When searching for accurate information on Cuba in the capitalist-controlled media, one is continually confronted with the same experience: almost all so-called reliable news sources–the sources we’ve been taught to trust our whole lives–put a negative spin on socialism and countries building socialism. We hear all the time about “state-controlled media” in communist countries, as if this phenomena is something Americans never have to worry about. But when reading the New York Times or the Washington Post, one gets the distinct feeling there is a pro-capitalist, pro-CIA and pro-State Department (and anti-socialist) agenda taking primacy over journalistic integrity and facts. Headlines read “What is behind the apparent successful Covid-19 containment in Cuba?”; “How COVID-19 Guidelines intensify Repression in Cuba,”; and “As Cuba develops COVID-19 Vaccine, Breadlines Grow.”
While these headlines are made to cause confusion, there is a fundamental truth behind them: Cuba has succeeded in containing the COVID-19 pandemic amid one of the cruelest blockades the US has ever instituted against another country, and is now developing a vaccine that will be given to every Cuban, no questions asked. Amid this success, mainstream news outlets scramble to obscure any Cuban achievements by diverting attention to the country’s hardships, which are created and reinforced by the United States’ blockade of Cuba.
To get a clearer picture of what’s going on, a picture free of the “red scare” bias reminiscent of the 1950’s, let’s compare Cuba’s socialized health system to Pennsylvania’s capitalist health system. In doing so, we will see in plain fact how Cuba was able to contain COVID-19 and send doctors abroad to help other countries, while almost 24,000 Pennsylvanians died. The comparison between Cuba and Pennsylvania might seem like a stretch—what does an island nation have in common with a landlocked state?
Pennsylvania has a population of about 12 million people; Cuba has a population of 11 million. Cuba’s land area is about 42 thousand square miles; Pennsylvania’s land area is about 46 thousand. With populations and areas in similar ranges, Cuba and Pennsylvania make for an interesting comparison. The main difference between the two, however, is not their different climates, but their economic systems. Cuba is a socialist country, run by workers, whereas Pennsylvania is a capitalist country, ruled by bourgeois elites and their corporate friends.
Cuba’s Socialized Medicine vs. PA’s Privatized Healthcare
Cuba’s massive healthcare achievements during the COVID-19 pandemic were not the result of chance, but of a socialist government committed at every level to preventative care and community participation. To understand how the Cuban healthcare system works and what socialism could bring to Pennsylvania’s most neglected people, it is necessary to bring forward the history of healthcare in Cuba since the revolution.
In an article from Counterpunch, Helen Yaffe explains that after the revolution, half of Cuba’s doctors abandoned the island, leaving the new worker’s state to create a new healthcare system from scratch. Cuba responded to this daunting task by creating the Rural Medical Service (RMS) in 1960. This program brought hundreds of doctors to formerly neglected communities across the island. The RMS helped to spur on early medical progress in Cuba, helping to implement immunization programs for all Cubans. In 1974, the community-based model of polyclinics was established. Polyclinics gave communities direct access to primary care doctors that took the holistic nature of medical treatment seriously. Building off of the success of the polyclinics, family doctor practices were set up in neighborhoods across Cuba. In these practices, the neighborhood’s doctor would live with their family above the practice itself, giving the neighborhood constant access to a familiar doctor. This model is replicated with doctors and nurses in schools of all levels, in homes for senior citizens, and even in large workplaces. Yaffe writes that, “By 2005, Cubans had one doctor for every 167 people, the highest ratio in the world. Cuba now has 449 polyclinics, each attending to 20,000 to 40,000 people and serving as a hub for 15-40 family doctors. There are more than 10,000 family doctors spread evenly across the island.” On top of all of these facts, most importantly, in Cuba, healthcare is free.
Long-time residents of Pennsylvania will immediately know that our state has far fewer doctors — whether you’re in the rolling valleys of Blair County or the dense city neighborhoods of Philadelphia, seeking medical attention does not come easily. In all of the state of Pennsylvania, there are 306 doctors per 100,000 residents; the Cuban health system has 598 doctors per 100,000 residents. The difference here is stark. Why does PA have about half of the doctors per 100,000 people that Cuba does? Much of this has to do with our for-profit healthcare system. Seeing the need for affordable doctors in much of the state, this for-profit system determines that there isn’t enough money to be made to supply them. In an article about the lack of doctors in PA, a former hospital nurse and trustee said, “Health care is like the Walmart of America…We have to keep those beds filled. That’s what it’s all about.”
This nonchalant statement reflects what drives healthcare in this country: instead of the socialized, community-based medicine that Cuba has, Pennsylvania has a for-profit healthcare system, which prioritizes the needs of corporate hospitals and wealthy investors over the actual effectiveness of treatment and the needs of any given community. Not only does Pennsylvania have a lack of doctors directly available to communities, but these doctors are paid, in large part, by private institutions and incentivized by the marketing of Big Pharma (our for-profit, private drug producers). This causes the treatments actually presented to patients to be shaded and altered by the profit motive of a tiny group of very rich people—not the needs of the people themselves.
