Health Care in Cuba: Free?

Rosa Martinez

Cuban doctors in Venezuela. Photo: Caridad

HAVANA TIMES, April 29 — I promised myself not to write about this issue again for a long time since I had more than enough reasons to make good on that promise.

The most important reason was that several children in my extended family have required medical attention, and in all the cases it had been excellent.  Just a few days ago my niece was admitted to the provincial pediatric hospital in very serious condition.

A sudden spell of pneumonia kept her in intensive care for a week, but the medical personnel didn’t leave her side.  They were able to bring her back to health, and for that I’ll always be grateful.

The second reason is the service that our health care professionals provide in different countries around the world.  In Haiti our physicians saved and continue saving thousands of lives over endless days, sometimes out in the open and always facing the risks of being infected with some illness.  The prestige of Cuban medicine was raised even higher in that poor nation.

Another reason that I am reluctant to criticize our public health system is that I already wrote two articles related to this issue, so I didn’t want to seem like a whiner.  I don’t have anything against our doctors, or anything that might seem to be.

A right to defend

On the contrary, I believe that it is the prestige of our medicine, its achievements over a half century and the excellence that we have gotten used to that obligate me to defend what is ours by right, a privilege of those of us who live on the island.

Then there’s the last reason, the same one that — paradoxically — made me return to this subject: the fact that these services are free.

But to what extent is health care in Cuba really free?  This is a question that some Cubans may have raised, others not.

Although many say that inadequate wages and people’s horrendous living conditions pay in advance for the health care provided to the whole population, even the most fervent opponents recognize that this is a great achievement of the Cuban Revolution.

There is one truth beyond the assertions of detractors and supporters alike.  Any Cuban who gets a sore throat, catches dengue fever, chicken pox, hepatitis or any illness can be treated at a first aid unit anywhere in our country – from Maisi Point to Cape San Antonio.  The sick person will only need to pay for the car, truck, bus or wagon that they use to get there, and later they’ll have to pay for the heavily subsidized medicines, provided they’re not hospitalized (in which case these too will be free).

Cuban doctor studies a case. Photo: Caridad

The same thing will occur in the event of a pelvic peritonitis, with appendicitis, a perforated ulcer, or an ectopic pregnancy, among others; only that in these events the patients will require surgical procedures that cost thousands of dollars in many other countries.

However these too are free here, as are blood or urine tests, a tomography, an x-ray or any exam that a patient requires, be they young or old, black or white, a leader or a dissident.  Everyone equally receives the appropriate health services, not only because the doctor treating them received excellent training but also because the technology used will be of latest generation, almost the same as in a developed country.

Stories that contradict

What’s sad though is that even when understanding the high-mindedness of our medical service, we will hear stories of sick people who seem to live outside of Cuba.  They seem to be in another country where so many thousands of people die daily due to the lack of resources and money to pay for decent medical attention.

I believe the story of my friend Ronaldo would be enough to illustrate this statement.

Ronaldo has been an economist for 20 years, but six months ago he began to suffer from terrible bouts of colic that didn’t permit him to work.  After the appropriate exams were performed, the urologist diagnosed him as having several stones in his left kidney.  The physician explained to him that in his case an operation would be very risky.

“We believe that it’s better to exhaust all the possibilities before resorting to surgery.  The ideal approach would be to carry out a laser lithotripsy on him in Havana, or wherever this can be done,” the doctor told his relatives.

So, Ronaldo and his older sister headed to the capital.  Making it to Hermanos Ameijeiras Hospital was easy; the hard part was finding someone who would help get him an appointment for the right tests.

A nurse who was a friend of the family told him, “I can get you in, but that won’t help because the equipment is out of service.”

“I’d like to be able to help you,” added a compassionate doctor who assisted them.

“The equipment remains broken, but when it gets repaired, the first ones to be treated will be the old cases.  That’s going to hold up us seeing to your case,” another doctor said.

