Health Care in Cuba: Myth Versus Reality

    Cuba's Economic Choice: The Regime's Health Over the People's

    Cuba's economy is in disarray as a direct result of its government's continued adherence to a discredited communist economic model. This decline has directly affected the health of ordinary Cubans. Lack of chlorinated water, poor nutrition, deteriorating housing, and generally unsanitary conditions have increased the number of cases of infectious diseases, especially in concentrated urban areas like Havana.

    The grave economic problems in Cuba were exacerbated by the demise of the Soviet Union and the ending of the $5 billion in subsidies that the U.S.S.R. gave annually to the Castro government. Cuba made significant advances in the quality of health care available to average citizens as a result of these subsidies. However, it devoted the bulk of its financial windfall to maintaining an out-sized military machine and a massive internal security apparatus.

    The end of Soviet subsidies forced Cuba to face the real costs of its health care system. Unwilling to adopt the economic changes necessary to reform its dysfunctional economy, the Castro government quickly faced a large budget deficit. In response, the Cuban Government made a deliberate decision to continue to spend money to maintain its military and internal security apparatus at the expense of other priorities--including health care.

    According to the Pan American Health Organization, the Cuban Government currently devotes a smaller percentage of its budget for health care than such regional countries as Jamaica, Costa Rica, and the Dominican Republic.

    Health Care in Cuba: "Medical Apartheid" and Health Tourism

    Of course, not everyone in Cuba receives substandard health care. In fact, senior Cuban Communist Party officials and those who can pay in hard currency can get first-rate medical services any time they want.

    This situation exists because the Cuban Government has chosen to develop a two-tiered medical system--the deliberate establishment of a kind of "medical apartheid"--that funnels money into services for a privileged few, while depriving the health care system used by the vast majority of Cubans of adequate funding.

    Following the loss of Soviet subsidies, Cuba developed special hospitals and set aside floors in others for exclusive use by foreigners who pay in hard currency. These facilities are well-equipped to provide their patients with quality modern care. Press reports indicate that during 1996 more than 7,000 "health tourists" paid Cuba $25 million for medical services.

    Cuba's "Medical Technology Fair" held April 21-25 presented a graphic display of this two-tier medical system. The fair displayed an array of both foreign and Cuban-manufactured medicines and high-tech medical equipment and services items not available to most Cubans. The fair showcased Cuban elite hospitals promoted by "health tourism" enterprises such as SERVIMED and MEDICUBA.

    On the other hand, members of the Cuban Communist Party elite, and the military high-command are allowed to use these hospitals free of charge. Certain diplomatic missions in Havana have been contacted and told that their local employees can be granted access privileges to these elite medical facilities--if they pay in dollars.

    The founder of Havana's International Center for Neurological Restoration, Dr. Hilda Molina, in 1994 quit her position after refusing to increase the number of neural transplant operations without the required testing and follow-up. She expressed outrage that only foreigners are treated. Dr. Molina resigned from her seat in the national legislature, and returned the medals Fidel Castro had bestowed on her for her work.

    In 1994, Cuba exported $110 million worth of medical supplies. In 1995, this figure rose to $125 million. These earnings have not been used to support the health care system for the Cuban public. In fact, tens of millions of dollars have been diverted to support and subsidize Cuba's biomedical research programs--money that could have been used for primary care facilities.

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