Being on a people to people tour in Cuba meant that every day of our week on the island was filled with cultural interactions. We met with Cubans in the arts, explored historical sites and museums, and also learned about some of Cuba’s community projects and government initiatives. Coming from a Communist regime, of course a lot of what we were seeing and hearing was the good side of Castro’s policies. Although overall communism in Cuba clearly does not work, there are a few things that are working exceptionally well such as Cuba’s Universal Health Care System.
During my week in Cuba, I had the opportunity to meet with a Cuban doctor at one of Havana’s clinics, visit a center for elderly Cubans, and hear lectures on the Cuban health care system, giving me fascinating insight into a few of the progressive policies initiated after the Cuban revolution.
As a nation, Cuba has one of the lowest infant mortality rates in the world (4 per every 1,000 live births per the World Bank) and provides free, universal health care coverage for everything and everyone. In fact, Cuba’s health care system is much more equitable than ours here in the United States: It is free.
Given Cuba’s free education policies instituted after the Cuban Revolution, Cuba has an extremely high percentage of doctors per capita. In fact, Cuba graduates over three times as many doctors per capital as the United States (1). More doctors means better patient per doctor ratio and more personalized care. Furthermore, the Cuban medical system is world renown and people come from all over the world to study it and try to learn how such a small, relatively poor country is providing much better than her neighbors (such as Haiti and the Dominican Republic, both similar in size yet world’s apart in health care).
A fascinating article: “Cuba Leads the World in Lowest Patient Per Doctor Ratio: How They Do It” tries to shed light onto how this tiny Communist island nation is beating the odds in health statistics:
People marvel at how Cuba has “accomplished so much with so little.” And they marvel with good reason. According to the World Health Organization, Cuba spent only $503 per capita on healthcare in 2009, the U.S. spent almost 15 times that sum. In fact we in the US spent $421 per person just on the administration of the private healthcare insurance system, almost enough to fund the Cuban system. Despite dramatically lower costs, Cuba has some of the best health statistics and health indicators of any country around the world.
On our second day in Cuba, we visited the Casa de los Abuelos in Old Havana, a day center for the elderly within the community. The institution provides rehabilitation day services for seniors over 60. Once a doctor prescribes treatment at the Centro de Rehabilitacion Geriatrica, a patient comes daily to receive one on one care with a doctor, nurse and/or rehabilitation specialist. They also are provided meals and social time with other seniors in their community. They can stay anywhere from three months to a year in the program and every single service including food is free. The center is a way for Cuba to manage their graying population and ensure that every health care need is being adequately met.
On our third day in Cuba, we visited a polyclinic in Eastern Havana called “Policlinico Camilo Cienfuegos” which is a complex of different clinics that services the local population. We met with a Cuban doctor who explained Cuba’s elaborate health care system. In Cuba, there are four levels of care (1) Family Doctors who are assigned to a group of families and provides home visits within the community (2) Polyclinics (3) Hospitals and (4) Specialty Institutes such as eye, heart, lung, etc.
So how does the Cuban health care system work? If you have an ailment, you first receive a visit by your family doctor at your home. If the issue is not resolved, you next head to the polyclinic and so forth. This system allows doctors to cover as much area and patients as possible and ensure that everyone is cared for. Family doctors also keep good track of their assigned patients. For example, every 2.5 years a woman must pass a mandatory gynecological exam. If she falls behind, the doctor comes knocking on her door.
Cuba’s pre and post-natal care are also world renown and help explain why Cuba, a relatively poor country, has some of the lowest infant mortality rates in the world. When a woman discovers she is pregnant, she meets with the family doctor around the 6th or 7th week of pregnancy and meets with her team of doctors at least twice a month throughout the pregnancy. All babies are delivered in a hospital as it is a mandatory law. After the delivery of the baby, the woman and her newborn continue their care for the next 40 days with the same team of doctors to ensure they are healthy and thriving. All these services are free.
Despite the grand achievements of the Cuban Health Care System, it does come with some problems. In a Communist society unfortunately doctors are not paid well at all – only the average salary of $25/month – forcing many doctors to leave to neighboring Venezuela or other eagerly accepting nations, and also prompting doctors to take on second jobs as taxi drivers or other allowed entrepreneurial jobs that pay in a day what a doctor can make in a month. The resulting brain drain and extra work load on doctors may lead to future problems with the Cuban Health Care model that are not easy to fix. Only time will tell.