Changes in Cuban health care: an argument against technological pessimism.

Since the popular revolution in 1959, alterations in the organization and delivery of health care in Cuba have paralleled the country's broader political, economic, and social changes. This paper discusses the evolution of the Cuban health care system during the past seventeen years within the wider context of societal development. The authors compare three "snapshots" of Cuba, the first in 1959, the second in 1970, and the last in 1976, and touch upon such issues as the organization of health care delivery, the recruitment and socialization of health workers, and aspects of the process of receiving health care. They point out that the Cuban experience should be of particular interest to the developing world. For though it is true that a larger portion of Cuban national resources has been directed to the health and social services than in other developing countries, nonetheless, it was largely through the reorganization and equalization of the prerevolutionary health care system that improvement in the health status of the population was achieved. It appears that Cuba could well serve as an example for those who are skeptical about the possibility of combining technical development with improvement in the humane quality of care.