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I've visited Cuba on a Canadian passport. Aside from the beautiful beaches the thing that struck me most was the desperate poverty of people living in shacks outside the 5 star resorts.

While I hesitate to predict that this change will be all for the good, I do believe that the poorest in Cuba will benefit significantly from increased trade.




I felt the same way visiting San Francisco, the abject poverty of the people downtown outside $400 a night hotels is just incredible.


It's because we don't criminalize homelessness as aggressively as other major cities and the homeless population is concentrated near downtown where the SROs and social services are located. Keep in mind that it's generally not simply poverty but mental illness or a history of abuse/violence that separates the homeless here vs. the working poor in the favelas and slums of the third world.


>> "It's because we don't criminalize homelessness as aggressively as other major cities"

I don't think that matters - the op's point still stands. Do you think criminalising homelessness solves the problem? It just (poorly) hides it. There may be a different between the 'working' poor and the mentally ill that you point out but I'd be willing to bet the mentally ill aren't left to live on the street and fend for themselves in Cuba.


I was pointing out a difference between the reasons for poverty (mental illness, etc.) between the homeless and people who live in poverty in third world countries (political/socio-economic oppression, etc.).

I don't believe in criminalizing homelessness as it's a public health issue but I would contest the opinion that it poorly hides it. Look at any thread about New Yorkers complaining about SF and count how many times they talk about how the streets of New York have so many less homeless people. Of course, they probably don't understand the reasons very well (Rudolph Giulianis war on the homeless, etc.) but it certainly seems effective at hiding it when you either lock up homeless, force them to go underground and out of sight, or buy them a bus ticket to sunny California.


I thought that was your intention. I'm interested to here your response to my second point.


I agree with you that criminalization doesn't solve any real problems, it just sweeps them under the rug. Short of wide public support and funding for an expansion of social services, housing, and in some cases institutionalization, I don't expect any solution to the problem anytime soon.


Do you think that poor social service provision is a more important factor than the the homeless being insufficiently criminalized? If you do, you should probably clarify that.


> It's because we don't criminalize homelessness as aggressively as other major cities

Yes, let's criminalize homelessness. How dare those homeless people refuse to stay in their mansions and apartments.

Do you think we should send the worst of them to Gitmo?


I read this as the commenter implying other places do criminalize the homeless more, not that criminalizing the homeless more is good or ideal. Simply pointing out that the reason you see more homeless around in SF is that it's not aggressively criminalized. Not sure why making that statement carries the implication that they should be criminalized.


The city of SF spends about $26,000/yr per homeless person ($167mm / 6,355 people).[1] It is not a money problem.

1: http://www.sfgate.com/bayarea/matier-ross/article/S-F-spendi...


From the article you linked "That's about $34 a day per homeless person"

$34*365 = $12,410.


That's only what they spend on housing, not total expenditures.


We could rent them all apartments for that much


That they could starve in comfort..


Not to mention the billions of dollars literally surrounding them.


This might have been your impression, coming straight from Canada. I visited Cuba a decade ago, having traveled in Latin America for > 1 year. I can't say that Cuba seemed to be worse off than many of these other countries.


Ahh I see how my comment could have been interpreted as meaning "everyone in Cuba lives like that." That's not what I meant. Outside of the few resorts I had access to there were always people begging and the beaches were spotted with shacks in severe disrepair. The stark contrast is what stuck with me.


This is true as well. I've seen worse conditions in both Costa Rica (a relatively successful country) and El Salvador.


exactly. The Latin America is filled with countries there people are poor and powerless and oppressed by their government and non-government organizations (criminal and drug cartels, guerrillas, left and right paramilitaries, etc...) As Cuba was an ally of USSR such policies were reasonable back then. The USSR had disappeared 23 years ago though...


>" I've seen worse conditions in both Costa Rica ... "

It depends on your definition of worse. In Cuba there was a general shortage of several basic items (toilet paper, eggs, meat... etc.) were most people (the only exception is the political class) have to face rationing and long lines. As far as I know that is inexistent in Costa Rica.


Inadequate overall wealth to supply basic needs leads to lines and rationing in socialist systems, and just pricing goods out of the reach of non-elites in basically capitalist systems, so the symptoms look a bit difference but the substance is much the same.


