If that was true then studies like the one done by the World Health Organisation would have placed private healthcare systems above government healthcare systems. As it stands most, if not all, of the top healthcare systems in the world are state ran. Regarding pharmaceutical companies, that is the first time I think I have ever seen an argument that suggests pharmaceutical companies don't recuperate money. If you're being a cunning realist and are serious on this point i'd like to know more information regarding the role that the US plays in subsidising R&D costs if you happen to have any interesting places where I can read about it. Cheers! And there is the swift blow to Cuba's system, praised by Kofi Annan, held in esteem by the majority of the world as a lesson in third world healthcare management and exported across the Caribbean Sea to South American countries. We'll ignore the "like most oppressive communist states" comment politically and move forward with accusations of padding nationwide statistics. To begin with, it is laughable that you say nationwide statistics in these "oppressive communist states" are often manipulated, as if it was almost something that doesn't happen in Western democracies. Nevertheless, it also ignores the many independent reports into Cuban healthcare and the stone cold fact that a lot of the continued support for Castro finds its source in the fantastically socialised services he brought to Cuba - the top one being healthcare. To draw back on your previous point above, Cuba is far and away more efficient than the US system and far more efficient than the UK system. Unfortunately the second part of your argument regarding the international community doesn't really stand the test of time either, since Cuba has often existed as an annoyance to the Western political powers and especially to the one located 90 miles to its North. I don't think Castro necessarily gives a damn about how the US view Cuba, or anyone else for that matter.