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Is Cuban public health being sacrificed for the benefit of the military's businesses?

The Cuban State invests 57 times more in Tourism than in Health. DIARIO DE CUBA talked about this with economists Emilio Morales, Rafaela Cruz, Elías Amor, Omar Everleny Pérez Villanueva, and the sociologist Elaine Acosta.

A hotel being built in Havana.
A hotel being built in Havana. Diario de Cuba

In early September, when Cuba had been reporting dreadful Covid-19 pandemic figures for at least two months, and the health system was already overwhelmed, the state's National Office of Statistics and Information (ONEI) recognized that the island's authorities had invested 57 times more in Tourism than in Health in the last six-months.

Specifically, Business Services, Real Estate and Rentals (a category encompassing Tourism) accounted for 45.5% of the state's total investments, compared to just 3.1% dedicated to Agriculture, 0.8% to Public Health, and 0.6% to Science and Innovation.

The figures are shocking, especially at a time when the tourism market is practically at a standstill, but the construction of hotels has never stopped in Cuba, even while hospitals have been unable to respond to the demands of the pandemic, and the shutdown of the country's only oxygen-producing plant caused yet-to-be-determined number of deaths.

Faced with such a situation, DIARIO DE CUBA asked the economists Emilio Morales, Rafaela Cruz, Elías Amor and Omar Everleny Pérez Villanueva, as well as the sociologist Elaine Acosta , a question: is the Cuban government mortgaging the future of public health for the benefit of the military, which controls tourism?

A lack of transparency, political decisions and an absent state

In the opinion of Emilio Morales, the president of the Havana Consulting Group, the extreme difference between tourism and health investments is due "to the lack of transparency regarding how the country's finances are managed."

"It is obvious that this dramatic disparity in the investments carried out in the aforementioned sectors of the economy is beyond the control of the Government itself, which indicates that the criminal group that controls Cuba handles the country's financial capital however it deems fit, in its own interest," the economist said.

Morales adds that a government "with a little common sense and social responsibility would have used the funds generated by the export of medical services to control and eradicate the Covid-19 pandemic as soon as possible, to stabilize the country and stoke the economy , as dozens of countries have done, not only in the first world, but also in the third world, such as Uruguay, the Dominican Republic, Chile and Costa Rica, to name several examples in the region."

He also believes that, with the decline in remittances sent from abroad, the regime has used the money from the export of medical services to build more hotels.

Omar Everleny Pérez Villanueva, a PhD in Economics: "it is nothing new in 2021 that in the structure of investments the highest percentage is in real estate and rental activities," which has been happening for several years.

In his opinion, this structure "was previously understandable" due to the “need to bolster hotels in the capital, which had lagged behind, especially with regards to five-star accommodations, and in the main tourism hubs, such as Varadero, Cayo Santa María, Cayo Coco and Cayo Guillermo."

"In a pandemic situation such as that of Covid-19, some of these projects should have been stopped, to improve the country's Public Health facilities," Everleny said.

"Although the authorities in this area have stated that the projects were already authorized, that they had the financial resources for these activities, and there was a lot of equipment already contracted, we know that this must not have been the case, because tourism collapsed worldwide," he says.

DIARIO DE CUBA analyst Rafaela Cruz agrees that "the tremendous difference between investments in the real estate sector —which includes Tourism and related businesses— and what is invested in Health, has been a fact for more than a decade." In her opinion "the reason for this is not economic, but political, because in Cuba "those who handle the country's money are not accountable, nor are the people represented in any economic decision-making body."

According to Elías Amor, president of the Partido Liberal Cubano, the difference is due to political decisions: "Investment in Cuba does not conform to procedures based on expected benefits and costs. Rather, it is the result of decisions by Communist central planning bodies, which fail over and over again because they don't take into account the fundamentals of wealth, accumulation, and investment motivation."

Cuban sociologist Elaine Acosta, a PhD in International and Intercultural Studies at the University of Deusto, Bilbao, noted that the social impact of this economic policy "is devastating in terms of health care and the quality of life for the Cuban people in general, and is poised to continue."

Acosta also pointed out that "the distribution of state investment for the year 2021 confirms the trend of the State's retreat from social protection and a transfer of care and health care responsibilities to families."

"The so-called Ordering Task, the cuts in subsidized products, the decline in the quality of protection services, the resources transferred through social policy (health, education, social assistance, etc.), and the decrease in social spending has been aggravating poverty and marginalization in neighborhoods and social groups that are finding it even more difficult to access social welfare benefits," the sociologist stated.

"The state's investments do not reflect any effort to address and reverse these problems. As a result, we can only expect a worsening of the population's material and living conditions, with a greater impact on some groups than others."

Where does the money from the "medical missions" go?

Despite the fact that tourism is one of the main sources of revenue for the Government, the allocation of these economic resources is not publicly reported on the island, Elías Amor observes.

