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Social Relations and the Cuban Health Miracle (Paperback)
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Social Relations and the Cuban Health Miracle (Paperback)
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For Cuba's supporters, health is the most commonly cited evidence
of the socialist system's success. Even critics often concede that
this is the country's saving grace. Cuba's health statistics are
indeed extraordinary. This small island outperforms virtually all
of its neighboring countries and all countries of the same level of
economic development. Some of its health statistics rival wealthy
industrialized countries. Moreover, these health outcomes have
resulted against all odds. Setting out to unravel this puzzle, the
author finds that Cuba possesses an unusually high level of popular
participation and cooperation in the implementation of health
policy. This has been achieved with the help of a longstanding
government that prioritizes public health, and has enough political
influence to compel the rest of the community to do the same. On
the other hand, popular participation in decision-making regarding
health policy is minimal, which contrasts with the image of popular
participation often promoted. Political elites design and impose
health policy, allowing little room for other health sector groups
to meaningfully contribute to or protest official decisions. This
is a problem because aspects of health care that are important to
those who use the system or work within it can be neglected if they
do not fit within official priorities. The author remains, overall,
supportive of health achievement in Cuba. The country's preventive
arrangements, its collective prioritization of key health areas,
the improvements in public access to health services through the
expansion of health facilities and the provision of free universal
care are among the accomplishments that set it apart. The
sustainability and progress of these achievements, however, must
involve open recognition and public discussion of weaker aspects of
the health system.
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