Who Pays for Health Care and Education in Cuba?

By Fernando Ravsberg

HAVANA TIMES — Cuban workers pay for healthcare and education. Ever since the 1960s, surplus value gained from their labor has gone to the State’s coffers, the State being the main owner of the country’s modes of production and only redistributor of this wealth.

The Revolution’s initial social agreement took away the importance of people’s wages, and the majority of what was distributed was handed out in equal shares among the Cuban people. Regardless of how much they earned, everyone had free healthcare and education, as well as heavily subsidized clothes, food and transport.

Salary caps were established, making it the country in the Americas with the least difference in income between rich and poor. Even privileged leaders didn’t receive their benefits in the form of wages but in the form of rewards (cars) or opportunities (tourism, trips or special stores).

Even if you take the existence of these privileges into account, Cuba continued to have a much higher level of social equality than any other country in Latin America. Extreme Mexican poverty didn’t exist and nobody on the island had a fortune like Carlos Slim.

Along with healthcare, education is accessible to all children and young people and takes one of the larger chunks of the national budget.  Photo: Raquel Perez Diaz

There isn’t free healthcare and education anywhere in the world. However, there are different ways of getting these two services, one is the “every man for himself” way, the other is to create a communal fund between all of the country’s citizens so as to give universal coverage to everyone.

The Cuban Revolution chose the second, giving all of its citizens access to these services regardless of their income or what they contribute to the State. The resources didn’t come out of Fidel Castro’s pocket but it was his government that prioritized public expenditure in these areas.

It was a strategic decision, just like other States within the region prioritized public infrastructure or the telecommunications sector. The general population contributes the hard cash in every country, but it’s the politicians who decide what to do with these contributions.

Normally, when a country sinks into crisis, the first thing that suffers cutbacks are social expenditures and budgets for healthcare, education and culture are the first ones to experience cuts so as to “balance out” fiscal accounts.

I arrived in Cuba in 1990, along with the greatest economic crisis in the history of the Cuban Revolution. I was very surprised when “budget cuts” began with the Armed Forces (FAR), and this didn’t spark any negative reaction from the military.

When the economic crisis began, the sector which suffered the greatest cutbacks in budget were the Armed Forces.  Photo: Raquel Perez Diaz

The FAR drastically reduced the number of troops, it stopped importing arms, they worked in the fields so they could eat, they learned to create businesses so they could be self-sufficient and they were also required to create an effective defense strategy during that time, under those conditions.

While this was happening to the military, ballet schools kept their doors open and 800 children from all over the country, went to ballet classes. Among them was a mulato from a modest Havana neighborhood, Carlos Acosta, who would later go on to dance on the world’s most famous stages.

In the middle of the crisis, my children went to primary school, secondary school and finished the pre-university course without having to buy books or pay enrollment fees. I didn’t even have to pay for their transport, food or lodging for the three years they were at boarding school.

I maybe would have had enough to pay these costs but I’m sure the construction worker, whose daughter studied in the same class as my son, at the Exact Sciences technical college, wouldn’t have been able to. And I prefer it this way; I’d rather every child has the same opportunities.

I was raised in Uruguay, a country where healthcare and education were free. As an adult, I lived a decade in Sweden, a country where children have access to both things from the minute they are born and the State hands out scholarships to students who ask for them.

During the most difficult years of the crisis in the ‘90s, all schools were kept open, even ballet schools.  Photo: Raquel Perez Diaz

I’m sure these experiences have shaped my opinions on the subject and that’s why I can’t help but feel that the “every man for himself” life philosophy makes us more like cavemen than the human beings we like to believe we are.

With the changes in the economy, Cuba is being forced to take a new path towards a new social agreement where salaries will have greater importance. Hopefully this can be done without losing this “communal fund” which finances healthcare, education, sports and culture.

These social advances might seem somewhat “natural”, but they aren’t. If the will of politicians to prioritize these sectors in the public budget vanishes or if the national economy is no longer able to finance them, they could disappear and having equal opportunities would disappear right with them.

22 thoughts on “Who Pays for Health Care and Education in Cuba?

  • May 16, 2017 at 10:55 pm

    As you write Shiba, 400 CUC is over a year’s income for a Cuban and in consequence is unlikely to ever be paid back. If you call the Cuban Consulate and give the name and address of the friend, it is highly likely that he will be visited by the State Police. Remember that the Cuban regime maintains a file on every resident and the mattter will go onto his record.
    Secondly in my personal experience the Cuban health service doctors and nurses are very good, but many of the hospitals leave much to be desired. In-patients supplying their own bedding and family members bringing in meals.
    If you decide to support, then I suggest that you seek the name of the hospital and its location, the nature of the medical problem that requires the operation and the address of where the husband intends to stay. In short a breakdown of how the sought money will be spent. Although in general Cubans do not have access to the restricted form of Internet, they do have access to e-mail – my wife and I exchange them daily when I am away from Cuba and friends also write. You need more detail!
    But you are correct in assessing that you will not be repaid.
    Although I have a step-daughter who is a lawyer in Cuba, I cannot advise you about Cuban law – except to tell you that if charged, you are guilty until proven innocent.
    Sadly, the regime has made Cubans into a society of beggars. But you are right to question the purpose. Do you intend to return to Cuba? I ask, because it might be sensible to say so to the friend so that you cease being a distant figure and that he knows you will be returning to call him to account.

  • May 16, 2017 at 2:11 pm

    We have made friends with a Cuba family and just returned back from Cuba 1 week ago. Today, we received an email from this friend that we meet last year and all together maybe 7 times that they need money. He has asked us to send 400 cuc (Cuba money) to help with an operation his wife needs. He sent us his complete name and account number and the bank name so that if we can send the money we can do so because it is Urgent. He also said that next year he will pay us back. We find this a little fishy, we met his wife and she was in perfect health and when we get back he is asking for emergency funds. I am doing research on the internet and everywhere I look it says that Cubans has good and free health services. We will also be calling 2 good friends of ours in Montreal because they are also Cuban and they can answer some of our questions, I will also be calling the Cuban Consulate this week. They truly are nice people but we are not in any position to give away 400 cuc. In our Canadian dollars it is 550.00$, this is a lot of money to give away to strangers that we met 7 times and now consider us their Canadian friends. Can someone respond if they know Cuba laws and how the hospitals work in Cuba. He told us in the email that he needs to live in the city where his wife is having her operation so this is going to cost money. He will never be able to pay us back the 400 cuc because we know that when they work they receive about 25 cuc per month. How can they possibly pay us back this money next year???? Any help????? thanks

  • April 7, 2017 at 9:06 pm

    I will be in traveling to Havana on April 19th from the US. I am a travel agent , a senior woman who wants to see the real Cuba. This is my 3rd visit to Cuba , having spent one day in Santiago de Cuba in March. My mission is to find off the beaten path experiences for my clients and stay only at casa particulars and eating in paladors. Most Americans are so ignorant of Cuba and its people. They need to open their eyes to the many wonders of this interesting country and what it has to offer. Unfortunately, they are so consumed with making money that their head remains buried. I will be flying back from Camaguey on April 26th. I have certainly enjoyed this discussion. Thank you [email protected]

  • April 4, 2017 at 4:23 pm

    CErmle, you have no clue whatsoever about the situation “on the ground” because you’re too afraid to leave your enclosed bubble.

    If you ever muster up the courage to explore a complicated situation and investigate Cuba with your own eyes then my offer to host you still stands.

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