But the profits from tourism are not as great as one might think, because the industry is not well managed, and the profits are shared with foreign partners, points out Emilio Morales.

"Therefore, the capital that remains to invest is very little, compared to the millions that have been invested in recent years. Thus, the question to ask is: where did the tourism industry's investment capital come from, used to finance dozens of hotels, when the industry itself is not capable of generating that capital used in the last four years?" Morales says.

In that sense, Pérez Villanueva states that it is very difficult to know what the investments with money from Tourism were; though the Statistical Yearbook indicates that part of the country's resources were spent on imports, it does not specify where they were from.

The centralization of expenditures, Rafaela Cruz's view: "is the fundamental cause of the misallocation of resources, and their opacity. For example, the transfers received from the USSR and Venezuela disappeared into projects that nobody remembers."

The Cuban regime justifies the exploitation of health professionals on its "medical missions," seizing 75% of the salaries paid by the countries to which they are sent, claiming that this money is used to maintain the island's health system, but in recent years the country's hospitals have been deteriorating due to a lack of infrastructure and resources.

In this regard, Emilio Morales asserts that, despite the fact that the exportation of professional services is the state's largest source of revenue, "that capital has, obviously, been going elsewhere for a long time."

"The Cuban health system's sudden collapse is proof of poor investment management in this sector, despite being that which contributes the most revenue to the national economy. This is more incontrovertible proof of the country's scant financial transparency, and the fact that it is managed by a criminal group controlling a submissive government," he adds.

Pérez Villanueva believes  that "resources have  been invested in Health, especially the purchase of raw materials to produce medicines, and certain medical devices, and the building of plants that produce vaccines and medicines," but the Covid pandemic -19 "revealed many deficiencies in the country's medical services for the people, such as poor hospital conditions, the need for transportation, like ambulances, and gurneys, among other things."

"You don’t need data to appreciate the scant investment in Health in the country," says Rafaela Cruz when asked about it.

The truth is that Cuba's spending on Public Health is high in relation to other countries; keep in mind that, even though they are sorely underpaid, Cuba is the country with the most doctors per inhabitant in the world. However, the country's supplies, equipment, material for the repair of hospitals, means of transport, medicines ... all this must be purchased, because practically nothing is produced here, and the result is that any Cuban feels the decline just by entering one of the hospitals for the people. The clinics for leaders and foreigners are another story," he adds.

The oldest and the poorest pay the price

In this situation the plight of seniors is particularly worrisome; in a country where pensions barely allow seniors to buy medicines, seniors are frequent users of the health system.

In this regard, Elaine Acosta believes that: "in the midst of a health crisis scenario, combined with the multiple crises that Cuban society is enduring, this state investment policy will only exacerbate poverty and social inequalities, worsening the patterns of vulnerability that have already taken shape in Cuba in which older people, especially those who live alone or do not receive remittances, are among the most affected groups."

"Faced with the challenges that the accelerated aging of the population poses in Cuba, plus the challenges that the pandemic has imposed, a growing and sustainable investment in health and social protection for the elderly would be required," but "more resources are still being allocated to pediatrics than to geriatrics or gerontology."

Senior citizens, those least able to emigrate, and those who have dedicated their entire lives to the regime's political project, are now the most vulnerable. For them, "access to food and medicine is especially difficult," while "mental health conditions are worsening, due to the even greater isolation they must undergo during the pandemic," the specialist explained.

Does Tourism merit sacrifice by the whole country?

Thus, without tourism, and with a pandemic that has left almost 7,500 dead in the country, why do the authorities continue to allocate so much to hotels?

For Morales, the only possible explanation is that  "the population's health is not a priority for the government, but satisfying the financial ambitions of the criminal group that has taken over the country is."

"They are preparing the ‘financial piñata’ that is coming, which will have the tourist industry as one of the most profitable when they start to sell the country," says the economist, who describes the government's management as "a great financial scam that has been carried out with total impunity, has cost the Cuban population thousands of lives, and has plunged an entire country into total misery. "

"All the money that is generated by the contracts for medical and paramedical personnel abroad goes to the Banco Financiero Internacional S.A. (BFI). And the man who controls that bank is none other than Luis Alberto Rodríguez López-Callejas," says Morales.

"Nothing happens at that bank without his authorization." If one wants to identify someone responsible for all this, it is him. We must also add President Díaz-Canel and the Economy Minister, Alejandro Gil, for their ineptitude, inability to do their jobs, and for not demanding the financial transparency that the country requires for its administration and development," Morales concludes.

"It is a lie that Tourism is the best possible investment in Cuba," says Rafaela Cruz. The island, "for decades has received thousands of investors to do business, even offering to put up all the capital, but the Government has rejected them all, barely giving explanations."

"Tourism is the investment that is best for the government, but not the country. As long as there is no freedom to invest directly on the island, we simply will not know what the most profitable investments are. We will only know those that are most advantageous for those in power," concluded Cruz.

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