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%.