Except when it is not. In Venezuela we are facing similar problems and even when people have the money you can't buy what you need, not even if you are on a elite.

It has more to do with the incompetence in economic areas rather than a capacity of making wealth.


On the other hand:

- average life expectancy in Cuba is almost the same as the USA (and higher than Mexico, Belize, Bahamas, Brazil, etc.).

- literacy rate in Cuba is higher than that in the USA

- Physicians per 10,000 people: Cuba has 67, USA has 24

In the Ebola crisis, Cuba has been leading from the front.


Physicians per capita figures are misleading.

The US figure reflects very long careers; late retirements; investment in large teams of trauma specialists due to high war, car crash, and gunshot wound rates; a high percentage of women physicians working part time; and a high concentration of expensive specialists with no documentation that they improve outcomes and paid for by large federal government subsidies.

The actual amount of primary physician and general surgery time available to Americans is very low compared to other countries with similar numbers of doctors. Most countries also allow as many as half the cases administered by fully licensed doctors with 12-20 years of post-secondary schooling in the USA to be handled by nurses and pharmacists. Prescriptions for sniffles or heartburn, basic non-controlled medications, simple physical assessments, and vaccinations are handled by professionals the USA would consider nurses or pharmacists or unlicensed assistants in most first world countries. In the USA those jobs take the time of physicians.

And that is the top reason, among many other unrelated ones, that health care is so much more expensive in the USA. US doctors are fewer and have more responsibilities and thus must be paid extraordinarily to work very long hours and not retire at the usual ages or else some must go without care. It's not an accident; medical societies have blocked medical school expansion for decades until recently as the population grew.

Cuba, on the other hand, appears to be counting nurse practitioners as physicians. That's fine to do because they're highly qualified, but it makes the numbers not comparable across countries.


> It's not an accident; medical societies have blocked medical school expansion for decades until recently as the population grew.

Sort of. There are a lot of very common misconceptions around this.

The AAMC (not AMA!) limited the number of medical school students until about ten years ago, at which point they announced an explicit goal of expanding the number of graduates from medical school.

However, this doesn't mean anything in practice[0], because the bottleneck isn't the medical school graduates - it's the residency programs. As a medical school graduate, you have an MD, but you are not actually qualified to practice medicine. That requires usually four years of training (minimum), plus several more for various specialties.

These programs are costly to run, and so hospitals that offer residency programs are funded by the federal government to do so (through Medicare). The only way to expand the number of practicing physicians in the US is to skimp on quality during training (which nobody wants to do), or to increase funding through Medicare (which nobody wants to do.

> US doctors are fewer and have more responsibilities and thus must be paid extraordinarily to work very long hours and not retire at the usual ages

They also have to be paid a hefty amount to pay off massive debt. If you see an attending physician in his 30s (or even 40s), even if he's making a respectable amount of money, there's a good chance he still has a negative net worth. The level of debt of course varies by location, specialty, and quality of education, but it's rather misleading to look at an e.g. $200K/year income for a physician and compare that to the equivalent amount in the tech industry.

[0] pun not intended, but very a propos!


Thank you for adding detail.

In this case, the bureaucracy eventually overcame institutional resistance of the wealthiest professional Americans to reform of a system that limited doctors and thus vastly expanded their incomes. I expect that same government and institutional bureaucracy to eventually increase significantly the residencies, but it will move in that typical slow motion of bureaucracy eventually doing good.

When it eventually adds to our production of new doctors, it will have a bigger impact than ten Obamacares or single payer plans or HIPAAs.

The debit of American medical students is as legendary as the vast incomes of doctors, both wildly out of proportion to the rest of the first world. Hazing practices during residency are also still crazy, though much reduced after glacial bureaucratic reforms.

I don't know if there's any better idea there than to hire and appoint good administrators to plan better. A violent revolution like the one in Cuba that built a better health care system seems too extreme.


The last vaccinations I received were from the pharmacist at the drugstore.


Licensing practice is mostly at the state level (aside from certain DEA pharmacy regulations). States that promote licensing, liability, and practice regulations that encourage more pharmacists and nurse practitioners to practice more independently have much lower overall health care costs (also dental hygienists, opticians, &c).

