Guantanamo Care Trumps ObamaCare

By Dr. Ileana Johnson Paugh

Four hundred air miles from Miami, Florida is the oldest overseas U.S. Naval base in a country with which U.S. does not maintain diplomatic relations, Cuba. In 1903, U.S. leased 45 square miles of land and water at Guantanamo Bay for use as a coaling station and later as a refueling station.

The treaty was ratified and signed by both governments in Havana in December 1903 for $2,000 gold coins per year. In 1934, the lease was renewed by granting Cuba and its trading partners free access through the bay and the payment of $4,085 in actual dollars, not gold. To end the lease, both U.S. and Cuba must agree or the U.S. must abandon the base property.

Relations remained stable until the Cuban revolution in the late 1950s. Since January 1, 1959, the territory outside the base remains off-limits to civilians and U.S. service members. Official diplomatic relations with Cuba were cut off by President Eisenhower in January, 1961. Some Cubans sought refuge on the base. Relations have been strained with the Castro government.

Of the original 380 who were allowed to stay and work on the base, there are 30 remaining. Of the 3,500 commuters in 1959 who were allowed to leave communist Cuba each morning and return in the evening through the North East Gate, only two remain today. They take retirement checks each month to the Cubans who retired from the Naval Station.

Thousands of Haitian refugees were processed through the Guantanamo base over the years during the violent coup of 1991 and the earthquake in 2010.  Asylum seekers who make it across the border by land or intercepted at sea by Coast Guard vessels live temporarily in migrant facilities on base until are processed to third-party countries in Latin America.

The Naval Station has a self-sufficient base, which houses 5,337 people, mostly civilians and 2,103 military. A desalination plant produces 1.2 million gallons of water per day and the power plant 350,000 kilowatt-hours of electricity per day.

The Naval Station is separated by Guantanamo Bay and it can be accessed by AMC Rotator flights that land on the Leeward side of the base. The bay can be crossed by utility boat and ferry to the Windward side of the base where the prison is located.

In the wake of 9/11, the base started to incarcerate individuals captured by the U.S. military during execution of the War on Terror. The first prisoners arrived at Guantanamo Bay on January 11, 2002.

Enemy combatants

The “enemy combatants,” a term coined by the Bush administration, have the legal status of unlawful combatants without protections under the Geneva Conventions. After legal fighting, the DOJ dropped in March 2009 the term “enemy combatant” from its legal lexicon and “established a new criterion for detention that did not rely on the Authorization for the Use of Military Force passed by Congress in September 2001.”

President Obama called for the closure of Guantanamo Bay detention facility and signed an Executive Order that called for closure by January 22, 2010. Many detainees were released to countries like Spain, France, Austria, Tunisia, Portugal, Ireland, Hungary, Germany, Italy, Albania, Latvia, Switzerland, Belgium, Afghanistan, Yemen, and Slovakia.

Controversy over the proper venue to try such individuals captured on the battlefield dragged on. The DOJ wanted the detainees tried in federal court in New York. Congress halted plans to close Guantanamo Bay by giving final approval to a defense-spending bill, which blocked detainees from being transferred to the U.S.  President Obama signed the Ike Skelton National Defense Authorization Act of 2011, which banned the use of funds to transfer Guantanamo detainees into the U.S.

Attorney General, Eric Holder announced that defendants would be tried before a military commission, thus ending in April 2011 Obama’s plan to try the accused 9/11 conspirators in federal courts.

On its tenth anniversary, Guantanamo Bay still houses 171 detainees down from 550 in 2005 and 779 in 2002. The detainees started a hunger strike on January 11, 2012, inspired by U.S. liberal activists with bleeding hearts for terrorists and criminals. Deutsche Welled interviewed the UK based legal group Reprieve, representing 15 detainees, about the “lack of hope that now pervades the camp.”

These are no boy scouts, they range from bomb makers, bridge bombers, terrorist trainers, terrorist financiers, recruiters and facilitators, high value detainees who were Osama Bin Laden’s guards, and at least five who are directly tied to the 9/11 attacks. Some detainees could have been released but no country wanted them. Some who had been released, committed new terrorist acts or returned to the battlefield. According to the Joint Task Force Guantanamo, “detainee assaults on the guard force occur on a regular basis.”

Government spends $70 million annually to house the 89 prisoners

According to the ACLU, our government spends $70 million annually to house the 89 prisoners who have been cleared for release. The Bush administration released 532 prisoners while the Obama administration only 68. “Six prisoners died in custody by apparent suicide, one as a result of a heart attack, and one died of cancer.”  Military commissions at Gitmo spent $12 million in 2011. (ACLU)

Detainee programs include a social program (recreation, sports, prayers, family phone calls, mail), intellectual stimulation program (books, magazines, puzzles, newspapers, handheld electronic games, movies, satellite television), an instructional program (literacy, second language classes, art classes, computer classes, personal finance and business), a library with more than 25,000 titles, newspapers and magazines in 15 different languages, video games, DVDs, CDs, and a full-time librarian.

Living conditions exceed what is required by the Geneva Convention: Three meals a day that meet cultural dietary conditions and special diets, shelter, clothing, personal hygiene items, prayer beads, rugs, copies of the Quran in the native language of people from 40 countries, and mail. Detainees are visited by the Red Cross quarterly.

The most interesting aspect of the camp is health care. Medical services are available to detainees around the clock, seven days a week. Prisoners are treated in a dedicated medical facility with state-of-the-art equipment and expert medical staff of more than 100 people. There are 20 inpatient beds, physical therapy, pharmacy, radiology, and a single-bed operating room. Intensive care is offered at the Naval Station hospital and specialists can be flown in. A separate facility offers mental health care. Immunizations are given to detainees because none was available in their home countries. Prosthetic limbs are provided and cancerous tumors removed.

As you contemplate the coming rationing of health care in Obamacare, consider Guantanamo care

As you contemplate the coming rationing of health care in Obamacare, consider Guantanamo care: there is one medical staff for every two detainees and one primary care provider for approximately 45 detainees. The U.S. national average is one primary care provider for every 880 citizens.

As you wait eight hours to see an emergency room doctor, weeks to see a general practitioner, or six months to get an appointment with a specialist, examine Guantanamo Care: 129,000 meds dispensed annually; 4,650 sick call visits; 3,600 provider appointments; TB screenings conducted via the most accurate method available; colon cancer screening; 10 colonoscopies; 370 annual dental procedures; 470 radiology and physical therapy services; numerous consultations in cardiology, gastroenterology, neurology, radiology, urology, dermatology, audiology, orthopedics, ophthalmology, optometry, podiatry, and pulmonology. (Joint Task Force Guantanamo)

Can we afford to keep Guantanamo open? Can we afford to close it? Based on the valuable information obtained from various detainees, details that saved innumerable lives, the nature of the dangerous individuals, and the cost associated with Gitmo’s maintenance, the questions seem difficult to answer.

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