Adam Smith Institute

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The myth of Cuban healthcare

On the 9th September, the ASI welcomed Cuban journalist and academic, Boris Gonzalez Arenas, speaking to us over Skype about his homeland - so often portrayed as content by socialists - where the Castro regime has for decades shut down dissent and held back development. Boris couldn’t be present in person, as the Cuban regime had blocked him from travelling to Britain.

I visited Cuba last summer, and it really is one of the most naturally beautiful countries in the world - with such a rich history. In Havana, it’s clear that something is bubbling amongst the younger generation, who are ready to challenge the status quo. But there’s something sad about visiting Cuba - it’s a country held back by a regime hellbent on appropriating the products of hard-working farmers, squashing opposition, and communism as a means to control - even though it quite blatantly, as always, is not working. Cubans are the seventh largest immigrant group in the US - remarkable for such a small country. As of 2013, more than 1.1 million Cuban immigrants resided in the United States. The current population of Cuba is 11.5million (2016.) Make of that what you will.

When Fidel Castro died, back in 2016, much was made about the notion that - despite the fact that he’d interned LGBT+ people in concentration camps, suppressed any kind of democratic opposition to his bloodthirsty ideology, and driven the Cuban economy into the ground - it’s healthcare system wasn’t too bad! 

This myth of a brilliant Cuban healthcare system is just that - a myth. Regardless, the extreme Left have an unerring need to believe in it, as proof that somehow, somewhere, their ideology can work. Yet even in Cuban healthcare, which they hold up as proof - they’re wrong. 

According to Hadley Heath Manning, this perception is entirely based on the international volunteerism of Cuban doctors - sent abroad by the regime to improve the ‘brand’ of Cuban healthcare. Of course, on some metrics, Cuban healthcare does seem to shape up well (it wouldn’t be so widely praised if it didn’t,) but most of these - notably low infant mortality rates - are unfair metrics to measure quality on when you consider that Cuban women with ‘risky’ pregnancies are strongly encouraged to have abortions by the State. 

According to Boris - it’s really important for the Cuban government to hide the real situation in Cuban public health. He claims that there’s been a massive decrease in the number of hospitals in Cuba in the last 20 years - and that hospital staff often steal from hospitals to sell medication on to the black market. 

Indeed, Cuba’s system is really a two (or even three) tier system. Dr. Jaime Suchlicki of the University of Miami’s Institute for Cuban and Cuban-American Studies explains this. The first is for foreigners who come to Cuba as medical tourists - they pay in hard currency and treated to quality medical treatment, as they would expect in Europe or North America. These facilities, which cater only to medical tourists, do expensive treatments in cosmetic surgery.

There’s also quality service for the elite in Cuba - and then there’s the ‘real’ system. Dr. Suchlicki documents a few of the vast array of testimonies on this and notes unsanitary conditions, crumbling facilities, and hospitals where patients are expected to bring their own bedsheets, soap, towels, food, toilet paper and even light bulbs. Katherine Hirschfeld of the University of Oklahoma, notes from her 9-month research trip to Cuba that ‘a number of people complained... informally that their doctors were unhelpful, that the best clinics and hospitals only served political elites and that scarce medical supplies were often stolen from hospitals and sold on the black market.’

Cuban healthcare may outrank other services provided in Cuba, but it isn’t the global beacon for healthcare it is often lauded as. A health system which discourages pregnant women from making their own choices (and a regime that tries to make the choice for them) on their own bodies, requires patients to bring their own light bulbs, and absolutely zero choice (all hospitals are run and owned by the regime) should not be celebrated

A memorable, and correct, George Orwell quote is from the Leninist rationalisation for communism that “you have to break some eggs to make an omelette.” Orwell reportedly replied: “where is the omelette?” Cuban healthcare, despite the headlines, is not an omelette.