Cuba: Is Healthcare a Gift or a Right?
Editorial from Progreso Semanal
HAVANA TIMES — Recently, a campaign has been launched to raise Cuban citizens’ awareness of the fact that while medical services have been free ever since the Revolution triumphed in 1959, they cost the government a lot of money.
As well as posters up at hospitals and polyclinics with the slogan “Healthcare is free, but it costs”, bills are also being printed with the cost of every procedure we don’t pay a single cent for. That’s right and it should be like this. But, is that what’s really happening here? Don’t we already pay?
This could be a very dangerous idea for the country, and its people. I have spoken to many friends about this issue. The conclusion, and what we have all learned over decades living here in Cuba, is that free healthcare and education is a right, not a gift. It’s a matter for government, which is doing well to remind us how much these rights cost. From a country like ours, we wouldn’t expect anything less.
Right now, at a time when we are experiencing a greater recession than in previous times, excluding the so-called “Special Period” crisis of the ‘90s, we find ourselves asking whether it isn’t the Cuban people who are paying and paid for keeping these services up and running every time they buy something at the Hard Currency Stores (TRD).
In Canada, for example, a country which doesn’t even have a trace of socialism, and in other countries too, they can boast about offering these services for free, given their economic power and resolute tax policy which they impose on their citizens. However, in Cuba, people pay up to 240% in a kind of value-added tax (IVA), one of the highest in the world, at every TRD.
It’s true that nothing falls from the sky. Many Cubans have always known this. While it is good for us to know that any medical service we receive has a price, it would also be useful and fundamental for us to also be informed of just how much it costs us to produce a ton of sugar. Or how much it costs to buy bottles of soybean or sunflower oil in bulk, which we have to pay 2.40 CUC = 57.6 Cuban Pesos for. Also, how much it costs us to lose tons of tomatoes in Guantanamo left to rot and what measures will be taken to deal with those responsible.
For these reasons, we don’t believe it is necessary for the government to remind us of how much a lung X-ray or complicated heart surgery costs, or that a nurse checks our pulse for 0.25 cents?
Our health system, which as well as exporting its services abroad and charging for them to the point that it has become the leading source of national income, also charges foreigners who come to Cuba to have treatment and other medical procedures done for its services. However, we also know that corruption has reached Cuban hospitals, and that there are even fees for plastic surgery “underneath the table or on the side”, like we say.
Knowing the difference between a breast implant for a woman who, quite simply, wants to have larger breasts, and an implant for a breast cancer survivor, maybe it wouldn’t be such a bad thing to charge the former. But, legally.
Making the public aware of what our health services cost is the government’s duty and a civil right. But, at the same time, the government should also give us other information about public expenditure and open up our minds to new ways of acquiring and producing wealth so as to maintain such a humanist model, just like healthcare and education should be irreversible rights.
So, it won’t be necessary to remind or mention how much a kidney scan costs to all those people who produce the State’s and their family’s wellbeing.
Yes, it is a good idea to know what things cost. Price signals are important to drive efficient utilization. There also differences between meeting basic human needs and life style choices. Nothing wrong with a mix of public goods to meet basic needs and legal market system for rest. In one form or another a TAX is always imposed by Society to pay for shared things. Nothing is ever really free that some one needs to produce.