author><text>Physicians per capita figures are misleading.&lt;p&gt;The US figure reflects very long careers; late retirements; investment in large teams of trauma specialists due to high war, car crash, and gunshot wound rates; a high percentage of women physicians working part time; and a high concentration of expensive specialists with no documentation that they improve outcomes and paid for by large federal government subsidies.&lt;p&gt;The actual amount of primary physician and general surgery time available to Americans is very low compared to other countries with similar numbers of doctors. Most countries also allow as many as half the cases administered by fully licensed doctors with 12-20 years of post-secondary schooling in the USA to be handled by nurses and pharmacists.  Prescriptions for sniffles or heartburn, basic non-controlled medications, simple physical assessments, and vaccinations are handled by professionals the USA would consider nurses or pharmacists or unlicensed assistants in most first world countries. In the USA those jobs take the time of physicians.&lt;p&gt;And that is the top reason, among many other unrelated ones, that health care is so much more expensive in the USA. US doctors are fewer and have more responsibilities and thus must be paid extraordinarily to work very long hours and not retire at the usual ages or else some must go without care. It&amp;#x27;s not an accident; medical societies have blocked medical school expansion for decades until recently as the population grew.&lt;p&gt;Cuba, on the other hand, appears to be counting nurse practitioners as physicians. That&amp;#x27;s fine to do because they&amp;#x27;re highly qualified, but it makes the numbers not comparable across countries.</text><parent_chain><item><author>xyahoo</author><text>On the other hand:&lt;p&gt;- average life expectancy in Cuba is almost the same as the USA (and higher than Mexico, Belize, Bahamas, Brazil, etc.).&lt;p&gt;- literacy rate in Cuba is higher than that in the USA&lt;p&gt;- Physicians per 10,000 people: Cuba has 67, USA has 24&lt;p&gt;In the Ebola crisis, Cuba has been leading from the front.</text></item><item><author>iandanforth</author><text>I&amp;#x27;ve visited Cuba on a Canadian passport. Aside from the beautiful beaches the thing that struck me most was the desperate poverty of people living in shacks outside the 5 star resorts.&lt;p&gt;While I hesitate to predict that this change will be all for the good, I do believe that the poorest in Cuba will benefit significantly from increased trade.</text></item></parent_chain></comment><story><title>Cuba and the U.S. will begin to normalize relations</title><url>http://www.bloomberg.com/news/2014-12-17/obama-to-announce-u-s-cuba-relations-shift-as-gross-is-released.html</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>scardine</author><text>I highly recommend reading &amp;quot;Guide to the Perfect Latin American Idiot&amp;quot; which explain how dictatorships can pick a handful of indicators and elevate them to first-world levels while still making everybody&amp;#x27;s life miserable.&lt;p&gt;[1] &lt;a href=&quot;http://www.amazon.com/Guide-Perfect-Latin-American-Idiot/product-reviews/156833236X&quot; rel=&quot;nofollow&quot;&gt;http:&amp;#x2F;&amp;#x2F;www.amazon.com&amp;#x2F;Guide-Perfect-Latin-American-Idiot&amp;#x2F;pro...&lt;/a&gt;</text><parent_chain><item><author>xyahoo</author><text>On the other hand:&lt;p&gt;- average life expectancy in Cuba is almost the same as the USA (and higher than Mexico, Belize, Bahamas, Brazil, etc.).&lt;p&gt;- literacy rate in Cuba is higher than that in the USA&lt;p&gt;- Physicians per 10,000 people: Cuba has 67, USA has 24&lt;p&gt;In the Ebola crisis, Cuba has been leading from the front.</text></item><item><author>iandanforth</author><text>I&amp;#x27;ve visited Cuba on a Canadian passport. Aside from the beautiful beaches the thing that struck me most was the desperate poverty of people living in shacks outside the 5 star resorts.&lt;p&gt;While I hesitate to predict that this change will be all for the good, I do believe that the poorest in Cuba will benefit significantly from increased trade.</text></item></parent_chain></comment><story><title>Cuba and the U.S. will begin to normalize relations</title><url>http://www.bloomberg.com/news/2014-12-17/obama-to-announce-u-s-cuba-relations-shift-as-gross-is-released.html</url></story>