Healthcare is Free in Cuba, but it Still Has a Price!

By Osmel Ramirez Alvarez

HAVANA TIMES — The title of this article chimes in with a campaign which has been repeated time and time again at Cuban health centers for many years now. Of course, I didn’t add the question mark at the end with the clear intention of changing its meaning. Along with this message appears a price list of every doctor’s visit or check-up, so that people are aware about how much they are taking out of the State’s pockets to keep this vital service running.

Having “free” healthcare when you go to receive it is an achievement, there’s no doubt about it, but that doesn’t mean it really is free or that the State is the one paying for it as a favor. The State (which is often confused with the government) has nothing that doesn’t belong to the people, it’s just our administrator, that’s it. The State is spending our money, the country’s money. That’s why we have every right in the world to demand that these health services be excellent, because it isn’t a gift but rather a collective “achievement” which is very expensive.

I would dare to go out on a limb and say that the most expensive healthcare in the world is here in Cuba. Nearly six decades ago, the State seized virtually every private company, land and productive asset on the island (anything which generated wealth!) in order to have resources and distribute these among the general population in the form of social benefits. So instead of the country’s resources belonging to a few individuals, they would be enjoyed by everyone. We gave up our personal financial freedom for the sake of collective interest, healthcare being a foundation of this.

Going even further, we Cubans approved a constitution, with a majority vote, in 1976 which protected this form of organization from the national economy and political situation, as an alleged guarantee of these social benefits and to make sure nothing would be changed. The political system here has been designed to preserve continuity and the Cuban people haven’t even had the power to change things. We ceased to be citizens as individuals and sovereign as people. We gave all of this up for our social achievements.

No other people in the world would be willing to pay such a high price for “free” healthcare and education. It’s a price that they wouldn’t think could be paid, non-negotiable. However, this is the system that the Revolution brought along with it; it needs to cut some human rights short in order to ensure others.

It would make sense to expect healthcare to be excellent in such a situation, but that isn’t the case. In spite of everything we handed over (our sacred rights and financial wealth) and a healthcare system which has been well-designed so that it is accessible to everyone, our public health services are awful and facilities are in a deplorable state because of a lack of funding, wage incentives, supplies and even personnel. The thing that used to fill private coffers slowly fell apart in the State’s hands, which ended up being an inefficient administrator, and it’s poor organization stands in the way of excellence.

A large number of doctors are on missions abroad (mostly doctors with the greatest experience), and even though they only receive a small part of what they are paid, that’s still a lot more than the pitiful sum they would earn here. Hospitals are in ruins with unsanitary sanitary services and a lack of the basics for any patient’s doctor’s visit or treatment. It hurts to see so much neglect.

Let me give you some examples:

My mother has been three months without her heart disease medicine because she needs a signature on her “card” and she can only get it signed by a cardiologist. We went to a great deal of effort to get an appointment for May 7th, but on Friday 4th, she was already too unbalanced and we took her to the hospital. In the 13 days she was admitted, her health recovered and luckily the doctor she had, a clinician, takes great care of his patients, which I am thankful for. She recovered and has been given another treatment which we aren’t sure she’ll be able to complete because it depends on what comes in to the pharmacy on a regular basis.

My mother is obese and there aren’t any wheelchairs or stretchers for people like her, which is why she had to walk down long corridors holding on to two people. There are two elevators, one seems to be broken forever and the other wasn’t working that day either. In such a run-down state, it gives you the jeebies going up in it anyway because the buttons don’t work properly and you have to shout up for people to send it down.

Beds in hospital wards are old, which you can’t put the brakes on and you can’t regulate the reclining feature. A lot of mattresses in bad condition. Not to mention the sheets that cover them, gruesome! Chairs and tables for visitors while disgusting, aren’t enough for every bed and newly admitted people need to be on the lookout for when people get released so they can steal them away from another cubicle, someone always left without them. What a state the bathrooms are in! I can’t even describe to you how bad they are, with foul-smelling leaks, no privacy, no water in sinks, compact… a disaster!

To end, I will just say that nurses need to ask patients (who bring their own) to lend them their thermometer or  blood pressure cuff to take everyone else’s temperature and blood pressure because they don’t have any at the hospital to do this. Next to my mother, there was an 88-year-old woman with ischemia, who needed a special need for a drip and my father had to go out on the street to get her one.

