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Healthcare in Cuba
The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. All healthcare in Cuba is free to Cuban residents. There are no private hospitals or clinics as all health services are government-run.
Like the rest of the Cuban economy, Cuban medical care suffered following the end of Soviet subsidies in 1991. The United States embargo against Cuba also has an effect. Difficulties include low salaries for doctors, poor facilities, poor provision of equipment, and the frequent absence of essential drugs.
The Cuban healthcare system has emphasized the export of health professionals through international missions, aiding global health efforts. However, while these missions generate significant revenue and serve as a tool for political influence, domestically, Cuba faces challenges including medication shortages and disparities between medical services for locals and foreigners. Despite the income from these missions, only a small fraction of the national budget has been allocated to public health, underscoring contrasting priorities within the nation's healthcare strategy.
Modern Western medicine has been practiced in Cuba by formally trained physicians since at least the beginning of the 19th century and the first surgical clinic was established in 1823. Cuba has had many world-class doctors, including Carlos Finlay, whose mosquito-based theory of yellow fever transmission was given its final proof under the direction of Walter Reed, James Carroll, and Aristides Agramonte. During the period of U.S. presence (1898–1902) yellow fever was essentially eliminated due to the efforts of Clara Maass and surgeon Jesse William Lazear.
In the 1950s the number of doctors per thousand of the population ranked above Britain, France and the Netherlands. In Latin America it ranked in third place after Uruguay and Argentina. There remained marked inequalities, however. Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente, were significantly worse. The mortality rate was the third lowest in the world. According to the World Health Organization, the island had the lowest infant mortality rate of Latin America.
Following the Revolution and the subsequent United States embargo against Cuba, an increase in disease and infant mortality worsened in the 1960s. The new Cuban government stated that universal healthcare would become a priority of state planning. In 1960 revolutionary and physician Che Guevara outlined his aims for the future of Cuban healthcare in an essay entitled On Revolutionary Medicine, stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices." These aims were hampered almost immediately by an exodus of almost half of Cuba's physicians to the United States, leaving the country with only 3,000 doctors and 16 professors in the University of Havana's medical college. Beginning in 1960, the Ministry of Public Health began a program of nationalization and regionalization of medical services. In 1965, Cuba became the first Latin American country to legalize abortion.
In 1976, Cuba's healthcare program was enshrined in Article 50 of the revised Cuban constitution which states "Everybody has the right to health protection and care. The State guarantees this right:
Cuba's doctor to patient ratio grew significantly in the latter half of the 20th century, from 9.2 doctors per 10,000 inhabitants in 1958, to 58.2 per 10,000 in 1999. In the 1960s the government implemented a program of almost universal vaccinations. This helped eradicate many contagious diseases including polio, tetanus, diphtheria and rubella, though some diseases increased during the period of economic hardship of the 1990s, such as tuberculosis, hepatitis and chicken pox. Other campaigns included a program to reduce the infant mortality rate in 1970 directed at maternal and prenatal care. As of 2012, infant mortality in Cuba had fallen to 4.83 deaths per 1,000 live births compared with 6.0 for the United States and just behind Canada with 4.8. Some experts have said that these statistics may reflect heavy-handed treatment of pregnant patients. Tassie Katherine Hirschfeld, an associate professor at the department of anthropology of the University of Oklahoma, said that doctors have incentives to falsify statistics, as a spike in infant mortality may cost them their jobs. She also said pregnant women may be pressured to undergo abortions if fetal abnormalities are detected or forcibly placed under monitoring if complications arise. Hirschfeld said Cuba does not allow for independent verification of its health data.
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Healthcare in Cuba
The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. All healthcare in Cuba is free to Cuban residents. There are no private hospitals or clinics as all health services are government-run.
Like the rest of the Cuban economy, Cuban medical care suffered following the end of Soviet subsidies in 1991. The United States embargo against Cuba also has an effect. Difficulties include low salaries for doctors, poor facilities, poor provision of equipment, and the frequent absence of essential drugs.
The Cuban healthcare system has emphasized the export of health professionals through international missions, aiding global health efforts. However, while these missions generate significant revenue and serve as a tool for political influence, domestically, Cuba faces challenges including medication shortages and disparities between medical services for locals and foreigners. Despite the income from these missions, only a small fraction of the national budget has been allocated to public health, underscoring contrasting priorities within the nation's healthcare strategy.
Modern Western medicine has been practiced in Cuba by formally trained physicians since at least the beginning of the 19th century and the first surgical clinic was established in 1823. Cuba has had many world-class doctors, including Carlos Finlay, whose mosquito-based theory of yellow fever transmission was given its final proof under the direction of Walter Reed, James Carroll, and Aristides Agramonte. During the period of U.S. presence (1898–1902) yellow fever was essentially eliminated due to the efforts of Clara Maass and surgeon Jesse William Lazear.
In the 1950s the number of doctors per thousand of the population ranked above Britain, France and the Netherlands. In Latin America it ranked in third place after Uruguay and Argentina. There remained marked inequalities, however. Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente, were significantly worse. The mortality rate was the third lowest in the world. According to the World Health Organization, the island had the lowest infant mortality rate of Latin America.
Following the Revolution and the subsequent United States embargo against Cuba, an increase in disease and infant mortality worsened in the 1960s. The new Cuban government stated that universal healthcare would become a priority of state planning. In 1960 revolutionary and physician Che Guevara outlined his aims for the future of Cuban healthcare in an essay entitled On Revolutionary Medicine, stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices." These aims were hampered almost immediately by an exodus of almost half of Cuba's physicians to the United States, leaving the country with only 3,000 doctors and 16 professors in the University of Havana's medical college. Beginning in 1960, the Ministry of Public Health began a program of nationalization and regionalization of medical services. In 1965, Cuba became the first Latin American country to legalize abortion.
In 1976, Cuba's healthcare program was enshrined in Article 50 of the revised Cuban constitution which states "Everybody has the right to health protection and care. The State guarantees this right:
Cuba's doctor to patient ratio grew significantly in the latter half of the 20th century, from 9.2 doctors per 10,000 inhabitants in 1958, to 58.2 per 10,000 in 1999. In the 1960s the government implemented a program of almost universal vaccinations. This helped eradicate many contagious diseases including polio, tetanus, diphtheria and rubella, though some diseases increased during the period of economic hardship of the 1990s, such as tuberculosis, hepatitis and chicken pox. Other campaigns included a program to reduce the infant mortality rate in 1970 directed at maternal and prenatal care. As of 2012, infant mortality in Cuba had fallen to 4.83 deaths per 1,000 live births compared with 6.0 for the United States and just behind Canada with 4.8. Some experts have said that these statistics may reflect heavy-handed treatment of pregnant patients. Tassie Katherine Hirschfeld, an associate professor at the department of anthropology of the University of Oklahoma, said that doctors have incentives to falsify statistics, as a spike in infant mortality may cost them their jobs. She also said pregnant women may be pressured to undergo abortions if fetal abnormalities are detected or forcibly placed under monitoring if complications arise. Hirschfeld said Cuba does not allow for independent verification of its health data.