DRESDEN, GERMANY. — BEFORE LAST FALL'S overthrow of the Communist regime, an American traveling in the German Democratic Republic might have feared, more than anything else, a late-night encounter with the Stasi, the notorious secret police. But reunification has shut down the Stasi and revealed what any traveler in East Germany should have feared more than anything else all along: a serious encounter with a Communist medical system.
Last month on a trip through Central Europe, my mother fell in a freak accident in Dresden and badly banged her hip and leg. The hotel staff summoned an ambulance by phone. After an hour and a half a panel truck, comparable to a 1950 Ford or Chevy, arrived. It contained no medical equipment of any kind. The emergency room to which she was taken was just as poorly equipped.
Late at night hospital emergency rooms in Baltimore can assault you with an ugly, even brutal, impersonality. But at least our system has equipped them with up-to-date medical devices and technology. In stark contrast, the hospital in Dresden appeared to possess almost no medical equipment at all. The x-ray machine looked 40 years old. World War I hospitals must have been better equipped.
My mother spent the night in the hospital, and the next day she was able to continue our family trip by rail to Leipzig and then on to Berlin. We are grateful to the hospital staff for their care and kindness. But we are even more grateful that we did not have to depend upon a Communist medical system to handle a heart attack, a stroke or a truly serious injury.
Communist regimes everywhere have always touted free, universal medical care as one of the triumphs of scientific socialism. In fact, as we discovered that night in Dresden, the medical system was hopelessly out of date. It lacked equipment which would be considered standard and essential in any Western hospital. The training for doctors and nurses did not approach the minimal requirements in the West. Pay was so inadequate that the few well trained professionals began to abandon the system in droves by the early 1980s.
Valiant men and women remained behind to provide service in their communities, but the facilities in which they worked would have been closed by government health authorities in any Western nation. At that, we were lucky we weren't caught in a medical emergency in the Soviet Union. The Economist recently reported that 65 percent of Soviet hospitals lack even hot water.
Doctors and nurses confirmed that for years the regime in East Germany simply made no investment in medical facilities, equipment or technology. As a consequence, the health-care system fell into a primitive, third-world state of neglect and decay. Health care belongs near the top of the long and growing list of communism's frauds.
From the beginning, the East German regime cannibalized its own economy and country in order to maximize investment in ''show'' projects and production intended to give the false impression that the communist economic system could keep pace with the booming free-enterprise economy across the closed border in West Germany.
The East German authorities simply ignored the needs of low-visibility infrastructure like the medical system. Highways that Hitler built in the 1930s were never repaired. Everywhere in East Germany, the housing is grim, in poor condition and totally inadequate for the population. The waiting list for an apartment is ten years long. Forty percent of the housing was built before the war and looks it.
The communist regime poured billions into a doomed attempt by its pet, state-run computer company Robotron to develop and manufacture an electronic memory chip comparable to the mass-produced chips of Western companies. Meanwhile, politically disfavored firms received no investment, even in industries in which German prowess had once led the world. As the manager of one Dresden complex told a correspondent, ''Come see my machine shop. It dates back to [King] Augustus the Strong.''
Socialist economics and totalitarian controls produced more than inefficiency. To match a health system that could not cure or heal, communism created the most unhealthy environment on earth. Everywhere in the former communist nations of Eastern Europe, the pollution hits you. The Czech Skodas and the East German Trabants look like stumpy circus jokes rather than real automobiles. But there is nothing funny about the exhaust fumes they spew behind them. The once-beautiful old-world cities of these countries reek with their smell.
Communist regimes never invested in pollution-control equipment in factories or power plants. The train from Prague to Dresden takes you down the beautiful Elbe River valley. The river, however, is no longer the majestic waterway about which Goethe and Schiller rhapsodized. Instead, the pollution from factories and mines has turned the river into a dark, disgusting flow of scum into which Dresden's chemical plants pour their own wastes.
Americans celebrate the triumph of our free-enterprise economy and democratic institutions over communist totalitarianism. But we cannot fairly gloat over our defeated rival's failures to invest in essential infrastructure. The potholes in our highways, our high infant mortality rate and years of underinvestment in our education system provide ample evidence that short-sightedness does not afflict communists alone.