What Cuba Can Teach Us About Health Care
The country’s universal, low-cost health care system works well.
It was a rare moment in the health care debate. A Trump supporter, Drea Holbert of Kentucky, was explaining her opposition to Republican health care bills to an NPR reporter when she said this: “Hopefully, they can take a look at what Canada is doing, and even Cuba.”
Inside the beltway, though, Canadian-style health care is off the table. Single-payer health care is dismissed even though Canadians and citizens of other countries with universal health care are getting higher-quality care at lower costs. One reason it’s off the table is the clout of the health care industry, which spent more than $272 million on the 2016 election cycle, according to Open Secrets, and another $515 million on lobbying.
Yet more Americans—like Holbert—are calling for Canadian-style fixes to our health care system. A recent survey by Pew Research Center, for example, shows that one-third of Americans favor single-payer (a much higher number than supported the Republican health care bills), up 5 percentage points since January 2017.
Holbert, though, recommended we go one step further and consider Cuban-style health care. Setting aside politics for a moment, does Cuba have something to teach us about universal access to medical care?
I went to Cuba in late 2006, where I visited clinics, hospitals, and advanced research institutions. In spite of being a poorer country than the United States, Cuba has a lower infant and child mortality rate and comparable life expectancy. Everyone can see a doctor or, if needed, go to the hospital.
But Cuba’s system doesn’t end with universal access for its citizens. Cuban doctors offer health care around the world. In fact, a group of them told me they were equipped and ready to come to New Orleans following Hurricane Katrina but couldn’t because the U.S. government declined permission. Cuban doctors did treat victims of earthquakes in Pakistan and Guatemala, but as they prepared to return home, they realized that they would be leaving locals behind with little access to medical care.
So Cuba began training students from Latin America, Africa, and other medically underserved regions to be doctors. The only condition: When they graduated, they agree to return to treat patients in their own communities.
“All we ask for in return is solidarity.”
Cuba has trained even American students.
Here’s how it happened, according to Mississippi Rep. Bennie Thompson, whom I interviewed when we were both in Havana.
Thompson told me he had met with Fidel Castro on an earlier trip and explained that his constituents in Mississippi had health outcomes similar to people living in less-industrialized countries. So Castro offered to train American students. I interviewed several of them, mostly young people of color studying at the Latin American School of Medicine. These students, I learned, were eager to return home after their studies to offer medical care to their own underserved communities.
Why would Cuba go beyond providing universal, low-cost, high-quality health care to its own people to also train thousands of low-income people from across the world to be doctors?
When I asked that question, the response I got over and over was, “We Cubans have big hearts!” Perhaps that is true, but I felt there must be more to the story.
The late Dr. Juan Ceballos, who was then the advisor to the vice minister of public health, filled in the picture. He too told me that Cubans have big hearts, but when I pressed him he said, “All we ask for in return is solidarity.” Those investments in health care missions “are resources that prevent confrontation with other nations. … The solidarity with Cuba has restrained aggressions of all kinds.”
Cuba’s spending on medical services and training, then, is an investment in its national security. By winning the friendship of countries like Pakistan and Guatemala, they increase their security without ships, airplanes, or bombs. They invest in training people to heal, not to kill, all over the world.
A fully socialized system like Cuba’s may not be in the cards for the United States. Still, Drea Holbert has a point. We have the resources to make sure everyone in our country has health care if we invest our vast wealth wisely.