Soon after this, Ronaldo was hit with a terrible attack of colic and had to go to the emergency unit closest to the house where he was staying.  There, he was attended by a specialist who prescribed a serum to alleviate the pain.  This health care worker also spoke to him frankly saying, “You do know that you’ll have to pay for the lithotripsy, don’t you?

“Yes, of course I do,” sheepishly responded my sick friend, who the next day returned to his home province, where he’s still waiting for a miracle before they have to remove his kidney.


5 thoughts on “Health Care in Cuba: Free?

  • April 29, 2011 at 6:11 pm
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    It may not be the doctors at all it could be the managers of the hospital or the group of people who manage the equipment. What Rosa described is not a situation unique to the medical system is everywhere. So if you try to buy medication they may not have what you need unless you can give them something under the table and so on. So it could be said that the system is broken. It is broken because it pays too little to the workers to survive. Any of you could you survive a month with a salary between 15 to 20 dollars a month to satisfy all your primary needs? Doctors do make around 20 dollars but even with the subsidies they receive it’s definitively not enough. So the system is bankrupt.
    On the other hand I know many people that will never do any of this and that are honest and incorruptible but those who are corrupted do it out of a real personal need. Not to enrich themselves.

    On the other hand the state sells for example cooking oil with a markup price of 270% something they said do so that they can finance the system and charge the people who have hard currency but then they only way for many of them to buy cooking oil is to convert their meager salary into CUC at a rate of 24 pesos to 1 CUC. Now tell me. Who is exploiting who? Who is stealing who?

    It is obvious that the regime is stealing and exploiting everyone.

    Going back to the question about of health care is free in Cuba.
    Cuban per capita income should be around 400 to 600 US dollars but as we know they only get pay from 15 to 20 dollars the rest could be said the regime keeps it to pay for all the subsides. Education and Health Care and food and the army etc. Then you realize the huge percentage of their salaries that is taken to pay for all those benefits and as can be seen. The administration of this benefits is unfortunately corrupted. What has happen is that none of them have real money. They are paid with Cuban pesos and to buy things they need to use CUC. Therefore each of them sells a little of what they can in order to make a little bit of money.
    If the salaries were sufficient to make a living many people will not do what they do today.

  • April 29, 2011 at 5:56 pm
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    sometimes, I find, this essys lack all facts so that a complete understanding is in hand. I would need to know is this type of surgury known to be one that a payment is required, or is it a one time issue, and the root cause is another issue? I personally received relatively good care from an optomologist in Matanzas City. She did not have the equipment to do a complete retinal health analysis. But what I was most struck was the patient examining chair was in teribble repair. I never doubted the knowledge. Actually Havanatimes, I would lke to understand the medico exit to Venezuela… Cubans seem to not like this yet to the person going, it appears they receive good attention, and that there is renumeration waiting for them in Cuba. This does not only refer to nurses, doctors, but other professions such as laboratory technologists. It would be interesting to know more about this relationship: benefits to the professional, benefits to Cuba, impact on the Cuban people, how are the families of the professionals working away compensated regarding lost of income and supports?? Having been recently there I find for the questions I was asking, I could not get a succinct answer..

  • April 29, 2011 at 1:34 pm
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    Sorry to hear of this underhanded action by the doctors. Several years ago I met an Irish surgeon who told me that Cuban doctors are held in high regard by the worldwide medical profession.

  • April 29, 2011 at 11:31 am
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    The fact is that some doctors take advantage of the problems of the system to make some extra money. In this case, the instrument for the laser lithotrips was broken or so they told the patient, but if he pays they would solve the problem.

  • April 29, 2011 at 10:52 am
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    This story is heart wrenching. Can you tell me why he has to pay for the surgery? Is this because doctor’s are taking advantage of the broken system so that they can get money? Or is this because everyone has to pay for surgery? Or is there some other explanation? Please explain. I don’t understand.

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