Health Policy and Social Change: A Comparative History of Chile and Cuba

The social histories of Chile and Cuba demonstrate the links between medicine and broader social change. When the socialist government of Salvador Allende took office in 1970, Chile already had a tradition of public health care, including a national health service. By comparison, the health-care system in Cuba at the time of its 1959 revolution was rudimentary and inferior. Chile did not succeed in developing a structurally different health-care system, while Cuba did. This paper argues that the consolidation of state power, mass mobilization, and resolution of the contradiction between the private and public sectors were key elements in Cuba's success. The Chilean and Cuban experiences show that incremental reforms in health care remain limited and tenuous without basic change in society.