Health care is a model, but tourist economy brings changes.
By Russell Mokhiber and Robert Weissman
Our first, short visit to Cuba has left us impressed with the accomplishments of the island-nation that for more than 40 years has stood up to global capitalism. We also returned home aware of the many limits of the revolution – some brought on or exacerbated by U.S. economic and military pressure – and uneasy about the difficulties Cuba faces in the coming years.
Walking into Havana’s Jose Marti Airport, we immediately sensed that this was not like other places: there was no raft of billboards urging us to drink Coke, smoke Luckies, charge with our MasterCard, or rent a Hertz. Indeed, there are virtually no commercial advertisements in Cuba. (Nor, by the way, is there a personality cult surrounding Fidel Castro: we saw far, far fewer images of Castro than we would, say, of President Daniel Moi in Kenya. The omnipresent image in Cuba is national hero Jose Marti, the poet and writer who helped lead the Cuban revolution of the 1890s.)
We saw a country with major accomplishments in health care, education, day care, and other services. Cuba’a infant-mortality and life-expectancy rates are comparable to those of the United States and other rich countries, and the country’s main health problems are now those of rich countries. “We die as wealthy people, even though we live as poor people,” one hospital director told us.
Cuba has invested in and maintains a sophisticated hospital system, with hospitals spread throughout the country, not just concentrated in Havana. Even more important is the national emphasis on preventive health measures and primary and community care. Every person has access to a community doctor and nurse, who serve several hundred neighborhood families and know the health profile of all their patients. The women’s association and other mass organizations, which are organized down to the block level, also help ensure care is delivered – for example, making sure every pregnant woman receives prenatal care. Cuba has also invested heavily in biomedical research, giving it one of the only genuine biomedical R&D capacities in the developing world.
We were also taken with the economic egalitarianism of the society. Following the collapse of the Soviet Union, Cuba lost more than a third of its national income in a single year. If the United States were to suffer anything remotely similar, there is little doubt that the heaviest burdens would be thrust on working people and the poor. In Cuba, the pain has been spread equally: people have maintained their right to health care and education and housing, and they were allotted food rations that gave them a minimum level of sustenance. Even in times of genuine food shortages, no one, so far as we know, starved.
The country’s former economic dependence on the Soviet Union was, as it it should now be obvious even to those who might once have argued otherwise, one of the great mistakes of the revolution. Of course, this was a dependence foisted on Cuba in no small part by the United States through its embargo and continuous military threat.
Relatedly, Cuba erred in relying on agricultural exports (sugar above all) produced on vast state-owned plantations, instead of cultivating food for domestic consumption on smaller, farmer-owned cooperatives. Over the last decade, the country has made considerable strides in remedying this mistake, with more autonomy granted to farmers and a new emphasis on organic agriculture (Cuba is now a world leader in the field). Food, however, still seems in short supply.
One of the biggest threats to Cuba’s accomplishments on the horizon is posed by the tourism industry and the dollar economy. Cuba’s greatest potential foreign-exchange earner, by far, is tourism. Tourism is certain to grow rapidly, spectacularly so if the U.S. embargo is ever lifted.
Salaries in the peso economy are on the order of $20 to $30 a month. With subsidized or free housing, utilities, food, health care, and education, this is enough, or at least close to enough, to get by. Workers in the tourism sector are tipped in dollars. A maid or waiter will easily make far more than $30 a month in tips. And so the incentive is for doctors, nurses, teachers, and others to leave their jobs and go work in the tourist sector. The result is both a misallocation of professional and skilled labor and the beginning of social stratification. There is no obvious solution to this problem that maintains the fundamental achievements of the revolution.
The problem is exacerbated by remittances from Cuban-Americans living in Miami and the gifts of toys, designer clothing, and other items that they provide to family in Cuba. Walking by the hip clubs in Havana’s Vedado neighborhood, one can feel the magnetic pull of the corporate culture on kids who have little way of understanding the very dramatic sacrifices their society would have to make were Versace and Nike goods to become freely available. (Bulatlat.com)
Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime Reporter. Robert Weissman is editor of the Washington, D.C.-based Multinational Monitor. They are coauthors of Corporate Predators: The Hunt for MegaProfits and the Attack on Democracy (Common Courage Press, 1999). Focus on the Corporation appears Tuesdays.