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Cuban health system -- call it superior?


 In a response to an article by Benjamin and Haendel on the Cuban medical system (Links, Fall 1991), A.F. Brown criticizes the 2 authors for failing to call the Cuban medical system by its rightful name: superior to that of the US. According to Brown, Benjamin and Haendel's own data bear out the fact that Cuba has a better medical system than the US. Life expectancy is 76 years in Cuba compared with 75 in the US. Doctor/patient ratio is double that of the US. In 1990, there were no measles cases in Cuba compared with 25,000 cases in the US. In Cuba, there is 100% prenatal care coverage and hospital delivery; abortion is free and available on demand; and immunization rates are nearly 100%. As Brown explains, the 2 authors omit an important feature of comparison between the 2 systems: in Cuba there is free and universally available medical care, while some 35 million US citizens lack any health insurance. In their article, Benjamin and Haendel describe Cuba's response to the AIDS epidemic--mass testing for HIV and confining all seropositive cases--as draconian. But according to Brown, the fact that Cuba's rate of infection is 0.19/100,000 compared with a rate of 13.88/100,000 in the US validates the policy. Brown also dismisses criticism that there are too many doctors in Cuba, that nurses have a low status, and that such physician-heavy system is not cost-effective. Failure to acknowledge the superiority of the Cuban health care system, Brown maintains, reflects an attitude that such a system is too good for them--and better than ours.
