The Cuban healthcare myth

Matt Gillow

September 16, 2019

On the 9 September, the Adam Smith Institute (ASI) welcomed Cuban journalist and academic, Boris Gonzalez Arenas, for a conversation about his homeland. Though much admired by socialists, the Castro regime has held back progress in Cuba and cracked down on freedoms that we in the UK take for granted. Arenas’s talk at the ASI had to be delivered via Skype, as the regime refused to allow him to travel to the UK.

Cuba is one of the most naturally beautiful countries in the world, with a rich history. However, to visit Cuba is to be struck by the sadness of wasted potential, of a country seemingly set up to succeed but one that’s being held back by the all too predictable results of a Marxist government. Cubans clearly feel this too – they are the seventh-largest immigrant group in the US, with over a million having crossed waters to make a better life for themselves and their families. The population of Cuba itself is a mere 11.5 million.

When Fidel Castro died in 2016, we had to sit through the usual parade of apologia that greets the death of any socialist tyrant. 

“Well, yes, the internment of sexual minorities in concentration camps was definitely a mistake. And the secret police thing, that’s just not on. You can’t be doing that. But let’s look at the bigger picture here. Cubans have free access to some of the best healthcare in the world!”

The myth of exceptional Cuban healthcare, and it is a myth, is a post hoc justification of support for a vile regime that has oppressed and tortured its people for decades, to the applause or complicit silence from large parts of the western left. Unable to point to any genuine accomplishments in Cuba, they instead resort to promoting this untruth.

According to Hadley Heath Manning, the perception of Cuban healthcare being high quality is primarily a result of Castro propaganda. The regime sends its best doctors around the world responding to international crises, where they talk up their homeland’s healthcare system. Of course, there are some areas in which Cuba performs well. It has an undeniably excellent infant mortality rate, although this is somewhat marred by the fact that women with “risky” pregnancies are strongly encouraged to have abortions by the state. 

Boris Gonzales Arenas explained to the ASI that the government in Cuba has to hide the real situation in their public health programmes. There has been a significant drop in the number of hospitals open to the public, he said, and it is routine for hospital staff to steal medicines and sell them on the black market.

Cuba’s healthcare system is a two-tier model. Dr Jaime Suchlicki of the University of Miami’s Institute for Cuban and Cuban-American Studies explains this. The first is for foreigners who come to Cuba as medical tourists – they pay in hard currency and are treated to the quality medical treatment they would expect in Europe or North America. These facilities, which cater only to medical tourists, are especially renowned for their work in cosmetic surgery. Members of the regime can also expect to receive this level of care.

And then there’s the real system, or what remains of it. Dr Suchlicki recounts only some of the many testimonies on Cuban healthcare, but he paints a bleak picture. Unsanitary conditions, crumbling facilities, and hospitals where patients are expected to bring their own bed sheets, soap, towels, food, toilet paper, and even light bulbs. Katherine Hirschfeld of the University of Oklahoma, notes a similarly disturbing situation from her nine-month research trip to Cuba: “A number of people complained to me informally that their doctors were unhelpful, that the best clinics and hospitals only served political elites and that scarce medical supplies were often stolen from hospitals and sold on the black market.”

Cuban healthcare may be less terrible than other public services in the country, but it is certainly not a model for the western world to seek to replicate. A health system that discourages pregnant women from making their own choices – and a regime that tries to make the choice for them – about their own bodies, requires patients to work to make the facilities inhabitable, and rejects out of hand the concept of consumer choice is a warning sign, not something to cheer.

Orwell once wrote of the Marxist-Leninist worldview that “you have to break some eggs to make an omelette”. Displeased with this rationalisation of Soviet atrocity, Orwell reportedly asked: “Where is the omelette?” Cuban healthcare, whatever Castro and his useful idiots might want you to believe, is no omelette.

This article was originally published on the ASI blog.


  • Matt Gillow

    Matt Gillow is co-founder of 1828 and communications and events manager at the British Foreign Policy Group.

Written by Matt Gillow

Matt Gillow is co-founder of 1828 and communications and events manager at the British Foreign Policy Group.


Capitalism and freedom are under attack. If you support 1828’s work, help us champion freedom by donating here.

Keep Reading



Sign up today to receive exclusive insights