Cuba: Healthcare Utopia?

In reading the comparative health care articles and wondering how the U.S. can improve their system, I thought of a recent trip to Cuba.  In much of our recent reading regarding health systems, there is mention of Cuba’s take on achieving more with less.[1]  I was in Cuba for about 15 days and I noticed emerging inequality, especially in rural areas.  The handful of people I spoke with in Cuba about the healthcare system were not happy with the system, and only spoke out when they were assured no one was around to hear them.  There were complaints of having to take their own bedding to the hospital and how people living in cities and tourists receive better health care.  However, much of the same can be said of many hospitals in the U.S.  In researching facts compared with my observations with Cuba’s healthcare system, I was impressed with Cuba’s take on having to do more with less and applying simple innovations to provide universal healthcare.  In doing research on trying to find all the negatives with Cuba’s health system, it just reinforced all the positives.

Some ways in which Cuba has been successful is that they focus on primary care and maintain local production of diagnostics and drugs.[2]  Cuba is divided into health zones and each is assigned teams of 10 – 12 general practitioners (each with a nurse), sociologists and psychologists.[3] The teams focus on prevention and health education, but include curative care and rehabilitation.3   Something I thought quite interesting is the amount of healthcare information available for the public and the emphasis of having a “health-literate” society.[4]  Health information is often stressed in three of the main national newspapers, the radio, television and regional media and they respond to state policies, not the market.4   I think Cuba’s focus on prevention and health education is one the main things that sets Cuba apart.  Even maternity homes for high-risk pregnancies in Cuba have a strong educational component to them with a strong emphasis on nutrition.[5]

Many things about Cuba’s approach to healthcare standout in contrast to the U.S. and there is, of course, much debate regarding the socialist model, especially in regards to how we can achieve universal coverage.  However, in dealing with our economic problems, I’ve seen how it affects healthcare in the way people ration medications and skip screenings and doctor visits due to loss of jobs and sudden loss of insurance.  Cuba has dealt with a poor economy over 20 years, and instead of cutting back on healthcare, they have insisted it remain a priority.2

[1] Birn, et al.  Textbook of International Health, 3rd edition. 2009.  New York, NY.  Oxord University Press.  pgs.583-655.

[2] De Vos, P. and Van der Stuyft, P. The right to health in times of economic crisis: Cuba’s way.  Lancet.  2009;374:1575-76.

[3] De Vos P. Health report on Cuba. “No one left abandoned”: Cuba’s national health system since the 1959 revolution. Int J Health Serv 2005; 35: 189–207.

[4] Briggs, Charles. “All Cubans are doctors!” news coverage of health and bioexceptionalism in Cuba. Social Science & Medicine. 2011;73:1037-1044

[5] Gorry, Conner. Cuban Maternity Homes: A Model to Address At-Risk Pregnancy. MEDICC Review.  2011;13(3):12-15.


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