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Changes among Cuban Americans*** For four decades there has been a lot of bluster in Miami about bringing down Castro spoken from radio studios and living rooms. Radio commentator Francisco Aruca refers to this as the ''evil industry,'' an appellation that carries more sting than it probably deserves.

Still, Gutiérrez-Menoyo has demonstrated that he has no use for that industry or for U.S. government help. ''I'm independent,'' he said. ''I'm not manipulated by the (U.S.) Interests Section.'' We'll soon see if he's manipulated by Castro.

His decision to stay in Cuba couldn't come at a more difficult time for the Bush administration. Its Cuba policy is in disarray -- or, more accurately, it isn't configured to deal with current realities. Even Gov. Jeb Bush has said so publicly. ''It's just not right,'' the governor told The Herald, referring to sending Cuban refugees back to negotiated prison sentences.

The White House was worried enough to dispatch presidential advisor Otto Reich to Miami to get disgruntled Cuban exiles back on the GOP reservation.

It will take more than calming words from Reich, who managed to put his foot in his mouth. He trotted out a cockamamie theory about the Castro regime's sending out balseros to force the Coast Guard to return them, to roil Cuban Americans.***

Cuba accused of ignoring health of jailed dissidents*** MIAMI -- When Miriam Leiva visited her jailed husband Thursday, the Cuban dissident journalist tried to talk but his tongue was sluggish. Oscar Espinosa Chepe, already debilitated and gravely ill from a liver condition, had been given new pills by a government psychiatrist this week.

"Oscar doesn't even know what they gave him. We don't even know what kind of treatment they are giving him," Leiva said by phone from Havana. "They are all-powerful, and we are helpless."

As the health of more than a dozen jailed Cuban dissidents like Espinosa deteriorates, U.S. officials and human rights groups say the Cuban government is purposefully denying them proper medical care. Their illnesses range from poor circulation to kidney trouble and gastritis, and "the Cuban authorities don't appear prepared" to provide them with adequate medication, said Eric Olson, Amnesty International's Americas advocacy director. This week, the United States said 75 dissidents arrested this spring are being held in "appalling conditions, with very poor sanitation, contaminated water and nearly inedible food."

"The Cuban government appears to be going out of its way to treat these prisoners inhumanely," State Department spokesman Philip Reeker said.

The United States called on the Cuban government to let independent groups like the International Committee of the Red Cross or Doctors Without Borders evaluate the patients.

Doctors Without Borders hasn't had a Cuba program for three years because the group was not allowed to act independently, spokesman Kevin Phelan said. [End]