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Public Health

Is Cuba planning on a Russian-style privatization of its health system?

A sector of the Cuban population, especially those over 50, has for years accepted the lack of freedom entailed by Communism in exchange for 'guaranteed health and education.' But what about now?

A pharmacy without medicines in Havana.
A pharmacy without medicines in Havana. Diario de Cuba

Strange things are happening in Cuba. They have just granted authorization to a MIPYME (TaTamanía) for doctors, nurses and therapists to set up a private business taking care of the elderly. And Havana has not reacted hostilely to the announcement of a private business (Horus Intellicare Solutions) to provide telemedicine services in Cuban territory from the United States, where the community of exiles will pay for the medical attention for their family members and friends on the island.

What is the reason for the regime's silence and tolerance of these developments while new and stricter measures are being devised against the exodus of doctors and nurses from the public health system?

The Cuba Siglo 21 think tank informed us last month that GAESA's oligarchs in Cuba are inclined to copying the economic system of Russia's mafia-controlled state. Unfortunately, this forecast was validated by an official Russian-Cuban announcement that Cuba would proceed with a general overhaul of its economic system, with Moscow's advice and supervision. While that is worrisome, what was happening with the Cuban health system, before this announcement was made, was already a cause for concern.

According to official figures, in Cuba the number of hospitals fell 32% from 2008 to 2021. Investments in luxury hotels, however, have for years surpassed those made in the Public Health sector, by billions of dollars. In just five years, from 2017 to 2021, public health and social assistance received 1.29% of investments, while "business services, real estate and rental activities" accounted for 50.48% of total investments. It is no coincidence that the poor hygiene at hospitals causes infections and deaths each year, the most recent being those of 10 newborns at a maternal hospital.

A sector of the Cuban population, especially those over 50, has for years accepted the lack of freedom entailed by Communism in exchange for "guaranteed health and education." But in the 2021 Covid-19 pandemic Cubans faced the cruel reality that the public health system is a mirage. Patients have to bring to hospitals not only sheets and towels, but also everything from sutures for operations to serums and antibiotics, and all this comes from the community of exiles, whether it is products, or through remittances to acquire them on the black market.

What exists today in Cuba is something new and worse than Communism: whether you call it a mafia state, a criminal state, a mafiocracy, an autocratic kleptocracy or whatever you prefer, the new Cuban state has no intention of providing its population with health and education in exchange for taking away their political and civil liberties. Rather, they keep taking them away without guaranteeing them anything else.

Will public health improve thanks to advice of the Russian mafia? It is unlikely. There should be no objection to the possibility of opening up a private health sector, but not a Russian-style one, in which case the public system would give way to a favoring of the oligarchy with permits to set up their private medicine businesses.

The ideas of the Russian technocrats resulted in, between 2000 and 2018, the number of hospitals in their country plummeting from 10,700 to 4,390, for a population of 146 million. And most were located in Moscow and St. Petersburg. Despite the existence of a private medical sector, it is currently estimated that only 20% of the Russian population has access to quality medical services. In Russia, investment in public hospitals has been neglected, and their infrastructure is deteriorating. Although private hospitals usually feature acceptable conditions, the average citizen cannot afford them.

The Russian leaders and technocrats now advising Miguel Diaz-Canel called that process in their country the "optimization" of public health infrastructure. Where will the island's public health end up under their guidance? Can they sink it any further? Will they "reorganize" it? Will they privatize it in favor of the new Cuban mafia and its friends?

This must be condemned and stopped in time.

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