ABSTRACT
The unprecedented accomplishments reported from China and Cuba in providing health care to their populations question the assumption that economic development along the model of Western nations is a sine qua non for developing effective health care systems among nonaffluent developing nations. Equal distribution of resources, emphasis on preventive public health measures, and attention to improving overall quality of life have been concepts employed to great advantage by both countries. When it is realized that improved standards of living have far overshadowed modern medical technology in upgrading the health of populations, the policies employed in China and Cuba become especially relevant to other nations, both developed and developing.
PIP: Considering the stage of economic development at which they started, both China and Cuba have accomplished notable improvements in public health. This fact challenges accepted theory that economic development along the model of Western nations is a necessary condition for improved health care in nonaffluent countries. Both countries achieved their health care gains by equalizing health resoruce distribution, emphasizing ambulatory delivery services, concentrating attention on the poor and rural areas, and effectively using paramedical and nonmedical personnel. Both countries avoided the Western models of hospital-based, curative-oriented medicine in favor of widely distributed, preventive medical services. Both countries have focussed on improving the general quality of life for the population. Cooperative, group achievement has been stressed in both China and Cuba. Community participation in health ventures has been encouraged. Taiwan and the Philippines are cited as developing countries which chose to follow the Western health care model with less success than China and Cuba have had with theirs. The Taiwanese example shows that economic development alone, without government attention on the general quality of life, will not achieve improvements in health care.