Instead of brigades of doctors going into the most remote corners of the state, patients have to drive hours to the nearest well-equipped hospital. Instead of having enough doctors and nurses for each patient in any given hospital, patients line the waiting rooms everywhere to see doctors who have no personal connection to them. In Pennsylvania, like everywhere in the US, getting medical help costs money even with the best insurance. Where does that money go? It certainly doesn’t go to adequately paying nurses, or the working people who dedicate their lives to caring for sick people. Instead, the profits on the fees we pay to get the most basic care go straight to hospital executives and healthcare billionaires. It is no surprise, then, that the federal and state governments have resisted putting serious COVID restrictions in place. Their reluctance allows hospitals to keep their very expensive beds filled, thus lining the pockets of the healthcare billionaires who spend a pretty penny every election cycle on political campaigns that maintain the status quo. Healthcare executives and billionaires have no reason to give preventative care, because they profit from sickness. Government officials and politicians have no reason to regulate hospitals or implement restrictions to prevent COVID-19 spreading, because they are paid-off in campaign donations by healthcare executives. This set of socioeconomic relations, between the government and healthcare executives, is nowhere to be found in Cuba. In Cuba, there is no profit motive behind the healthcare system. With these facts in mind, it should be no surprise that less than 300 Cubans have died from COVID-19, while almost 24,000 Pennsylvanians have died.
COVID-19 Containment: A Matter of Socialism vs. Capitalism
COVID-19 presents a concrete lens through which we can see the difference between Cuba’s healthcare system and Pennsylvania’s healthcare system, between Socialism and Capitalism. As the pandemic began to spread to Cuba, the nation implemented a COVID-19 Prevention and Control Plan. This plan, reiterated here, represents measures that Cuba was dedicated to taking to protect its population. They implemented quarantines, the likes of which have not been seen in Pennsylvania, they created isolation facilities, they guaranteed information to all households through mass organizations and they increased the production of food to be given to Cuban citizens. Further, Cuban’s don’t have to pay for health care and rent, leaving them safe in the wake of suspended pay and a shut down. The WHO and PAHO (Pan American Health Organization) praised Cuba for their quick response to COVID-19 which was led primarily by the primary care network and family doctor practices described above.
In the first weeks of the COVID-19 pandemic in Pennsylvania, there was a mass shut down of non-essential activities, but no plan to get further information to residents besides live-streamed press conferences and certainly no plan to feed the mass number of working class and poor people who lost their jobs. This left elders and at-risk families to go to the grocery stores, which were packed with frantic people, putting many working class people at risk for COVID-19.
While in Cuba, treatment for COVID-19 is free, across the US, in-patient treatment for COVID-19 can come with staggering surprise costs. Congress has set aside funds for insurance companies to use to mitigate the hospitalization costs of COVID-19, but this has not stopped the accumulation of surprise charges that working people struggle to pay. As of July 2020, 30% of Americans would not be able to pay $400 in the event of an emergency cost. For those with high school diplomas or less education, the problem of emergency costs is even more daunting: 36% of White people, 58% of Black people, and 48% of Latino people in this category would be unable to pay their monthly bills if they encountered a $400 emergency bill. Even with insurance, if hospitalized, surprise charges can result in poor and working class Pennsylvanians going into debt.
Perhaps the most stark difference between the Cuban response to the pandemic and the Pennsylvanian one has to do with the difference between socialism and capitalism. Despite economic and structural problems largely caused by the US blockade of Cuba, Cubans’ total housing costs are low compared to what is standard in capitalist countries because 90% of Cubans own their own homes and don’t have to pay for mortgage or rent. They don’t have to pay for healthcare and their doctors know them personally. Food is accessible. All the basic means of survival are guaranteed by the workers’ state. In Pennsylvania, the average rent for a two-bedroom house varies from as low as $800 dollars to $1,600. Workers who make 20 dollars or less an hour, working full-time, can end up paying between 1/3 and 2/3 of their monthly wages on rent. The fact that over 15,000 Pennsylvanians are homeless is a testament to the exorbitant costs of living in this state. To add insult to injury, out of the 691,000 housing units across the state, 53% sit empty.
While Cuba has lost less than 300 lives to COVID-19, close to 24,000 Pennsylvanians are dead. While brigades of Cuban doctors traveled around Cuba and the world to treat COVID-19 patients for free, Pennsylvanians had to scramble to find doctors. While treatment for COVID-19 costs nothing to Cubans, many Pennsylvanians paid tens of thousands of dollars for treatment. By October of 2020, healthcare billionaires in this country got 150 billion dollars richer, while many Pennsylvanians lost their jobs, couldn’t afford groceries and rent, and paid for treatment that could and should have been free. There are no billionaires in Cuba; Cubans don’t have to pay for rent, they don’t have to go hungry, and they get the care they need comfortably.
Out of these two systems, capitalism and socialism, there is only one that benefits the workers and only one that benefits the billionaires. Working people know that capitalism has failed them and Cuba provides a powerful example of how socialism, built from the ground up, can save lives.