Healthcare is Free in Cuba, but it Still Has a Price!
By Osmel Ramirez Alvarez
Havana Times
May 16, 2018

The title of this article chimes in with a campaign which has been repeated time and time again at Cuban health centers for many years now. Of course, I didn’t add the question mark at the end with the clear intention of changing its meaning. Along with this message appears a price list of every doctor’s visit or check-up, so that people are aware about how much they are taking out of the State’s pockets to keep this vital service running.

Having “free” healthcare when you go to receive it is an achievement, there’s no doubt about it, but that doesn’t mean it really is free or that the State is the one paying for it as a favor. The State (which is often confused with the government) has nothing that doesn’t belong to the people, it’s just our administrator, that’s it. The State is spending our money, the country’s money. That’s why we have every right in the world to demand that these health services be excellent, because it isn’t a gift but rather a collective “achievement” which is very expensive.

I would dare to go out on a limb and say that the most expensive healthcare in the world is here in Cuba. Nearly six decades ago, the State seized virtually every private company, land and productive asset on the island (anything which generated wealth!) in order to have resources and distribute these among the general population in the form of social benefits. So instead of the country’s resources belonging to a few individuals, they would be enjoyed by everyone. We gave up our personal financial freedom for the sake of collective interest, healthcare being a foundation of this.

Going even further, we Cubans approved a constitution, with a majority vote, in 1976 which protected this form of organization from the national economy and political situation, as an alleged guarantee of these social benefits and to make sure nothing would be changed. The political system here has been designed to preserve continuity and the Cuban people haven’t even had the power to change things. We ceased to be citizens as individuals and sovereign as people. We gave all of this up for our social achievements.

No other people in the world would be willing to pay such a high price for “free” healthcare and education. It’s a price that they wouldn’t think could be paid, non-negotiable. However, this is the system that the Revolution brought along with it; it needs to cut some human rights short in order to ensure others.

It would make sense to expect healthcare to be excellent in such a situation, but that isn’t the case. In spite of everything we handed over (our sacred rights and financial wealth) and a healthcare system which has been well-designed so that it is accessible to everyone, our public health services are awful and facilities are in a deplorable state because of a lack of funding, wage incentives, supplies and even personnel. The thing that used to fill private coffers slowly fell apart in the State’s hands, which ended up being an inefficient administrator, and it’s poor organization stands in the way of excellence.

A large number of doctors are on missions abroad (mostly doctors with the greatest experience), and even though they only receive a small part of what they are paid, that’s still a lot more than the pitiful sum they would earn here. Hospitals are in ruins with unsanitary sanitary services and a lack of the basics for any patient’s doctor’s visit or treatment. It hurts to see so much neglect.

Let me give you some examples:

My mother has been three months without her heart disease medicine because she needs a signature on her “card” and she can only get it signed by a cardiologist. We went to a great deal of effort to get an appointment for May 7th, but on Friday 4th, she was already too unbalanced and we took her to the hospital. In the 13 days she was admitted, her health recovered and luckily the doctor she had, a clinician, takes great care of his patients, which I am thankful for. She recovered and has been given another treatment which we aren’t sure she’ll be able to complete because it depends on what comes in to the pharmacy on a regular basis.

My mother is obese and there aren’t any wheelchairs or stretchers for people like her, which is why she had to walk down long corridors holding on to two people. There are two elevators, one seems to be broken forever and the other wasn’t working that day either. In such a run-down state, it gives you the jeebies going up in it anyway because the buttons don’t work properly and you have to shout up for people to send it down.

Beds in hospital wards are old, which you can’t put the brakes on and you can’t regulate the reclining feature. A lot of mattresses in bad condition. Not to mention the sheets that cover them, gruesome! Chairs and tables for visitors while disgusting, aren’t enough for every bed and newly admitted people need to be on the lookout for when people get released so they can steal them away from another cubicle, someone always left without them. What a state the bathrooms are in! I can’t even describe to you how bad they are, with foul-smelling leaks, no privacy, no water in sinks, compact… a disaster!

To end, I will just say that nurses need to ask patients (who bring their own) to lend them their thermometer or  blood pressure cuff to take everyone else’s temperature and blood pressure because they don’t have any at the hospital to do this. Next to my mother, there was an 88-year-old woman with ischemia, who needed a special need for a drip and my father had to go out on the street to get her one.

On the other hand, my wife has gallstones which torment her with pain, but it’s still not a life or death urgency so she still hasn’t been operated. She has to look after our small daughter like this. She received the diagnosis in November and she was only put on the surgeon’s operations list in January. It’s been five months now and she still isn’t anywhere near being operated. Her complementary tests have expired and she needs to do them again. When she did them, there weren’t any needles so I had to go out and find them outside. I have no words.

This is the current state of the Revolution’s main achievement. I have so many more examples from my family alone so just imagine how many disaster stories exist in the country’s everyday life. People didn’t stop calling us a medical power in vain, it would be too much.

It’s free, but it still has a high price! Mostly because of what we have had to give up in order to have it and how much we suffer when we need it. We deserve a better service and it isn’t fair to only blame the blockade. It doesn’t really have much to do with the country’s lack of supplies, trained doctors, medicine, upkeep and small systematic investments. Even more so when an extremely high percentage of qualified healthcare professionals provide services abroad and make up the main source of income for our country today (to put the icing on the cake).