Your pharmacist is part of a system that got your health care right this time.


yes, good points. It seems that Cuba has become something of a health resource for other countries in Latin America, where there is much less access to doctors (and NPs) than in Cuba. Middle-class people in those countries travel to Cuba for health care. At least that is picture I get when I've spoken to a bunch of people in the region over the past few years. I hear about a number of people travel to Cuba, others got to Chile, and almost no one can afford to go to US to get treated.


> others got to Chile

At the south of the continent, it is far more common to travel to Argentina, to get free health care. As Argentina has a large public health system, (that has been gradually loosing a lot of quality in the past 20 years) it's common that poor people from Bolivia, Chile and Paraguay travel and get attention for free in Argentina's public hospitals.


Not only that, but more physicians per capita isn't inherently a good thing.


Perhaps good idea for startup, medical turism..


I highly recommend reading "Guide to the Perfect Latin American Idiot" which explain how dictatorships can pick a handful of indicators and elevate them to first-world levels while still making everybody's life miserable.

[1] http://www.amazon.com/Guide-Perfect-Latin-American-Idiot/pro...


You're talking as if the dictators sit around, wondering about some sort of "SEO" to game their ranking on these lists.

The "life expectancy" figure can't be gamed, unless you out and out lie.

Here's a recent article for thought: http://www.wired.com/2010/04/cuban-health-lessons/


The indicators per se are not gamed. Instead, you select a few indicators like "Olympic medals", "life expectancy" (etc) and commit every resource of the country to them at all cost and without regard for everything else. The indicators you picked will show amazing and you can use them to justify your ideology. Pretty much like a SEO hack, they are hacking public opinion (looks like it worked on you).


I highly recommend travel to those countries so that you can observe it for your self. The picture is different than the book.


Michael Moore needs to read this book.


He's already mastered the essential strategy of selecting a handful of indicators to make your point seem right.


I'm sure he already did


> - Physicians per 10,000 people: Cuba has 67

2nd highest in the world, behind Monaco (70): http://kff.org/global-indicator/physicians/

For comparison: Sweden (38), UK (27), Japan (21), Canada (20)

Makes you wonder if that number has any significance at all. Japan has 1/3rd the number of doctors, but the highest life expectancy in the world.


Maybe there's a cause-effect going on in Japan.

They just aren't unhealthy enough to demand more doctors?


Japan has a lot of welfare fraud which inflates their life expectancy numbers. It also has a fairly low level of income inequality relative to their per capita GDP which helps things. (AKA few poor people.) And to top it off universal healthcare which significantly increases a population’s life expectancy.

Edit: Arguably the high food prices reduce obesity which is really important.


> Arguably the high food prices reduce obesity which is really important

I don't think it's the food prices, because the cheapest foods tend to be the ones that lead to obesity (among other health problems). Fast food burgers and white bread are not expensive here in Japan, but fresh fruits and vegetables are.

I think there are many factors, but the pretty great universal health care system has to be a big one. As a working adult in Tokyo, I receive tons of preventative care and thorough annual check ups. It's cheap, and virtually all health care for my kids is completely free until they turn 15.

The lack of equal access to health care in the USA is almost certainly a reason that poor people die 5 years earlier than affluent people[1]. I would guess good access to health care is a big reason that Cuba does so well on that front, despite its obvious economic obstacles.

[1]: http://news.rice.edu/2012/06/21/poorer-us-citizens-live-five...


my experience in Japan is they eat more vegetables more often. I think this helps in so many ways. They also eat too much salt, smoke too much and probably work too many hours, but apparently the vegetables and great tea are doing something right.


You're focusing too much on Japan. Japan was just an example. This number that Cuba excels on has little relation to health. So what is the point that Cuba has this great number? It's just a number.

Canada, which has even fewer physicians, has a life expectancy only 2 years less than Japan.


Ehh, just pointing out that having more doctors is not that important from a public heath perspective. Plenty of people in the US for example only really see/need a doctor at birth for vaccinations and then suddenly die in there late 80's or early 90's. For much the same reasons that some people actually lived into there late 90's 2000+ years ago.

