Rojas Ochoa F, López Pardo C M
Representación OPS/OMS, La Habana, Cuba.
Int J Health Serv. 1997;27(4):791-807. doi: 10.2190/HBXE-6KWM-0H9V-1DCF.
An economic contraction occurred in Cuba at the beginning of the 1990s, of a magnitude greater than in any developed country in the last half century. This resulted primarily from the disappearance of the European socialist bloc and simultaneous tightening of the U.S. government's blockade at a time when Cuba was engaged in correcting its main economic problems. The economic crisis affected a number of areas of Cuban society. The state adopted a series of measures to cope with the socioeconomic situation, which have yielded positive results in the social and economic fields, as well as some undesirable results. In the health sector, the economic crisis has mainly reduced the availability of resources and has adversely affected some health determinants and some aspects of the population's health status. Despite the prevailing economic difficulties, the government is determined to preserve the country's achievements in health, and to develop them still further. The solution is not privatization or the introduction of health insurance systems or similar measures. Rather, Cuba will seek greater rationality and economic efficiency in the health sector. It has ratified the principles that the state should continue to finance the health system and maintain universal coverage and accessibility through free services.
20世纪90年代初,古巴发生了经济衰退,其规模大于过去半个世纪中任何一个发达国家。这主要是由于欧洲社会主义阵营的消失,以及在美国政府加强封锁的同时,古巴正在着手解决其主要经济问题。经济危机影响了古巴社会的多个领域。国家采取了一系列措施来应对社会经济形势,这些措施在社会和经济领域取得了积极成果,但也产生了一些不良后果。在卫生部门,经济危机主要减少了资源的可获得性,并对一些健康决定因素和民众健康状况的某些方面产生了不利影响。尽管面临普遍的经济困难,政府仍决心维护该国在卫生领域取得的成就,并进一步加以发展。解决办法不是私有化,也不是引入医疗保险制度或类似措施。相反,古巴将在卫生部门寻求更高的合理性和经济效率。古巴已经批准了国家应继续为卫生系统提供资金,并通过免费服务维持全民覆盖和可及性的原则。