Many people who claim the U.S. healthcare system is broken point to Cuba as a country that spends little on health but gets high returns. Michael Moore’s documentary Sicko even visited Cuba and claimed that it could be a model for a single payer system in the U.S. As the Economist reports:
“Until recently, Cubans were justifiably proud of their health-care system. Life-expectancy matches that of Americans, who are eight times richer. Infant mortality ties with Canada’s as the lowest in the Americas. Measles jabs have been near-universal for more than 20 years, putting Cuba ahead of many rich countries.”
However, a recent cholera outbreak is showing that the Cuban system does have its drawbacks.
“But Cuba’s crumbling economy has put this system under stress. Though the state still trains armies of doctors, a third of these are deployed overseas in “soft-power” missions. Pharmacies are generally ill-stocked. In many hospitals patients must provide their own sheets, food and dressings. Neglect of infrastructure means that almost 10% of the population lacks access to clean drinking water.”
A centralized health system could outperform a decentralized system most in public health arenas (i.e., maintaining access to clean water, vaccinating) since it can coordinate centralize efforts; installing clean drinking water and vaccinating generally do not need to be tailored to the needs of specific patients as most other medical treatments do. However, if the centralized system lacks funding or coordination, then these public health efforts may be doomed to failure. Cuba’s reaction to the cholera threat will be telling regarding its systems ability to respond to these types of public health treats.