Moakley, Maureen

Advisor Department

Political Science




Health; Cuba; Rhode Island; Healthcare System

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Improving Rhode Island’s health care system: lessons from the Cuban model

Cuba is world renowned for its health care system. In regards to international health crises, Cuba is a leader in sending workers abroad and training doctors from all over the world. Within its own borders, the Cuban model provides free access to all citizens in which every individual has a primary care provider. Cuba boasts high vaccination rates, a long life expectancy, low infant mortality rate, and a population that is one of the healthiest in the western hemisphere.

The purpose of this research project is to evaluate the Cuban model of healthcare and compare it with the United States model. More specifically, for this research, we compared the Cuban province of Sancti Spíritus and the U.S. state of Rhode Island.

The methods taken to evaluate the Cuban and American healthcare systems include the following: Review of the Cuban Health Care Model, review of the Rhode Island Primary Care Trust, and interviews with multiple individuals in both health care systems. The interviews were conducted with both Cuban and American health care professionals, medical students, and the former director of the Department of Health, Dr. Michael Fine. Dr. Michael Fine is an expert on community health programs.

Primary care and prevention are the most cost effective and attainable methods of securing a healthier population. In the United States it is common that physicians continue on into specialized fields that compete for patients and do not consider the larger health care need for service in the community. This creates a dire need for primary care providers and is in contrast to what occurs in Cuba. In Cuba, physicians, physician’s assistants and nurse practitioners are trained specifically to continue their work in the primary care field tending to the basic needs of the Cuban population. Providers trained at the Latin American Medical School System in Cuba do not pay for their education. On completion of their expense-free training, the graduates are expected to return to their communities and provide primary care, thus ensuring social commitment. In the United States, providers continue on to specializations thus creating obstacles to achieving an effective model of primary care. This research explores the many barriers to forming an effective primary care system in the United States with access for all.

After interviewing students and providers in both Cuba and Rhode Island, we conclude that Rhode Island should continue to expand and promote the community health care model outlined by the Rhode Island Primary Care Trust. Given the need for more primary care providers, models of education and treatment should focus on nurse practitioners and physicians assistants who are committed to social action and effective community health. The implications of this model require change to the American health care system as we know it. These changes will challenge Rhode Islanders to imagine the future of health care, not as competition, but as collaboration.

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