It's "Free" . . . But Healthcare Costs Us / Jeovany Jimenez Vega
Posted on April 29, 2014
"Your health service is free… but it costs"
By Jeovany Jimenez Vega
You've been able to see them for almost two years in every health care
unit of the Cuban Public Health System, from any primary care office or
clinic, passing through each second level hospital, even in tertiary
care centers in each Institute. They welcome us from the door of the
consultation room or from the trade union wall and assure us that our
omnipotent government has always been zealous to guarantee absolutely
fee medical care for our people.
Seen that way, without more, it would seem a simple matter. In this
world, where to the shame of the species, dozens of thousands of
children still die of curable illnesses because they do not have access
to a few tablets and a measly intravenous infusion, it would be the most
natural thing for Cubans to prostrate ourselves in gratitude before such
an excess of philanthropy. But if there is one thing we learned long
ago it is that here, when you look into the background of the matter, we
have all been charged.
It is true that the hospital does not charge us directly at the hospital
or at our children's school, but without doubt the cash register at the
"hard currency collection store" (TRD*) charges us, and in a currency
arbitrarily overvalued 25 times in relation to the other currency in
which we are paid an unreal salary of little use to us.
These words are not trying to be an inquisitorial onslaught against the
health care system to which I belong, whose essential function is
impeded by limitations that no sector in Cuba can escape.
Any gratuitous attack would leave on this page the odor of the knife in
the back, an aroma that this Cuban detests, but 40 years of hammering
did not end up convincing me that guaranteeing a right, or trying to,
grants in any way authority to my government to deprive us of other
rights as essential as that.
And it is here — more than at the door of the TRD and the hotels, or in
the immoral taxes of the General Customs Office, or in the extortionate
cost of each consular administration abroad, among other hundreds of
shameful examples — where we millions of Cubans have been charged the
true currency exchange: it has been through the humiliation of the
famous diplo-tiendas*, or in the door of the prohibited hotels, or
through the despotism of the migratory authorities or the mistreatment
by any other kind of official or through the systematic deprivation of
our civil and political rights.
And invariably in the background posters like the one illustrating this
post justifying as life-saving the entitlements that crush us at every step.
On the other hand these public governance schemes are not unique to Cuba
nor to socialism, as has historically been insinuated to us. There are
dozens of examples of countries — and not necessarily from the first
world — that sustain health and education systems as public and free as
ours, and all without demanding in exchange such high doses of
Very true it is that sustaining the presumed public health costs each
state on a world level very dearly, and Cuba was not exactly going to be
the exception, but also I remember here that each Cuban worker has about
30% deducted from his monthly salary precisely to cover these public
I also remember that when our state undertakes to guarantee public
health and education services — the two prime examples — it does not
fulfill only a duty but its more conspicuous obligation, perhaps its
only authentic obligation.
In particular, I ask myself by what magic method the Cuban government
invested $4386.00 pesos in me alone, for the approximately 120
consultations that I did in my last 24-hour medical shift, in which I
used only — if we except the $24 pesos that they paid me for night hours
— my stethoscope, my blood pressure monitor, and some disposable depressors.
But as I am not an economist, I better leave the accounts to others and
dedicate myself, as a good cobbler, to my shoes. After all, it is true
that it costs us . . . and quite expensively, for sure.
*Translator's note: The government itself named the stores that sell
only in hard currency, "Hard Currency Collection Stores"–TRD is the
Spanish acronym–making explicit that their major purpose is to capture
for the government coffers (through extreme overpricing) a major share
of the remittances Cubans receive from their families abroad. Many items
are often, or only, available in these stores (or in the black market).
An early incarnation of these stores were known as "diplotiendas," that
is "diplomat stores" catering to foreigners residing in Cuba.
Translated by mlk.
28 April 2014
Source: It's "Free" . . . But Healthcare Costs Us / Jeovany Jimenez Vega
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