Photo by Bruno Sanchez-Andrade Nuño
Americas / Cuba

Lessons from Cuban Healthcare

It may be strange to think that Cuba takes better care of its citizens than the United States, but in a certain sense this is true. Cuba has a lower infant mortality rate and the same life expectancy rate. Its various cancer survival rates are on par with ours and even surpass American rates for breast cancer survival. What’s more, Cuba does it on budget, spending 23 times less on healthcare for the average citizen. What makes their system so much more efficient is its focus, dissimilar to that of the US in many ways, on preventive care and inclusivity.

Healthcare in Cuba is universal, and because it is run by the government as opposed to private companies, costs are significantly less for the average citizen. Doctors aren’t paid as much and insurance companies don’t turn exorbitant profits. Most significantly though, in terms of saving money and lives, illness is caught and prevented early. Keeping individual costs low encourages Cubans to see a healthcare provider about small concerns or a budding problem, whereas in the US, one might avoid seeing a doctor to save money and go in only with an emergency. The benefits of frequent visits to the doctor are an increased chance of preventing catastrophic illness, saving money for both the system and the individual and potentially saving a life.

Cuba’s emphasis on prevention and inclusivity is not just policy rhetoric–it’s a cultural orientation that is deeply embedded in its institutional practices. While in medical school, Cubans focus mainly on primary and preventive care. After graduation, every student moves to a rural area and assumes the role of town doctor, applying these two principles of medicine. They complete two years of rural care, after which they have a bit more flexibility in their practice. 35 percent move into a specialty, but the remaining 65 percent stay in communal-preventive care after realizing how critical it is. Contrastingly, in the US, medical students specialize before graduation and only 8 precent go into family care, the field that encompasses primary and preventive care.

In Cuba, after the rural care program, every doctor is responsible for a group of people who live within a certain boundary, usually a few square blocks, and develops close relationships with them. Appointments are regular, and doctors will often go to a person’s house to check in if somebody misses one. People often bring gifts of crafts or food in exchange for services. At the core of these practices is the idea that doctors are caregivers, not bureaucrats.

Cuba has done a lot with a little, but its overall lack of recourses prevent it from solving many of the problems that still plague its healthcare system. The country does not have the resources to be on the cutting edge of medicine, and as a result its intensive care statistics lag behind. Unlike Cuba, the United States has a lot more resources–they’re just distributed poorly. If we were to allocate our national recourses more effectively, we could not only increase efficiency in the ways Cuba has but also progress in countless ways.