How does Cuba do it?


by Cheryl LaBash

“Cuba has the lowest [infant] mortality rate in the Americas, in spite of the economic blockade imposed against it by the U.S. for more than five decades,” announced Granma newspaper on Jan. 3.

Before Cuba’s 1959 revolution ousted the racist, corrupt, U.S.-puppet Batista regime, infant deaths, when recorded, exceeded 60 per 1,000 live births. In 2010, the rate of infant mortality was only 4.5 per 1,000 live births — overall a better and more equally distributed outcome than in the much wealthier U.S.

This is a stark contrast to the huge disparities in infant mortality rates in the U.S.; for example, there are 14.7 deaths per 1,000 live births among African Americans in Mississippi, as reported in the “2010 Mississippi Infant Mortality Report.”

According to Granma, some contributing factors to Cuba’s success are “the political will of the revolutionary government, the high education levels of its population, the vaccination program against 13 diseases and a free universal health system for everyone.”

Ray Suarez reported on PBS Newshour that Cuba’s health achievement also includes a higher life expectancy than the U.S. and costs less — a lot less! “According to the World Health Organization … the average Cuban lives to the age of 78. That’s slightly longer than the life span of the average [U.S. resident]. The cost of health care in Cuba is less than $400 a year per person. In the U.S., the annual tab is almost 20 times higher” (Dec. 21).

According to the Centers for Medicare and Medicaid Services, U.S. health care spending amounts to $8,086 per person or 17.6 percent of its gross domestic product (

The PBS report points to Cuba’s large number of doctors, its emphasis on preventive care, the growing biotech industry that develops new vaccines and medicines, and free universal education including medical school. But there is more.

Cuba’s socialist economic system eliminates the profit motive that shapes and distorts every aspect of health care in the capitalist U.S. The education of doctors and the distribution of health facilities are planned and organized to meet human needs, not left to the “invisible hand of the market.”

Confronted with $200,000 to $300,000 in education debt, many U.S. medical students must steer toward higher income specialties, making career decisions that — subtly or not — avoid treating uninsured, poor or rural patients where doctors earn less.

Decisions over every aspect of capitalist health care from direct patient care, insurance and hospitals to pharmaceuticals, lab work, research and high-tech tests are all geared to maximizing profits, even increasing the use of these goods or services, whether warranted or not. Medication, surgeries and procedures are even advertised directly to the public to promote sales.

Yet 50 million U.S. residents have no insurance and even insurance doesn’t guarantee affordable, quality or preventive care (The Kaiser Family Foundation, September 2010).

The U.S. health care cost and outcome crisis can be solved. Cuba has proved it.

© 2011 Workers World. This story was originally published Jan. 12, 2011, by Workers World, 55 W. 17th St., New York NY 10011,,, at


  1. Republished from Workers World? An organ of the Communist Party of the USA? A group that was funded by Joseph Stalin, a man who organized the mass murder of millions of Ukranians, among other crimes.

    I'm familiar with the kinds of lies perpetrated by Communists. Ask anyone in the former Soviet Union or the Eastern Bloc.

    Thank God for Ronald Reagan. I'm beyond offended that you expect me to accept lies printed by an organization funded by mass murders, genociders, and hate criminals.

    You are seriously out of line.

  2. Do some research, just a teensy tiny tiny bit of research. Please. Try.

    Recently released statistics on the infant mortality rate in the Western hemisphere yielded an odd conclusions — Cuba’s infant mortality rate, 16 6.0 per 1,000, is now lower than the U.S. infant mortality rate, at 7.2 per 1,000. Given Cuba’s poverty level, its 6.0 rate is very impressive, but is it accurate to say that Cuba now has an infant mortality rate lower than the United States? No.

    The problem is that international statistics on infant mortality are helpful in revealing large differences, but when it comes to small differences such as that between Cuba and the United States, often other factors are really behind the numbers.

    The primary reason Cuba has a lower infant mortality rate than the United States is that the United States is a world leader in an odd category — the percentage of infants who die on their birthday. In any given year in the United States anywhere from 30-40 percent of infants die before they are even a day old.

    Why? Because the United States also easily has the most intensive system of
    emergency intervention to keep low birth weight and premature infants alive
    in the world. The United States is, for example, one of only a handful countries that keeps detailed statistics on early fetal mortality — the survival rate of infants who are born as early as the 20th week of gestation.

    How does this skew the statistics? Because in the United States if an infant is born weighing only 400 grams and not breathing, a doctor will likely spend lot of time and money trying to revive that infant. If the infant does not survive — and the mortality rate for such infants is in excess of 50 percent — that sequence of events will be recorded as a live birth and then a death.

    In many countries, however, (including many European countries) such severe medical intervention would not be attempted and, moreover, regardless of whether or not it was, this would be recorded as a fetal death rather than a live birth. That unfortunate infant would never show up in infant mortality statistics.

    This is clearly what is happening in Cuba. In the United States about 1.3 percent of all live births are very low birth weight — less than 1,500 grams. In Cuba, on the other hand, only about 0.4 percent of all births are less than 1,500 grams. This is despite the fact that the United States and Cuba have very similar low birth rates (births where the infant weighs less than 2500g). The United States actually has a much better low birth rate than Cuba if you control for multiple births — i.e. the growing number of multiple births in the United States due to technological interventions has resulted in a marked increase in the number of births under 2,500 g.

    It is odd if both Cuba and the U.S. have similar birth weight distributions that the U.S. has more than 3 times the number of births under 1,500g, unless there is a marked discrepancy in the way that very low birth weight births are recorded. Cuba probably does much the same thing that many other countries do and does not register births under 1000g. In fact, this is precisely what the World Health Organization itself recommends that for official record keeping purposes, only live births of greater than 1,000g should be included.

    The result is that the statistics make it appear as if Cuba’s infant mortality rate is significantly better than the United States’, but in fact what is really being measured in this difference is that the United States takes far more serious (and expensive) interventions among extremely low birth weight and extremely premature infants than Cuba (or much of the rest of the world for that matter) does.

    This does not diminish in any way Cuba’s progress on infant mortality, which is one of the few long term improvements that the Cuban state has made, but infant mortality statistics that are that close to one another are often extremely difficult to compare cross-culturally.

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