If nothing breaks there is little need to fix anything.


Comparing statistics from small, homogeneous populations to statistics from larger, heterogeneous populations is fraught with peril. Doubly so for metrics on education and health. (I like to call this the Scandinavian Fallacy)

As engineers we would never compare uptime statistics from a small, niche startup serving a couple thousand people to uptime statistics from, say, Google. Why do we immediately ignore these principles outside of engineering?

Edit: wording


I'd expect the uptime of Google to be better than the uptime of a niche startup.


small, niche startups usually have poor uptime on their services. we commend them if they have a year up (hell, if they still exist after a year), but criticize Google for being down once every few years.

therefore, if you want to bring in the analogy of startups and Google, it should be even more impressive that small countries (viz. people in small countries, viz. Cuba) live longer than Google (viz. people in large countries, viz. United States).


No, because the specific topics at hand are not comparable (service uptime and, say, physicians per capita). The analogy was meant only to illustrate the fact that you cannot (should not) directly compare statistics from such different entities without attempting to control for the variables.


What does the heterogeneous populations of the US have to do with it? Maybe when it comes to life expectancy you're right, because genetics is a large factor in that. But when it comes to literacy rate and the proportion of physicians that's entirely down to government policy.

Do you really think the US couldn't beat Cuba on those metrics if they decided spending money on those topics was more important than spending money on the military?


I believe the point that is being made is that the US was designed from the outset with the idea that diverse factions compete against factions, and that was the only way such a large and varied democracy could work. See Federalist 10.

Citizens of the US have wildly varied views about what it means to be a good American, and we often have greater cohesion to groups such as race or state, etc. Just about the only thing we do agree upon is when there is an existential threat to the country, hence military growth over time.

Cuba or Norway have much less divided societies to govern, and Cuba's leadership is so small that it can focus on specific issues in a way US politics cannot.


Sure, that's a factor in US politics. I'm just saying that has nothing to do with having a heterogeneous population as the parent was claiming.

The parent was comparing the proportion of physicians in Cuba v.s. the US and claiming that the US couldn't match Cuba because of its heterogeneous population.

Now if you look at the WHO report on density of physicians[1] you see first-wold countries like Japan and Canada ranking below the US on the number of physicians per-capita.

I think numbers like these have a lot more to do with how the health care system is structured than the sort of population you have. E.g. maybe nurses in Japan and Canad have a bigger role in health care than the US.

1. http://www.who.int/gho/health_workforce/physicians_density/e...


Government policy is heavily affected by cultural heterogeneity.


> Comparing statistics from small, homogeneous populations

Cuba is small. Does it have an homogeneous population?

No, amigo!


Since when has Cuba had a homogeneous population?


I really like that term. Is that your own?


Furthermore, as Cuba lacks any agrochemicals, almost of their food production is organic, proving that agrochemicals are completely unnecessary.


Huh? I'm a big proponent of eliminating agrochemicals, but you've set up a huge straw man here: No one is arguing that agrochemicals are "necessary" in the sense that agriculture is impossible without it (indeed, millennia of experience prove otherwise). Rather, the rationale is that they allow us to increase productivity for the same input of acreage and man-hours.

I'm not saying that agrochemical proponents are right (I've heard that crop rotation is as good or better than synthetic fertilizers, though it's hard to argue against the labor efficiencies of huge tractors and lots of pest/herbicides), but the simple fact that agriculture is possible without agrochemicals doesn't disprove the argument that it might be better with them.


It's the same in India and other countries I've visited. Trade alone won't help. I realize India and Cuba are apples and oranges, but my point is that significant trade doesn't necessarily trickle down to the poorest.

That said, I do hope it does help some people in Cuba who have fallen victim to unnecessary stresses caused by the embargo.


> my point is that significant trade doesn't necessarily trickle down to the poorest

Nothing trickles down to the poorest, spontaneously, almost anywhere in the world.


That's absolutely not true. People live better across the world today than they lived 50 or even 20 years ago. I read statistics somewhere that people in some obscure African country today (can't recall the name) have a living standards of Finland of 20 years ago.

Think about this: the major health issue nowadays across the world is obesity, not hunger.


That's practically impossible.

