1. The numbers used to gauge the Cuban health care system is highly suspect.
These numbers are provided by the Cuban Government, which is is an authoritarian dictatorship.
Amnesty International in it 2012 Annual Report stated that:
“The [Cuban] authorities continued to severely restrict the freedom of expression, assembly, and association of political dissidents, journalists and human rights activists. They were subjected to arbitrary house arrest and other restrictions on their movements by the authorities and government supporters which prevented them from carrying out legitimate and peaceful activities. All media remained under the control of the Cuban government.”
amnesty.org/en/region/cuba/report-2012
I very much doubt that the Cuban government is going to release any numbers that reflect badly on the regime.
(It is illegal for Cuban doctors to speak to foreigners without permission from the government.)
Reports from dissident doctors state that the real numbers are very different from the propaganda.
The mortality rate of children in Cuba from 1 to 4 years is 34 percent HIGHER than the U.S. (11.8 versus 8.8 per 1000). The maternal mortality rate in Cuba is almost FOUR TIMES that of the U.S. rate (33 versus 8.4 per 1000)
Also, It can be argued that the infant mortality rate in Cuba is so low because of the widespread practice of aborting any child suspected of having a birth defect. Close to 70% of all Cuban pregnancies end in abortions.
pop.org/content/abortion-and-infanticide-in-cuba-1089
**2. There is a huge disparity of the quality of care. **
Medication and equipment is available, but only to those who can pay in American Dollars or Convertible Pesos.
The poor and middle classes of Cuba have no access to these types of currency and thus get none of the benefits.
The ‘pesos pharmacies’ and local state hospitals are drastically under-stocked and thus access for the poor to needed medication is minimal, despite the service being free.
If you are provided services you are expected to give a gratuity to the provider.
walrusmagazine.com/articles/2012.04-travel-on-tipping-in-cuba/4/
3. Medical Diplomacy and the quest for hard currency
Cuban has one of the largest per capita numbers of doctors and nurses of any country in the World.
But upon completion of their training, they must serve 3 to 5 years for the Cuban government. They have no choice in where they are assigned. Vast numbers are sent overseas to generate hard currency for the government. In the mean time, these medical professionals make less than $20 a month.
When they are overseas they are under continuous surveillance by Cuban officials in order to prevent them from defecting.
Cuba does possess one of the best medical schools in the world, The Latin American School of Medicine in Havana. It provides free medical education for students from around the World. However this institution is NOT available to Cubans only international students.
sld.cu/sitios/elam/
Cuba has a World class bio-tech industry. It is the largest exporters of pharmaceuticals in Latin America. Almost none of the drugs ever reach the domestic market. It is instead used to generate hard currency.
Finally, almost all the best hospitals and medical personnel are used for medical tourism. People flock from around the world for low cost cosmetic surgery and other procedures.
Medical tourism is one of the largest sources of income for the Cuban government.
Once again, poor and middle class Cuban have no access to these facilities.
…
Though it is touted as providing free access to everyone, the health care system is highly unreliable and does not cater to even the basic needs of the Cuban people.
It’s primary purpose is as a source of hard currency for the government.
Thus where the need is the greatest, among the poor and the middle class, the assets are the least available.