Cuban Health Care: Benefits Without Costs

Abstract

The suggestion by P. K. Drain and M. Barry (“Fifty years of U.S. embargo: Cuba's health outcomes and lessons,” Policy Forum, 30 April, p. [572][1]) that Cuba can provide the United States with the know-how to provide high-quality care at low cost is suspect. Cuba's system is specific to a small, centrally controlled country. This is not necessarily translatable to a large, heterogeneous nation profoundly focused on individual liberties, including the personal freedom to eschew preventive care. Many countries can provide medicine and other medical technologies at lower cost than the United States. Missing is the fact that these low-cost generics are based on discoveries mostly made in the United States and a handful of other developed nations. The United States bears the substantial burden of direct development costs as well as the general costs for development of an educational system and an infrastructure that has yielded an astounding array of medical advances over the past several decades. Others, such as Cuba, reap the benefits while avoiding most of the costs. Perhaps the authors would like to speculate on what the quality of health care in Cuba would be were it only based on discoveries and medical advances originating in Cuba. [1]: /lookup/doi/10.1126/science.1189680