The Count: Cuban edition

[Editor's note: Wow, the Count has certainly been traveling a lot these past weeks! After going to China to investigate it's commercial ties with Latin America and flying to Europe to ask pissed off Greeks in the streets about their opinions of the IMF, the Count has finally come home to the Western Hemisphere. But without further ado, maladjusted brings you this week's Count.]

78.6...

...is the number of years the average Cuban is expected to live (unless they live in Miami, in which case all bets are off).

The current issue of the prestigious Science Magazine features an article (sorry, subscription-based) on the quality of health care in Cuba since Castro took power. We've all heard of Cuba's health care before, but now it turns out Michael Moore was right...according to scientists! In all seriousness though, Cuba has managed to achieve first world health levels on a third world budget and all while enduring the U.S. embargo, which restricted medicinal imports. From the article:

"Despite the embargo, Cuba has produced better health outcomes than most Latin American countries, and they are comparable to those of most developed countries. Cuba has the highest average life expectance (78.6 years) and density of physicians per capita (59 physicians per 10,000 people), and the lowest infant (5.0/1000 live births) and child (7.0/1000 live births) mortality rates among 33 Latin American and Caribbean countries."

Not bad. Not bad at all. The graph below shows average life expectancy in Cuba, Latin America, Canada and the U.S. Notice how fast average life expectancy increased and caught up to U.S. levels after the revolution. Since then, Cuban life expectancy has more or less been on par with that of the U.S. except for the period after the collapse of the Soviet Union, when aid to Cuba contracted sharply.
But how did Cuba achieve such good results in the face of the embargo while at the same time spending far less per person than the U.S. and most European countries? The article explains:

"Cuba has one of the most proactive primary health care systems in the world. By educating their population about disease prevention and health promotion, the Cubans rely less on medical supplies to maintain a healthy population. The converse is the United States, which relies heavily on medical supplies and technologies to maintain a healthy population, but at a very high cost."

Another side of the story, the article notes, is the government's emphasis on community access to health care and deliberate policies to tailor each local practice to the health profile of the community it serves. This, combined with universal coverage and free service, explains a lot of the outcome. To this I would add a more broader point: government priority. Specific strategies aside, what is most striking about Cuba's health outcomes is that no matter how many obstacles a country faces (such as, for instance, fending off the most powerful country in the world for five decades) it can provide free health care to all its citizens so long as it prioritizes their well being.

There's a lesson to be learned somewhere in there me thinks.