Cuba

Cuba's population of 11,142,000 is very close to Ohio's 11,353,140. The infant mortality rate in Cuba is 7.51 deaths/1,000 live births, comparable to our 6.82/1000 but definitely worse. In Cuba, life expectancy at birth for a man is 73.84 years, again slightly worse than our 74.24; for a woman, it is 78.73 years, more than a year off our 79.9. For the first time in this booklet, we have an example of a country with worse results than ours, though not as much worse as ours are worse than the best.

Cuba has a per capita GDP of $1,700. This is about 5%, or 1/20 of the amount of wealth available to the US. It does not even make sense to ask what percentage of Cuba's GDP is spent on health care because, if they spent every penny of it on health care, they would only spend 39% of the $4373 per person that the US spends. In terms of available wealth, Cuba is clearly not in the same league as the United States.

All Cubans receive free medical care, period. Personal finances or social standing is not a factor. There is one doctor for every 200 Cubans. The emphasis in the Cuban system is on preventive care for children, with the result that 9 out of ten one-year-olds are fully vaccinated. While services are available, there is a shortage of medications, including basic medications such as insulin, asprin, and antibiotics. Medical equipment, especially the newer and more expensive variety, is also quite scarce.

The Cuban economy has diminished overall by a third since 1989. The United States Trading With the Enemy Act, mandating restrictions on the import of medications and equipment to Cuba for more than thirty years before the collapse of the Soviet Union, is still in effect. As a consequence, prescriptions, even for items we would consider simple over-the-counter drugs, are rationed. The government response has been to emphasize priority of care for the most vulnerable groups in the society; children, women with children, and the elderly. In 1997, Cuba ranked second among developing nations according to the Human Poverty Index, which weighs factors such as safe water, malnutrition, literacy and life expectancy, in addition to access to health care.