Finland in 1994 had a very high standard of living. Their GDP per capita in '94 was equivalent to roughly $40,000 in today's dollar.

Maybe Finland of 1914. Nigeria's GDP per capita today, for example, is $3,000.


"the average Botswanan today earns more than the average citizen of Finland did in 1955."

http://www.davidbahnsen.com/index.php/2013/11/10/the-rationa...

I read Scott Ridley's book. And I recommend it highly.


You're talking about the longest-term possible scale, which is called progress.

We were talking about everything below that scale.


The key word was "spontaneously". You have to make sure the money gets there.


Other Caribbean countries are like that without embargoes though. The first time I went to the dominican I saw all kinds of shacks made out of whatever they could fine/steal. The second time they built a new highway that avoided this and basically you ran through fields. I was disappointed because I wanted to show my family the real DR.


Caribbean countries are typical areas that lost their economic identity and are now basically overpopulated. The reasons people moved (or rather were dragged) there, are no more; and they would probably do fine if only they could go back to pre-1500 population levels (or thereabout) and just live off tourism. But they can't, so they will keep struggling to find new economic identities.

The Cuban revolution could ignore this for 30 years, because of their ties with the USSR and emphasis on redistribution of existing resources; and then the old problems came back once the USSR crumbled. Now they are trying to build an economic identity around healthcare and education, and without the embargo (which stops technology from entering the country) they might actually succeed in ways that will hopefully inspire other islands.


Cuba is also much bigger than the typical Caribbean country. They could have an actual diversified economy eventually.


I visited Cuba a month or so ago and one thing that struck me was the way a general lack of wealth didn't manifest it's self in a way in you'd associate with impoverished people in developed countries. The quality of the health and education systems are tangible and one of the biggest points of contention from the people I spoke to seemed to be the lack of internet.


>"The quality of the health and education systems are tangible "

I will be very careful with that statement. Cuba government is very good at propaganda and making people to think that.

In Venezuela we have a first hand experience about that since there is a lot of "collaboration" between both countries (basically oil in exchange of medical and education services). The result is a lot of cases about medical malpractices.

Also education is very opinionated with a strong emphasis in political indoctrination.


> Aside from the beautiful beaches the thing that struck me most was the desperate poverty of people living in shacks outside the 5 star resorts.

This is, unfortunately, not a problem unique to Cuba. I had this very same reaction when my wife and I vacationed in Jamaica. To get to this lush, tropical all-inclusive resort, you spend two hours riding in a minibus across bumpy barely-paved roads through some of the most abject poverty I've witnessed anywhere. It was very difficult to reconcile the insulated world of endless food and finely manicured lawns inside the resort with the world you witness just outside its gates.


I'm also not sure whether the flooding of subsidized US agricultural products will benefit the poorest in Cuba. Take Haiti for instance that went from self sufficiency to a net importer of rice when local producers can't compete with US subsidies.


How was that for people who buy food, though? You have to look at the whole system, not just at one group that might lose out.


That's theoretically a good thing. If it costs less to eat rice from the US, then that capital can be put to use in other ways. The problem can be an existing large imbalance in income producing resources. If rice agriculture is the only thing available, then wealth imbalance can/will increase and power dynamics start looking like oil or natural resource rich countries.

If, on the other hand, people are able to eek out improved standards of living, in general, with savings on food costs, they can increase health and education spending and get into a virtuous cycle of increased living standards.

There's a bigger context necessary.


There have been good things happening in Cuba before this announcement such as issuing private business licenses and allowing people to sell their homes (instead of the old bartering system).


Same thing in any of the big Caribbean islands: Jamaica, DR / Haiti.

Trade with the US for DR has not helped much - US dumps Agro products (Powdered milk, meat) and bans Sugar.

http://www.census.gov/foreign-trade/balance/c2470.html#2014


When you start from such a low base, there is enormous room for growth. The question is what can they export? Cigars? Medical personnel?


> Medical personnel?

Cuba actually has an incredible socialized medicine healthcare system, and the US embargo specifically carves out an exception for cancer pharmaceuticals developed and manufactured there. Its not that far fetched that you would see medical tourism take off from Florida with its vast retiree population.

