The Journey
A newsletter for chapter advisors, chapter officers, and regional officers.

Cuba’s Universal Health Care System: Bedrock of Revolution
By Susan Hult Edwards, Chapter Advisor, Houston Community College System, Houston, Texas

¡Vive el socialismo! ¡Abajo la mentira! ¡Libertad para los héroes!
On June 12, 2002, millions of Cubans took to the streets to protest United States policy toward their nation and to support the Socialism Amendment to the Cuban constitution. One week later, they confirmed by national vote their commitment to socialism. Cuban lawmakers followed suit on June 27 making socialism an irrevocable part of their constitution. Vice President Carlos Lage, quoted in The Wall Street Journal on June 28 in response to George W. Bush’s call for capitalism and democracy in Cuba, insisted, “For our people to return to the past is undesirable, unthinkable, impossible....The homeland is sacred, the revolution is unconquerable and socialism is irrevocable.”

Their health care system is one dimension of the nation’s socialist system of which Cubans are inordinately proud. Free, and arguably first rate, health care of all kinds is a bedrock of revolutionary Cuba and is available to Cuban citizens from the cradle to the grave.

Professor Delio Carreras Cuervas of the University of Havana lauds Cuba’s good physicians and waits, even without appointments, of “no longer than half an hour” to see them. Particularly before 1989 and the fall of the Soviet Union, Cubans could go anywhere for their health care and count on no lines. Sitting in medical offices or hospitals for hours at a time was unimaginable, and house calls were commonplace. Specialists were readily available for illnesses requiring distinctive treatment. Though their system is different from ours, Cubans had many choices in the maze.

The World Bank’s World Development Indicators for 2001 bear out the excellence of the system. Despite its status as a developing nation, Cubans have a life expectancy of 76 years, only one year shorter than that of Norte Americanos, as Cubans refer to those of us who hail from the United States. Though the percentage of Cuban males who live to age 65 is less than that of American males (69 percent to 80 percent), Cuban women rank up there with American women (86 percent to 89 percent). These figures belie the shortages of food and medicines for Cubans that have resulted from the 1993 withdrawal of nearly $3 million per day of Soviet aid and the American embargo of Cuba since 1961.

Since 1993, Cubans have had fewer choices in terms of medical care and longer waits in doctor’s offices. The biggest problem associated with the collapse of Soviet aid and the U.S. embargo, however, is the lack of medicine and medical supplies in Cuba. Cuba is replete with talented, dedicated doctors who can diagnose illness and prescribe preventative care, but whose patients cannot necessarily fill their prescriptions. Their choices in this sense are most definitely limited. Still, Dr. Cuervas cautions that unfettered access to over-the-counter drugs is the other side of the equation, “Americans medicate themselves, can poison themselves.”

International travelers have more choices. As tourism replaces sugar as the principal force behind the Cuban economy, officials understand the necessity of treating visitors who need medical assistance well. Dr. Cuervos admits, “foreigners can get medicine,” while it is much more difficult for Cuban citizens. Tourist hotels have relatively inexpensive clinics, and, for emergency care, tourists can utilize Cuban hospitals and other health care facilities.

While in Santiago de Cuba, on the east side of the island, studying the health care system as my Mosal Scholar Award project, one of my colleagues re-broke his ankle while descending steps that led from a monument to freedom fighter, Antonio Maceo. One of our hosts summoned a cab to take Tom to a nearby clinic. The clinic’s staff met us outside, checked on Tom, and referred him to the emergency room of the Hospital Provincial Saturnino Lora, a general hospital which hosts a variety of specialists. Tom was admitted, his ankle set in a cast, and he was back at our hotel within an hour and a half.

Over the next two days, his physicians, an orthopedic surgeon and a general practitioner, checked with him by phone and in person at the hotel. When Tom complained his cast was too tight, his doctors re-opened it and set it with gauze to ease the pain. Symptomatic of Cuba’s medical shortages, his doctor opened a ceiling tile, reached up, and removed gauze from where it was hidden for just such occasions. Back in the United States, Tom visited his personal physicians to reinforce his ankle with steel rods and pins and was told the work done by his Cuban doctors was outstanding.

Cuba’s medical students study a curriculum of theoretical studies and practical experiences for six years before interning in any of the nation’s provinces. Once finished, they are well prepared to serve the Cuban people and live lives as respected, if not financially rewarded, members of society.

Fidel Castro himself commended Cuba’s doctors, who make approximately $12.00 US per month, in a speech delivered at the Riverside Church in Harlem on September 8, 2000. Castro told the assembled crowd that a congressman from Mississippi informed him, “Listen, there are a lot of places in my district where there isn’t a single doctor.” Castro offered to send “...a few doctors free of charge...” or grant scholarships to “...poor youth in...[the congressman’s district]...who cannot afford to pay the $200,000 it costs to get a university degree.”

Economics is defined as the allocation of scarce resources. When resources are scarce, choices have to be made. Cuba, at first glance, has chosen first-rate universal medical services as the bedrock of its socialist system. As we examine the dimensions of our own system, where we have an increasing number of citizens without easy access to basic health care, Cuba offers another perspective — an opportunity to study a nation that has, for the past 43 years, made universal health care a priority.

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This page last modified -- Friday, 14-Nov-2003 11:00:24 CST (cwe)