Cuba's health care policy: prevention and active community participation.

In Cuba, health care is considered a human right for all citizens; health care is therefore a national priority. Cuba's health policy emphasizes prevention, primary care, services in the community, and the active participation of citizens. These emphases have produced an impressively high ranking on major health indicators, despite economic handicaps. The Cuban experience demonstrates the influence of ideological commitment and policy-making on the provision of health care and challenges the assumption that high-quality care for all citizens requires massive financial investment. The evolution of the Cuban health care system since the revolution thus has implications for the U.S. health care system; specifically, it suggests that the equitable distribution of health care services in the United States requires a national health insurance and service delivery system.