Leftists revere Communist Cuba for numerous reasons, not the least of which is the government-run, universal health care system that was put in place by Fidel Castro. Many of these admirers -- among the more notable of whom is the filmmaker Michael Moore -- form their impressions of the Cuban health care system from its tourist hospitals, which are, by any standards, clean, well staffed, and of excellent quality. Indeed Cuba, in an effort to attract wealthy foreign tourists who might be willing to spend their money on health care services, has pioneered the practice of so-called "health tourism" through agencies such as Servimed, which markets Cuban medical services abroad. Calling Cuba “the ideal destination for your health,” Servimed frankly admits to being "a tourist subsystem."
But after providing for the needs of affluent tourists (and of the country's top government officials), the Cuban health care system has little left for the general public. Hospitals for ordinary Cubans possess a dearth of even the most basic medicines and medical equipment. They have virtually no access to antibiotics, insulin, heart drugs, sphygmomanometers to measure blood pressure, sterile gloves, clean water, syringes, soap, or disinfectants.
Cuban hospitals typically feature unsanitary conditions. Hospital gowns, linens, and towels must be provided and cleaned by the patients' families. Poor sanitation is extended to the medical instruments handled by doctors and nurses; often these items are not properly sterilized and they remain soiled with traces of tissue and blood after their use. Syringes are frequently used to inject multiple patients without any sterilization, and "disposable" gloves are likewise used and reused. Consequently, infectious diseases such an impetigo and hepatitis, and infestations such as scabies, lice and fungal diseases, are commonplace in the Cuban hospital population.
Cuba's health care system is a disaster not only for patients but also for physicians. Because of the meager salaries paid to Cuban doctors -- on the average 400 pesos per month (equivalent to $20 U.S.) -- many have quit the profession to seek jobs in the only industry that offers them any degree of economic opportunity: the Cuban tourism industry. Former doctors in Cuba can commonly be found driving dilapidated taxis, acting as tour guides, or even working in family inns as waiters or cooks. Those who choose to remain in the medical profession work long hours in dismal conditions.
It is noteworthy that in the pre-Castro years of the 1950s, the Cuban population as a whole had access to good medical care through association clinics (clinicas mutualistas) which predated the American concept of health maintenance organizations (HMOs) by decades, as well as through private clinics. At that time, the Cuban medical system ranked among the best in the world; its ratio of one physician per 960 patients was rated 10th by the World Health Organization. In addition, Cuba had Latin America's lowest infant-mortality rate, comparable to Canada's and better than those of France, Japan, and Italy.
Adapted from: "Socialized Medicine in Cuba: A Poor State of Health," by Miguel Faria (August 20, 2002); and "Bad Cuban Medicine," by Larry Solomon (April 15, 2003).