Maybe it's like that in politics. There is a pervasive belief that communism was a bad idea. This is certainly justified, the record ain't great, is it? But it must rankle that those remaining communist (in name at least) regimes haven't ground themselves into the dust by now. I mean, Cuba has a high level of literacy, their medical facilities and graduates seem to have a good reputation. People from there seem to feel national pride. These things must seem incongruous to some, how can they be possible? Since it's such an evil place, shouldn't everything be truly awful. Of course real life is never what propaganda says it is. People can't stand contradictions, especially religious or political ones, because unlike important things like food or health or shelter, religion and politics are mostly about ego. That is: I believe "A" therefore "B" must be bad BECAUSE I believe "A". But if "B" happens to do some things right, this froths people up something fierce.
Doesn't rankle me that the remaining communist regimes haven't ground themselves to dust, but then, you wouldn't expect them to. Neither would you expect the rising rightwing governments in Eastern Europe to do that either. Today, the technology of repression is so good (witness the terrible conditions in North Korea, where a good part of the population apparently starves every time there's a crop problem) that once a regime has a grip, there's no way out. In the more sophisticated regimes, as in Vietnam, there's a level of personal freedom as long as you don't do or say anything that the regime views as a threat. The sophisticated regimes have learned to accept levels of criticism that are insignificant, as a safety valve. But the grip never goes away.
As far as Cuban doctors are concerned, I've been told (and I think correctly) that most of them function on a level that's about equivalent to an American nurse practitioner, which for most medical problems, is good enough. There are several thousand Cuban doctors in Miami, and most work as nurses or medical techs because they can't pass American medical exams. The Cubans simply haven't been able to keep up with modern medical technology, and so (most) Cuban doctors don't know how to work with it.
There have been a number of comments during these threads that compare America unfavorably to Canada. Some of that doesn't seem to me to be especially controversial (given a choice, I think many Americans, probably a majority, including myself, would prefer a "Medicare for all" system, like Canada's) but none of us should make the mistake of thinking that Canada is basically the US with better medical care. The two countries are quite different, in my experience, and have very different political cultures. Canada actually remains quite close to the British system, and America, of course, threw the Brits out. I personally prefer the US flavor, even with all the problems we have.