On the other hand, my wife has gallstones which torment her with pain, but it’s still not a life or death urgency so she still hasn’t been operated. She has to look after our small daughter like this. She received the diagnosis in November and she was only put on the surgeon’s operations list in January. It’s been five months now and she still isn’t anywhere near being operated. Her complementary tests have expired and she needs to do them again. When she did them, there weren’t any needles so I had to go out and find them outside. I have no words.

This is the current state of the Revolution’s main achievement. I have so many more examples from my family alone so just imagine how many disaster stories exist in the country’s everyday life. People didn’t stop calling us a medical power in vain, it would be too much.

It’s free, but it still has a high price! Mostly because of what we have had to give up in order to have it and how much we suffer when we need it. We deserve a better service and it isn’t fair to only blame the blockade. It doesn’t really have much to do with the country’s lack of supplies, trained doctors, medicine, upkeep and small systematic investments. Even more so when an extremely high percentage of qualified healthcare professionals provide services abroad and make up the main source of income for our country today (to put the icing on the cake).

Osmel Ramirez

I'm from Mayari, a little village in Holguín. I was born on the same day that the Vietnam War ended on April 30, 1975. A good omen, since I identify myself as a pacifist. I am a biologist but I am passionate about politics, history and political philosophy. Writing about these topics, I got to journalism, precisely here on Havana Times. I consider myself a democratic socialist and my main motivation is to try to be useful to the positive change that Cuba needs.

Osmel Ramirez has 174 posts and counting. See all posts by Osmel Ramirez

12 thoughts on “Healthcare is Free in Cuba, but it Still Has a Price!

  • It was not possible to “reply” to your comment below Ken regarding health care in the Americas and Cuba being ahead of Canada, so I do so here.
    Tommy Douglas first pursued the concept of health care in Saskatchewan, Canada in 1947 prior to it being enacted in the UK.
    You may note that I avoid trying to use the US as the best example for almost anything, but do try to get folks (for example) to read the US Cuban Democracy Act which introduced the embargo of 1961, because the defined purpose is excellent – but it didn’t work!

  • If Cuba started universal health care before than US and Canada, what
    happened that it is a big disaster now??

    My father is a great surgeon with more than 30 years of experience, in
    order to survive he rents part of our old family house Saturdays and
    Sundays so he can´t rest properly, he has not a car, his salary is
    under 80 dollar per month, he was 5 years without see me because Cuban
    government didn´t allow him to go visits me in Spain alleging he would
    not return.

  • A reply to Carlyle MacDuff, below.
    I am sure you are right and Cuba was not the first to introduce universal health care. Although they may have been the first in the Americas. I don’t know, although I can say that they were ahead of Canada and the US.

  • There are many better examples of health care than that of the US Ken!
    Health care in Cuba is not original, the credit for that has to go to the UK which introduced the system in 1948. It was a consequence of the Beveridge Report produced during the Second World War (Churchill P.M. not in support of the idea) to discuss social actions to be pursued after the war. The concept in consequence ought to be credited to a combination of William Beveridge and the British Labour Party (Minister of Health Anuerin Bevan).
    Many other countries followed the UK initiative although not politically socialist, proving that a good idea should be pursued and implemented. The US is an exception! Cuba did not lead, it followed.

  • Must Cubans believe our health care system is great, as concept, but it cannot be well administrated for an almighty government that can do whatever they want while the people have not a way to control it.

    If the government centralize all economics aspect in Cuban life, them they are responsible for all those thing that Osmel denounces in his article.

  • Judging by what I read on this list, very few Cubans feel they would be better off with a US style health care system.
    And, judging by the overheated reaction of some people in the US, in adopting “Obamacare,” the US was taking a step towards the Cuban system.

  • The difficulty in Cuba Ken is that when the government in Cuba has done spending money Cubans receive on average less than $21 US per month. How would you fancy your own government spending some 97% of the GDP leaving you with 3% ?
    You also say: “Until someone comes up with something that governments can do for free, WE’LL have to decide where best to spend government revenues.”
    Where you live Ken the people do have choice, in Cuba they don’t.

  • Government programs cost money. Who can deny it?
    Highways cost money, even if we don’t pay a fee each time we turn onto a public road. If missiles are used in combat, we can be pretty sure that someone has to pay for them.
    Until someone comes up with something that governments can do for free, we’ll have to decide where best to spend government revenues. I think health care is a good place to spend money.

  • With an effective income tax rate of more than 95%, healthcare and education services are anything but free….

  • Yes Osmel, Cubans pay a very high price for “free” health care and education.

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