NCPA - National Center for Policy Analysis


July 13, 2010

When the health care bill became law in March, Fidel Castro emerged from semiretirement to praise it as a "miracle."  So it's a good time to check in on the state of the Cuban health care system.  That's just what Laurie Garrett, a senior fellow at the Council on Foreign Relations, does in the current issue of Foreign Affairs magazine. 

The system is in an advanced state of collapse.  It is bankrupting the state and driving doctors out of the medical field and the country.  Its ostensibly egalitarian nature disguises a radically inegalitarian reality, with a tiny number of well-appointed clinics catering to paying medical tourists and senior Party apparatchiks while most Cubans take their chances in filthy, under-resourced hospitals. 

Consider the facts as laid out by Garrett: 

  • There are 73,000 physicians licensed to practice in Cuba.
  • This allows Cuba to boast of having the best doctor-patient ratio in the world, with one doctor for every 170 people, as opposed to one for every 390 in the United States. 

Yet reality belies the statistics: 

  • Slightly more than half of all Cuban physicians work overseas; taxed by the Cuban state at a 66 percent rate, many of them wind up defecting.
  • Doctors who remain in the country earn about $25 a month.  

As a result, Garrett writes, they often take "jobs as taxi drivers or in hotels," where they can make better money.  As for the quality of the doctors, she notes that very few of those who manage to reach the United States can gain accreditation here, partly because of the language barrier, partly because of the "stark differences" in medical training.  Typically, they wind up working as nurses. 

As for the quality of medical treatment in Cuba, Garrett reports that hospital patients must arrive with their own syringes, towels and bed sheets.  Women avoid gynecological exams "because they fear infection from unhygienic equipment and practices."  Rates of cervical cancer have doubled in the past 25 years as the use of Pap tests has fallen by 30 percent. 

Sound inviting?  The truth is that socialism and related forms of command-and-control technocracy work as well in the health care market as they do in every other, says Stephens.  Which is to say, not at all. 

Source: Bret Stephens, "Dr. Berwick and That Fabulous Cuban Health Care; The death march of progressive medicine," Wall Street Journal, July 13, 2010. 

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