If I were in the travel business in Florida, I'd start advertising now to get your name out there, and fly to Havana to have a conversation with Raúl Castro about how much yearly revenue you could be bringing in (all in USD I might add). About $39 billion/year is spent in Florida on Medicare; taking only a small piece of that is an incredible proposition for a country the size of Cuba.


I was thinking visas for Cuban doctors and nurses to come here too.


The greatness of Cuban health care system is an urban myth, just like Jackalope.


http://www.wired.com/2010/04/cuban-health-lessons/

"Despite a 50-year trade embargo by the United States and a post-Soviet collapse in international support, the impoverished nation has developed a world-class health care system. Average life expectancy is 77.5 years, compared to 78.1 years in the United States, and infant and child mortality rates match or beat our own. There’s one doctor for every 170 people, more than twice the per-capita U.S. average.

Not everything is perfect in Cuba. There are shortages of medicines, and the best care is reserved for elites. But it’s still a powerful feat. “In Cuba, a little over $300 per person is spent on health care each year. In the U.S., we’re spending over $7,000 per person,” said Drain, co-author of Caring for the World and an essay published April 29 in Science. “They’re able to achieve great health outcomes on a modest budget.”"


"There are shortages of medicines, and the best care is reserved for elites."

Nice healthcare system!


Please explain how that's any different than the US when you can't afford medicine or care? It makes little difference whether the shortage is due to no physical supply vs not being able to afford it. If you can't get healthcare, you can't get it.

http://www.nerdwallet.com/blog/health/2014/03/26/medical-ban...

“In 2013 over 20% of American adults are struggling to pay their medical bills, and three in five bankruptcies will be due to medical bills. While we are quick to blame debt on poor savings and bad spending habits, our study emphasizes the burden of health costs causing widespread indebtedness. Medical bills can completely overwhelm a family when illness strikes,” says Christina LaMontagne, VP of Health at NerdWallet. “Furthermore, 25 million people hesitate to take their medications in order to control their medical costs. Unfortunately this can lead to even worse financial outcomes as preventative treatments are not rendered and patients end up using expensive ambulance and ER care as their health worsens.”


I am an anesthesiologist. I worked in some of the best hospitals in the country in residency (UCSF and Harvard's BWH), and I worked in Detroit and I work now in a small Catholic hospital. And I can tell you that quality of care poor get is the same as rich ones get.

Then I also grew up in Soviet Union, where supposedly great healthcare was developed. And I can tell you they had a horrible health care like they have it in Cuba today.

If Cuban health care is so great, where is their great health research and studies? When did they publish the last time in Lancet on in NEJM? Where is that?


And I can tell you that quality of care poor get is the same as rich ones get.

That's because you're an anesthesiologist, and you see the acute cases which have already been admitted to the hospital. Poor people don't receive comparable long-term care. They don't receive comparable followup care after procedures. They can't afford lifesaving medication, they can't afford physical therapy, and they can't afford psychiatric care. They're denied for transplants, and many surgeons won't accept them as patients because their recovery stats are so much lower due to the aforementioned lack of followup.

All of this, without even mentioning the increasing number of specialty surgeons that operate on a cash-only basis, or the poor who don't go to the doctor simply because they cannot afford to. There's no comparison between the care that the rich and poor receive in this country, except possibly once they're unconscious in the OR.


> If Cuban health care is so great, where is their great health research and studies? When did they publish the last time in Lancet on in NEJM? Where is that?

Cuba invests heavily in cancer research.

"Even in times of economic hardship, the Cuban Government has remained constant in its political and financial support for biotechnology. In the last 20 years it invested around one billion US dollars in research and development. Today, the Cuban biotech industry holds around 1200 international patents and markets pharmaceutical products and vaccines in more than 50 countries. Exports are soaring and generate yearly revenues of several hundred million dollars."

http://www.who.int/features/2013/cuba_biotechnology/en/ http://investmentwatchblog.com/cuba-develops-anti-cancer-tre...

http://www.medicalnewstoday.com/articles/255830.php


What does getting basic primary care to the population (vaccinations, preventive care, well baby care) have to do with how many research papers get written?

