Opinion: The Cuban healthcare system and its lessons for the US

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I was in Cuba (again) during the first week of December. I traveled with a delegation of members of the National Single Payer organization, which is working to achieve a national healthcare system in the US that would fully cover everyone under a single, comprehensive, government-funded program. We visited a variety of healthcare institutions in the cities of Havana and Matanzas, the capital of the province of the same name.

One of the most memorable interactions took place at the University of Medical Sciences in Matanzas. After receiving a presentation about the organization and curriculum by one of the leaders of the institution, I asked the assembled academic and clinical professors how many of them had participated in international medical missions. I was amazed when approximately 20 of the 24 faculty raised their hands with enthusiasm and pride. Through my follow-up question I learned that the medical practitioners had provided medical care to people in Angola, Bolivia, Brazil, Ethiopia, Ghana, Venezuela, and Yemen, among more than a dozen countries.

Poster on wall of the University of Medical Sciences in Matanzas, also featuring Fidel Castro Ruz and the “Cuban Five.”

Why was this so remarkable for me? I certainly knew about Cuba’s international solidarity in the healthcare sector, which began in Algeria in 1963 and included Cuba’s offering to send medical personnel to New Orleans in 2005 after the devastation of Hurricane Katrina as well as sending multiple medical brigades (including in Italy) during the Covid pandemic.

I also was aware that Cuba’s international medical missions are referred to as the Henry Reeve Brigades, named after an American who fought in Cuba’s first war of independence against Spain.

However, I have been bombarded with propaganda from the US government and some corporate media in the US that Cubans participating in the medical missions were “slaves” and the international programs constituted “human trafficking.” That the university professors I met showed such enthusiasm and pride in reporting on their participation in international medical missions provided strong evidence that the propaganda to which I was exposed in the US was another example of misinformation about Cuba.

It is true that Cuban doctors and nurses involved in medical missions don’t get paid all the funds that Cuba receives when another country pays for such services (though many countries don’t pay anything). Nevertheless, while Cuban healthcare workers are abroad, they continue to receive their normal Cuban salaries as well as getting a stipend in the foreign currency. How is this an example of “slavery” or “human trafficking?” Why does the US government promote misinformation about this admirable international solidary activity by Cuba? I believe this is part of a broader economic war against Cuba, designed to undermine the revolution and achieve regime change, given that the missions generate foreign revenue that can be used by the Cuban government to fund healthcare, education, and other services in Cuba.

I should also note that Human Rights Watch claims that Cuban healthcare professionals participating in international missions might be disciplined if they “have ‘relationships’ with anyone whose ‘actions are not consistent with the principles and values of the Cuban society,’” arguing such “rules severely restrict health workers’ freedom of expression, association, movement, and privacy.”

Although the organization references a Cuban policy (Resolution 168), it fails to note one of the main reasons Cuba has such a policy is because the US government has what it calls a “medical parole program,” which is designed to try to weaken Cuba’s medical system (and its revolution) by contacting and trying to recruit Cuban healthcare workers involved in international missions to abandon Cuba and come to the US.

I should mention something about the “Cuban Five,” who are also featured on the poster included in the photo above.

The five were Cuban intelligence officers (Gerardo Hernández, Antonio Guerrero, Ramón Labañino, Fernando González, and René González) who were arrested in September 1998 and later convicted in Miami of acting as an agent of a foreign government. They were in the US to observe and infiltrate the Cuban American groups, such as Alpha 66, the F4 Commandos, the Cuban American National Foundation, and Brothers to the Rescue, which had engaged in or sponsored attacks on Cuba.

They were not spying on the US government and, indeed, were only arrested after they reported to US authorities about some of the terrorist acts being planned by these groups. Sentenced to various prison terms, the last of the five were released (and returned to Cuba) on December 17, 2014, as part of the prisoner exchange negotiated by Presidents Barack Obama and Raul Castro. This followed a broad and sustained campaign by US solidarity activists to free the Cuban Five. The 10-year anniversary of their ultimate freeing was approaching while we were in Cuba.

Our group had opportunities to visit University of Medical Sciences in Havana as well as the Latin American School of Medicine, which was founded in 1999 and has recruited and graduated more than 20,000 students from at least 110 countries, including the United States. In addition, we had interactions with Cubans at neighborhood doctors/nurses’ offices, polyclinics (the second level of healthcare institutions in Cuba), and general and specialized hospitals (e.g., cancer, maternity, pediatric) in Havana and Matanzas. We were also scheduled to go to one of Cuba’s biotech institutes (the fourth level of healthcare institutions in Cuba). However, because of problems with electricity (caused by the US embargo/blockade, which creates financial obstacles for Cuba to purchase fuel and replacement parts for the aging electrical grid), this visit was not possible on the day it was scheduled.

We learned from the healthcare providers as well as some of the patients whom we were able to talk informally during our visits how comprehensive, consciously planned, personalized, and effective Cuba’s healthcare system was. Not only does Cuba have more doctors per population than other countries, but all Cubans have a doctor/nurses’ office (available 24/7) within walking distance of their residence. Healthcare providers lived above their offices and came to know their patients/neighbors on a personal level. When a higher level of medical care was required, Cubans were referred to polyclinics or hospitals, where they were treated personally by the professionals working there. Oh, by the way, all of this healthcare was available to all Cubans and free. These facts, of course, were what motivated members of the National Single Payer group to travel to Cuba.

We also learned of the major challenges faced by healthcare professionals in meeting the needs of their patients. As noted above, there have been occasional blackouts, requiring generators operating with limited fuel at some institutions. Moreover, some medical equipment and some medicines are in short supply, again because of financial and logistical constraints because of the US embargo/blockade. For instance, during the Covid pandemic, while Cuba produced its own, effective vaccines, the country had to rely on syringes being donated so Cubans could be vaccinated. As an example, the Saving Lives Campaign – in collaboration with Global Health Partners – raised funds to send 6 million syringes to Cuba in 2021, and it more recently it sent over 300 pacemakers to help treat Cubans with serious heart problems. We were told by healthcare professionals and other Cubans that the impact of the 60+ year embargo/blockade was being exacerbated by Cuba’s inclusion on the State Department’s List of State Sponsors of Terrorism– a designation that has no basis in fact; Indeed, for many years Cuba has been the target of US government and government-sponsored acts of terrorism.

The embargo/blockade has been condemned on more than 30 occasions by the U.N. General Assembly. Cuba’s inclusion of the SSOT was done in the last few days of the previous Trump administration and was not removed during the Biden administration.

For US citizens who want to learn more about – and to work to change – these wrong-headed policies, see the website of the Alliance for Cuba Engagement and Respect.

Along with my Cuban colleagues and friends as well as those who participated in the National Single Payer delegation, I am very worried that US sanctions and other actions could be even more aggressive and hurtful during Trump’s second term, especially given that he’s nominated Marco Rubio to become Secretary of State.

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