There have been a few posts here about Michael Moore’s movie Sicko, and those posts eventually get to a discussion of the Cuban health care system. Since it is very likely I’m the only person posting the SDMB who has experience the Cuban health care system first hand I figured I’d come in here and give my experiences.
First of all let’s get this out of the way, the Cuban health care system used to be good. Not great, but good. Until about 1990 there were clinics everywhere, where you could walk in and get seen by a doctor, not every place had the best diagnostics, so sometimes a visit to the doctor meant travelling between several hospitals and clinics, in one place you would get and x-ray, in the next you would get a blood test and so on. Once you were diagnosed, chances were you could get the medicine you needed at a local pharmacy, no charge just like the doctor visit. If your condition required some other kind of treatment, you might have to get yourself to Havana, or if the drug was not available in Cuba a friend or a relative living abroad would have to get it for you.
That was the system back then, like I said, not great, just good.
Sometime in the late 1980’s the Cuban government started to send doctors overseas as a way to get cash. The government had always sent doctors overseas in humanitarian missions, but in the late 1980’s the government started charging for the doctors services. I have two relatives that worked in this capacity in Nicaragua. At about this time local clinics all over the island started to close because of lack of doctors. You could still get seen by a doctor but now you might have to travel to the city or town hospital.
Then the USSR fell and things got really bad. Where before you could get care somewhere in the island, suddenly there were no doctors in the hospitals and there was nothing in the local pharmacies. There were medicines available in Havana in what were then called diplo-tiendas, for foreign diplomats where only dollars were accepted. Right about then Cuban started to develop tourism, including medical tourism, and some previously public hospital became for foreigners only. Any kind of advanced treatment, like chemotherapy was not available. If you needed any kind of medicine, including aspirin it had to be sent by friends or relatives from overseas. During this time in my hometown hospital there was a riot when doctors refused to operate on a local boy until the family paid in cash for the gloves and sutures they would use.
It was also during this time that many people all over the island started suffering from severe vitamin deficiencies and some maladies associated with that, including blindness and death. Eventually there was an actual demonstration in Havana which forced the government to distribute vitamin supplements throughout the island.
Since then things have improved, especially in the big cities like Havana, Holguin, and Santiago de Cuba. Many medicines and treatments that had dissappeared are again available. Most local clinics that closed never opened again, and many Cubans must travel to a hospital to see a doctor. If you’re familiar with the Cuban transportation system then you know that this puts health care almost out of reach for a lot of Cubans. Today I would say that the Cuban health care system is somewhere in between the heights of the 1980’s and the lows of the early 1990’s. So if it was good in the 1980’s and awful in the 1990’s then today I can call the system so-so.
Even during the best years of Cuban health care there had been two systems, one for everyday people and one for government officials. A third one exists now, it is for cash paying foreigners, this one is not available to Cubans even if they have hard currency.
I said a little earlier that you could see a doctor and get medicines free of charge. In fact Cubans pay for every bit of their health care, not only do all Cubans work for the government, which caps the salaries of all Cubans at about $20 a month, (one exception is police officers who can make twice that), but Cubans also pay taxes. Any Cuban who rents their home for tourists, or runs a restaurant, or sells trinkets in the street must pay both an occupational license and a monthly tax on their operation, even if they had no business transactions during that month.
For those who point to Cuba’s current health care system as a mitigating factor in favor of the Castro regime I would say why must it be freedom or health care? Why can’t both be available? Canada does it.