Cuba, 60 years after the socialistic revolution
In 1960 Fidel Castro announced the Cuban revolution a socialistic one. Although initially a marxist model was implemented, nowadays only the randomly placed soviet-style building blocks remain remnants of the communistic legacy of the young Fidel and Ernesto ‘Che’ Guevara. At least at first sight. 60 years of socialism have brought Cuba quite something: education and health care is still free, and sports are promoted. What’s more, health care costs are only 12,1 percent of the GDP, while the outcomes are similar to first world countries: life expectancy is at 77 causing the same population aging problems OECD countries are facing. Malaria is nonexistent (in contrast to, say, Florida). Aids is under control using completely free sanatoria (let’s ignore the compulsory nature of the treatment). There is a doctor for every 175 Cubans. Cuba is becoming very popular amongst health care tourists, especially for rehab and skin problems, due to the climate and the reasonable quality of the staff. Cuban doctors are sent all over Africa for humanitarian purposes, which I, as a citizen of a country cutting 60% of humanitarian aid, find rather embarrassing. So what are Cuba’s secrets? First of all, education is completely free. Any Cuban born can become a doctor, which not many industrialized countries can say. This semester the Netherlands raised the costs of a medical education with over 3000 euro. Plus the Netherlands have a policy of strictly limiting the number of available places. In the USA a non-wealthy-born doctor starts its career with a five- or six-digit debt. Surely that will be discouraging. Then there’s salary, perhaps correlated with the starting debt. In Cuba there are no rich, so forget a 300.000 euro average salary. In Cuba the decision for becoming a doctor will be based primarily on the ridiculous notions of helping and caring for other people and making a difference. Could this be a sustainable option for capitalistic countries? It appears not, since Cuban doctors send abroad tend not to return. In fact, the only reason Cuba sustains its relatively qualitative health care system, is the strict travelling restrictions it imposes. Cubans are not allowed to travel. One could predict that opening the country will cause a large afflux to other Latin-American countries, and a Cuban doctor moving to Argentine doubtfully will have the same effect as an Argentinean doctor moving to Cuba[2].
Actually, the strict foreign policy is one of the communistic remains in a by tourism to capitalism converted country. In 2008 little brother and fellow guerilla Raul Castro allowed Cubans to open shops and sell ‘state property’ like cars and houses. As long a tax is paid. However, the communistic view on foreign policy leads to the second reason health care is cheap: almost all medicines are Cuban Made. Not that Cuba doesn’t want to import medicines from the villains of this world, like Bayer, Roche or Pfizer, Cuba isn’t allowed. You see, the communistic view on foreign policy is not from Cuba but from the United States. In a cold war ancient time the States decided on a Cuban embargo, which for some dark reason is still upheld. Cuba is not allowed to import or export anything from or to the USA & cohort, directly or indirectly. The perestroika had cost Cuba 85% of foreign trade. With Florida 100 miles away, most tourist are Canadian (the rest is European). Given that the USA also occupies the Guantanamo Bay, they do not exactly act as a friendly neighbor. Cuba puts its hope now on distant friend China, resulting in line buses to Hong Kong driving through Havana.
A third possibility that health care in Cuba is cheap, is because being fraudulent is much more difficult. The Committees for the Defense of the Revolution or CDR[3] comprises about two thirds of the population and is one of the largest organizations in terms of members in the world. It’s duty is to report on the activities of fellow members, to ensure that everyone behaves in a socialistic way. This leads to a strange contradiction when comparing the communistic system and the capitalistic system. Suppose a person acquires wealth (due to virtue or fraud). In the capitalistic system, the neighbors would want the same, but instead of asking how wealth is acquired, money is lent in order to obtain the same level of consumption. In the communistic system, the neighbors also would want the same, but instead of asking, they report to the CDR and the wealth is taken away (redistributed). One would expect at least the virtuous to rise against the system and demand more freedom. But this is not the case, not just because Cubans’ every move is watched (it is difficult to use phones, impossible to use internet), but also because Cubans are loathed with national pride. The Cuban system may not be the best system in the world; as long as it’s called ‘Cuban’ it is to the Cubans. After 60 years it’s still: Patria o muerte!
[1] The homeland or death, a battle cry used during the revolution: viva la revolution! Patria o muerte. (long live the revolution, homeland or death!)
[2] Reference to Che Guevara, who studied medicine in Argentina before guerrilia-ing Cuban dictator Batista out of power.
[3] In Spanish: Comités de Defensa de la Revolución
