Castro's Dictatorship and Cuban Health Care:
[Ilya Somin, February 20, 2008 at 6:03pm]
Cuban communism may be repressive, but at least it provides good health care. This is a common trope of left-wing apologias for Castro's brutal dictatorship. This claim is getting recycled yet again in the wake of Castro's recent resignation (e.g. here). One response to this point is that of liberal Berkeley economist Brad DeLong: Cuba would likely have a much higher standard of living (and better health care) today had it not gone communist in 1959. As DeLong documents, Cuba in the 1950s was one of the richest countries in Latin America and rapidly approaching Western European standards of living and health outcomes. Under communism, it became one of the poorest nations in the Western hemisphere - despite receiving vast quantities of heavily subsidized oil from the Soviet Union for decades. Taking Cuban official statistics at face value (as DeLong does), Cuban health outcomes and standards of living are roughly similar to those of Mexico and the Dominican Republic. In the 1950s, DeLong notes, Cuba was vastly better off than these countries and, on some measures (such as infant mortality) better than many Western European nations.
But there is an even more basic problem with the "at least Castro improved health care" excuse: it assumes that official Cuban government health care statistics are accurate. I find that assumption highly improbable. A government that brutally represses dissent and executed over 100,000 political prisoners out of a population of just 6.3 million is unlikely to be above falsifying its official statistics in order to improve its image. That was certainly common practice in other communist societies, including those which Castro used as models for his own.
When the Iron Curtain fell in Eastern Europe, scholars rapidly determined that official Soviet and East European statistics were routinely falsified to burnish the communist regimes' public image. As this foolishly credulous 1973 Time article noted, official East German stats indicated that, by 1970, East Germany had a higher standard of living than Italy and was rapidly closing in on Britain. Anybody with even the slightest familiarity with actual East German living standards knows how far such communist claims were from reality.
How bad is Cuban health care really? I don't know. Probably no one will know until the regime finally falls and honest data can be collected. For now, it's at least worth noting that the government health care clinics available to ordinary Cubans (those not members of the government elite) look like this and this. It's also worth noting that if Cuban living standards and health care really were as good as the government claims, it's unlikely that millions of Cubans would have risked their lives to flee the country - not only for the wealthy United States, but even for such far poorer destinations as Puerto Rico and the Dominican Republic. It's especially telling that many Cuban refugees prefer even Haiti (the one Latin American nation that probably really is poorer than Cuba) to life under Castro. The evidence of people risking their lives to vote with their feet is a lot more compelling than the Cuban government's dubious health statistics.
UPDATE: I am aware that some of the data on Cuban health care comes from the United Nations and other international organizations. However, the UN and the others depend on information provided by the Cuban government. You can't do independent data collection in a totalitarian dictatorship. Thus, the UN numbers are derivative of Cuban official statistics.
Related Posts ( on one page):
volokh.com
The Impact of Castro's Repression on Cuban Health:
[Ilya Somin, February 20, 2008 at 9:05pm] Trackbacks
As I noted in my last post, Castro's alleged improvements in Cuban health care are often used as a counterpoint to his repressive policies. Maybe he repressed political dissent, apologists claim, but at least he improved health care. For example, CNN urges its reporters to "[p]ease note Fidel did bring social reforms to Cuba – namely free education and universal health care . . . in addition to being criticized for oppressing human rights and freedom of speech."
In addition to the more obvious objections to this line of argument, it's also essential to recognize that political repression is bad for health. As I discussed in this post, the Cuban communist government executed some 100,000 political prisoners and imprisoned some 350,000 others in brutal labor camps during the the 1960s alone. This in a population of just 6.3 million as of 1960. Obviously, getting executed is bad for your health. Due to the milder climate, Cuban forced labor camps probably have better health standards than Soviet Gulags. Nonetheless, even a tropical Gulag isn't too good for the health of the inmates. A substantial number of the labor camp inmates likely either died before their sentences were up or had their lifespan substantially reduced as a result of privation they endured.
Calculating the odds, this implies that the average Cuban at the start of Castro's regime had a roughly 1.5% chance of being executed by the regime and a 5.6% chance of being incarcerated in a labor camp. In reality, the risks were probably higher than that for those who stayed in Cuba, since the 6.3 million population figure includes several hundred thousand Cubans successfully fled the country in the early years of the regime ( the US alone admitted some 750,000 Cuban refugees between 1960 and 1976).
Even if Castro's government really did improve health care substantially for those Cubans who were fortunate enough to avoid being executed or incarcerated in labor camps, the improvement would have to be pretty enormous to outweigh the negative health effects of the regime's repressive policies. How much of an in improvement in health care would be enough for you to be willing to take a 1.5% chance of being executed and a 5.6% chance of being sent to a brutal labor camp for at least several years?
UPDATE: I have corrected a minor calculation error in my estimate of the odds of being sentenced to a forced labor camp in 1960s Cuba. The correct figure is 5.6%, not 4.8%.
Related Posts ( on one page):
Interesting Interview with Cuban Dissident Armando Valladares:
Are Cubans Satisfied With their Government?
The Impact of Castro's Repression on Cuban Health:
Castro's Dictatorship and Cuban Health Care: volokh.com |