I have worked in one of the top medical schools in the US, with world-class researchers, and know that there is very little there that is directly applicable to a population of rural farmers and impoverished city dwellers.


[flagged]


Why repeat your comment from above word for word, when the facts clearly do not support your conclusion?

https://news.ycombinator.com/item?id=8764077


My conclusion is correct. Your conclusion comes from a propaganda perpetuated by dictators and their left-leaning sympathizers.

You can't describe Cuba's state of the art modern medicine by repeating a mantra that Cuba has more doctors, or Cuba delivers immunizations, etc etc.

When your grandma falls in the West and has a syncopal episode, she will get a full work up in the hospital. That includes a CT or MRI scan, Holter, maybe even cardiac EP study, pacemaker, and maybe cardiac ablation, etc etc.

The evidence is clear: Cuba does not and never had anything resembling a great health care system.


> The evidence is clear: Cuba does not and never had anything resembling a great health care system.

I'm sorry you're unable to digest facts.


As opposed to the U.S., where the best care is reserved for the people who can afford to pay for it out of pocket.

Elites, in other words.


The US system -- despite being the mist expensive per capita in the world -- has both of those features, too; sure, the rationing method in the USA is different (rather than a formal elite with special access, we have pay-to-recieve and an elite defined by the ability to pay -- but there's still limited supply and the best care going only to the elite.



One of the lasting myths emerging from American rhetoric is that Cuba is starting from a low base. In fact the per capita GDP (as well as quality of life) is approximately on par with Panama and far exceeds the Dominican Republic, Haiti, Jamaica, and Nicaragua. Tourism will remain the major source of foreign currency, but I think this change will lead to further development in pharmaceuticals and telecom.


Cubans enjoy greater economic and medical security under socialism than their counterparts in capitalist neighboring countries, even without subsidies from Russia and even with a strict embargo with the US.

The country is surprisingly politically free for a tiny nation facing an existential threat from a hostile super power that has invaded, attempted to assassinate it's leader, and funded militants dead set on violent revolution for decades.

American leadership immediately resorted to torture and illegal domestic surveillance when faced with the loss of two skyscrapers and 3,000 lives from an enemy that is more like an annoying gnat than an existential threat.

Cuba is a success story for socialism, and that is why US policy has sought to punish it, and to make it fail. The US did not want a successful socialist nation in it's sphere of influence, it gives the other nations subject to the Monroe doctrine ideas.


> The country is surprisingly politically free for a tiny nation facing an existential threat from a hostile super power that has invaded, attempted to assassinate it's leader, and funded militants dead set on violent revolution for decades.

Despite the fact that I spend much of my working life writing "if" statements, I am going to ignore everything after the sixth word of this sentence and express disbelief at how you can claim that Cubans are politically free.


What everyone thought I meant:

if cubaFree

> True

What I meant:

Considering how much political freedom was jettisoned by the US after 9/11, I am amazed that Cuba sits as close to the free side of the freedom spectrum as it does considering its been under existential threat for five decades.

Cuba is not a completely free and open society, and I don't claim to be able to pinpoint with certainty where on the freedom spectrum it sits exactly. I have never been there, as a US citizen I have not been free to travel there.

We are not free to go see for ourselves, we just echo the dominant ideology.

From the reading I have done I know that Cuba is more free than I was led to believe in school. It is not an Orwellian state.

I cite a comment from this thread on the topic:

> When I was there I was struck by people saying how hard it was and how they had to get by on about US$2 a week - this was a while back now.

Cubans are free to complain, I've heard it's a national past time.

They are free to engage in politics within socialism.

They are not free to oppose socialism and work to end it.

Americans have never been free to undermine capitalism. Anarchist/Marxist revolutionaries in the US have always been monitored, harassed, imprisoned and sometimes killed. See the history of the FBI, the Palmer raids, the Wobblies, Joe McCarthy, the black panthers, SDS, etc...

The US has given the Cuban government justification to curtail rights. This justification would not exist if the US would have respected Cuban sovereignty and not tried to murder it's leader, invade and destabilize.

How do you tell the difference between a sincere citizen activist and a foreign spy when the most powerful empire the world has known is actively trying to sabotage your government?

