Health and Education in Capitalist Countries

There’s one misconception that I hear time and time again in Cuba that needs correcting. Barely a week goes by without someone telling me that in capitalist countries people have to pay for all health and education services. That’s simply not true. In many, many countries with capitalist economic systems, health and education are provided by the government, just as they are in Cuba, and citizens aren’t charged for the service when they use them.

In the UK for example, the government’s National Health Service (NHS) provides healthcare to every British resident. Most of the services are free at the point of use and some, such as emergency treatment, are also free for tourists. Some services aren’t free for everyone – prescriptions or eye tests for example – but the more vulnerable and lower income groups normally aren’t charged. The NHS employs more than 1.6 million people making it one of the top five of the world’s largest employers (the US Department of Defence, McDonalds, Walmart and the Chinese People’s Liberation Army are the other four). And 1 million people are treated every 36 hours. The system’s not perfect – which health system is? – and faces lots of criticism and new challenges every year but in 2014, the Commonwealth Fund found that in comparison to healthcare systems in other developed countries, the NHS was the most impressive overall.

It’s the same with primary and secondary education in the UK. There are some private or ‘independent’ schools but most British kids, 93% of them, go to schools provided by the state, funded from taxes. Full-time education is compulsory for all children aged 5 to 18 and children between the ages of 3 and 5 are entitled to 600 hours per year of state-funded, pre-school education.

In other European countries the governments take a similar approach. Health care in Sweden is financed primarily through taxes levied by county councils and municipalities. Italy, Portugal and Norway have similar health systems to the UK. Outside of Europe, there are many other countries – Costa Rica, Canada, Japan and Malaysia for example – that provide universal health coverage – ensuring everyone has good access to health care without suffering financial hardship – in a variety of ways.

And the UK and Cuba aren’t the only countries where you don’t pay to go to school. Every Swedish child over the age of six has access to free education. And in Finland, known for its excellent education system, there are no tuition fees and all school materials, school meals and commuting are provided free of charge to children in basic education (i.e. those aged 16 or under).

Of course none of these education or health systems is really free. The money has to come from somewhere. The NHS costs £116 billion to run. Just as in Cuba, the money for the salaries, desks, electricity, operating theatres, stethoscopes, scanners, schools, hospitals and pretty much everything else comes from the state and is collected from the country’s citizens through taxation in one form or other. So the service is free ‘at the point of use’. But only then.

I hope that’s cleared up the misunderstanding. Let’s talk about something else next time we meet.