What We Can Learn From Cuba (And Vice Versa)

Fidel Castro's passing this month was felt not only in Cuba, but in certain pockets of the United States and all over the world.

Castro's Cuba was indeed, for most Americans, a mysterious land - a place where few could visit and explore.

Unnoticed because of this sense of mystery is how progressive Cuba is in many ways (healthcare, for example).

Indeed, we can borrow much from Cuba's playbook - and vice versa.

The learning is really just getting started.

Disclosure: Rutgers University, where I serve as a distinguished professor, recently re-signed a Memorandum of Understanding with the University of Havana.

There will be formal research and exchange opportunities for students and faculty. We will be visiting Cuba in the years ahead (and Cubans will be paying visits here, too).

So, the lanes of information exchange are now open between Cuba and parts of the U.S. Cuba is not such a mystery anymore - to our benefit.

How We Can Learn From Cuba: Healthcare

Cuba's healthcare model, unlike ours, is focused on access and primary care. Doctors really get to know their patients and, when someone has a problem, they can see their doctor in the clinic, usually the same day.

If you can't imagine that happening in the United States, you are not alone.

The United States is the only developed country without universal access to a nationalized health care system.

Countries such as Cuba see healthcare as a basic right and insure everybody. Everyone gets primary care. That would be a first step.

Starting in the mid-1960s, Cubans have encouraged all medical school graduates to do at least two years of service in a rural area. That program became so popular that by the mid-1970s, almost all new physicians were doing rural service.

Almost all Cuban medical residents do family medicine. They focus on primary care for all ages before they would go on and specialize. Meanwhile, only 35 percent of Cuban residents choose to practice a specialty - most stick to primary care.

Cuban doctors have a more altruistic mindset - they go into medicine to treat people in their communities and are making a fraction of what we make in the U.S., but most Cubans aren't going into medicine to earn money. They're going into it to treat people in their communities.

It's quite the opposite of what we have in the U.S., where slightly less than one-third of doctors practice primary care. Maybe our system would be different if we generalized more and specialized less.

Medicine has a different economic system, too, in Cuba. This is an important factor.

In the Cuba system, education is paid by the government, so students don't have debt. In the United States, medical students come out $200,000 or $300,000 in the hole, which deters them from going into primary care.

In 1999, Cuba created a school of medicine for Latin America. They bring students in, train them for six years, give them room and board and a stipend.

Afterward, the students are required to go home and practice in poorer areas. It's a remarkable program, with 10,000 students now from 33 countries. Maybe we can think of developing health care workers the same way.

We can also learn how to institutionalize universal health care from Cuba. They understand it in ways that we do not, in the U.S.

When you compare United States against most developed countries, we're near the bottom in most health indicators. Our life expectancy isn't as good, our infant mortality rates are higher, and we spending twice as much money.

If Cuba's system isn't perfect, it is stunningly different than what we have. We can certainly learn much from them.

What They Can Learn From Us: Urban Education

While visiting the U.S., the University of Havana cohort spent time at the LEAP Academy University Charter School, which is known for having a Cradle-to-College learning model designed specifically for a low-income student population.

Camden is a small city where we see some of the worst aspects of America -- violence, crime, drugs, high unemployment, poverty, dangerous under-performing schools and fragile families struggling to make ends meet.

LEAP is more than just a school; it is a community that is dedicated to using education to lift its population from generations of poverty.

The formula for LEAP Academy includes a longer school day and year. It involves offering teachers pay for performance incentives, and features getting parents engaged in the educational process. Parents and guardians are active in the school, volunteering at least 40 hours during the school year.

A health center at LEAP, staffed by a full-time pediatrician, provides access to quality healthcare in a comfortable setting (not unlike the Cuban healthcare model).

Furthermore, LEAP's Parents Academy helps low-income adults earn admission to college programs themselves - allowing the adult to grow academically, just as their children are doing the same.

A Look Ahead

Camden is a small city of about 77,000 residents, where we witness the worse America has to offer -- violence, crime, drugs, high unemployment, poverty, forgotten children, dangerous nonperforming schools and fragile families struggling to make ends meet. If a change agent can work in Camden, it may be able to work anywhere.

If we can use this city to show Cubans how institutions of higher education are making a difference in transforming the life of children and families, then there is hope for making Cuba a better place as they are transitioning into a new society and mainstream system.

Fidel Castro won't be around to see it. But their people will! And that, in the end, is what matters more.