In the US in the years after 9/11 we heard a dire meme repeated over and over that went something like "If we get hit again it will be martial law" and we mostly accepted that as inevitable.

I find the finger pointing at Cuba to be unfair and lacking historical context.


Cuba is a success story for socialism, and that is why US policy has sought to punish it, and to make it fail.

I don't think your argument is supported by any of the facts.[1]

[1]http://en.wikipedia.org/wiki/Human_rights_in_Cuba#Contempora...


Indeed, I don't think the communist government would remain in power long if they ever had a free election. When I was there I was struck by people saying how hard it was and how they had to get by on about US$2 a week - this was a while back now.


He was making an economic argument, not a political rights argument.

How come nobody hit the ceiling when we didn't close our embassy with China today?


His economic argument is just as wrong as a political argument would have been: Cuba is a complete failure economically and has been for the last 50 years.

Cuba is third world poor. A country where the average person earns $300 to $500 per month, is a slave pen. State sponsored slavery is the only way you can repress people to such an extreme extent as to hold their standard of living that low for 50 years.

Given there has never been an economically successful Socialist nation in world history, it makes perfect sense that Cuba would be a failure just like all the rest.


In 2007, the life expectancies at birth were as follows (World Bank data): Cuba, 78.26 years; Latin America and Caribbean, 73.13 years; United States, 77.99 years.[24]

The mortality rates for children under five in 2007 were as follows (World Bank): Cuba, 6.5; Latin America and Caribbean, 26.37; United States, 7.60;

http://en.wikipedia.org/wiki/Health_care_in_Cuba#Comparison_...

You are right, Cuba is third world poor and they still beat their capitalist neighbors and even the wealthy and powerful US in life expectancy and infant mortality.

Cuba does so much with so little because of the radical idea that we are all in this together. Cuba spends $300 per citizen on health care, the US spends $7000. I spent $5000 personally just this year on health care and I'm young and healthy.

Those in capitalist countries are getting fleeced, and Cuba shows us that. If Cuban socialism didn't exist I couldn't point out these facts, and that is why Cuban socialism was such a threat and why the US has acted so insecure towards the tiny island's revolution.

I don't want the US to adopt the Cuban system, I just believe we had no right to violate their sovereignty, and having different political systems out there lets us have a sort of A/B test for politics. I don't believe a global political and economic monoculture is healthy.

As an American I wouldn't want to trade places at birth with a Cuban, but if I had the choice between being born to asset-less parents in Jamaica or asset-less parents in Cuba, I know I would be healthier, more materially secure and far safer from violent crime in Cuba. I also would have a much greater chance of not dying during my birth.


Compared to their neighbors? After adjusting for a worldwide-unique embargo?

Honestly, I'm not into communism and am very surprised that their figures are as good as they are. It's dumbfounding.'

I guess it's more a statement of how hard it is to come up from the bottom whatever your system is. Russia and China both showed great results in their first couple 5-year plans before communism petered out and didn't deliver further gains.


If Cuba is such a success story, why do they have to force their people to stay and why do people risk their lives to escape and defect to the United States anyway?


This has to be a troll post. Cuba has operated under a violent, murderous, strict dictatorship for five decades. The exact opposite of politically free. Fidel was never afraid to murder his competition, or anyone that dared to oppose him in fact. If your country hasn't seen a leadership change since the 1950s, and you have zero freedom of speech or press, what you have is not freedom.


>Cuba is a success story for socialism

With that type of success who needs failure.


Sugar, shellfish, citrus and coffee. Medical products and tobacco are small parts of what they export. They also export nickel and cobalt which have generated more than $2B/yr in some years.


It would be easy to increase tourism which would bring in foreign currency in a similar manner to exports. Just dropping the restrictions on US tourists visiting and on Cuban locals being able to run shops, restaurants and lodgings would probably pretty much double GNP.


Cane sugar, nickel (at least, looking at http://en.m.wikipedia.org/wiki/Cuba#/image/File:Tree_map_exp...) and tourism. Until the Cuban Revolution, Las Vegas had tough competition from Havana (http://petermoruzzi.com/2011/10/31/family-feud-havana-vs-las...)


Baseball players.


Beautiful women.


It's because socialism works!!!




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