a cluster · CubaHavana

Cuba's capital, about two million people, and the only hub in this directory where every hospital and clinic is state-owned. Foreign patients are sold care through a government trading company rather than by the hospitals themselves, and the currency they bring is the point of the arrangement. It is also the only hub here whose largest source market is legally barred from most travel to it.

There are no private hospitals or clinics in Cuba; all health services are government-run, and there were 150 hospitals in the country as of 2019. Foreign patients are handled through a state marketing company, Comercializadora de Servicios Médicos Cubanos, which sells access to the national system as a package of treatment, transfers, accommodation and support for a companion.

The treatments that travel are the unusual ones: eye surgery, multiple sclerosis and Parkinson's disease, retinitis pigmentosa, orthopaedics, addiction treatment. In 2005 more than 19,600 foreign patients came for care, most from Latin America, with the retinitis pigmentosa programme drawing patients from Europe and North America. Annual revenue from this trade has been put at around forty million United States dollars, a figure repeated without a stated year and one this directory carries as a circulating number rather than a measurement.

Cuba also runs the inverse trade. Under Operación Milagro, from 2004, it paid for Venezuelans with reversible blindness to fly to Cuba for free sight-restoring surgery; more than 200,000 Venezuelans were operated on, the programme was then exported, and by 2019 more than four million people in 34 countries had been treated through it. Free surgery flown in one direction and hard-currency surgery flown in the other, out of the same hospital system.

That is exactly where the argument sits, and this record reports it rather than settling it. The Cuban neurosurgeon and dissident Hilda Molina has argued that after the Special Period the state turned the medical system into a foreign-currency business and created a gap between what a Cuban and a foreigner receive. Others hold that the revenue funds the domestic system that treats Cubans for nothing.

Inference — the gap is structurally hard to measure from outside, because the same ministry owns the hospitals, sells the packages and publishes the statistics.

Care is bought from the state company, not from a hospital, and paid in hard currency. For United States residents the constraint is not clinical but legal: 31 CFR § 515.560, the travel section of the Cuban Assets Control Regulations, authorises twelve categories of travel — family visits, official business, journalism, professional research and meetings, education, religious activity, public performances and competitions, support for the Cuban people, humanitarian projects, private foundations and research institutes, informational materials, and certain export transactions. Going for treatment is not among them, and paragraph (f) states: "Nothing in this section authorizes transactions in connection with tourist travel to Cuba." A note to the section does authorise the receipt of emergency medical services and payment for them.

As of 16 September 2026 the Cuban health system remains wholly state-owned and sells to foreigners through a single state company; the United States regulation governing whether its own residents may lawfully pay for that care is 31 CFR § 515.560.

Nothing here is legal advice. A sanctions reading turns on facts this page does not have, and the regulation moves.