Cuba's stats are misleading. Much of this data is self-reported, and Cuba has obvious incentives to lie. Furthermore, many Cuban doctors are "exported" to places such as Venezuala (something like 20,000 Cuban doctors work abroad, but are still considered Cuban citizens and would be included in these statistics. Just to put that in perspective, the US trains only a little over 15,000 doctors a year).
But no doubt, Cuba has an impressive healthcare system given their tattered economy, particularly in terms of preventative medicine. Almost the exact opposite approach to the US.
My brother was an OB/GYN resident in the 1990's; he earned about $7 a month.
Those that want to become doctors in Cuba do it because of pure love for the field. However, the severely poor economy forces many to leave the profession in order to provide for their families. My brother quit his residency in his fourth year so that he could rent out video games we sent him for American dollars and help support his wife and child.
We brought him to the states in 2003. He is now learning English in Miami in hopes of starting over: taking boards, redoing residency, etc. Medicine is his life, but his family is also is life. He's not giving up, already in his early 40's.
but yeah, I would agree that the ranking is misleading, since he was identified as a doctor (in Cuba, everyone has these identification cards used for quotas of food, etc., and probably used for these types of reports) until he left the country.
Every time I hear of people praising Cuba for their health care system, I remember my brother telling me the story of how he had to deliver his own child WITHOUT ANESTHESIA, because there simply was none in the hospital he worked at. I do praise the physicians and the educators, because they do it out of poor love of medicine, but not the system, because it is the communist government, rather Castro, that runs everything.
My point: it's important to have a balance of the forces controlling health care assets. Cuba's health care system is not as pretty as it sounds, and there's not much anyone can do about it under that government. I feel very fortunate to have the opportunity to practice medicine in the states, and if at some point in the future the Cuban government changes, i will be the first on a plane over there. For now, I'll do what I can to make changes in this country's health care system, where we still have a chance to make a difference.
