Kraft Healthcare Consulting Explores Cuba

Throughout the years, Scott Mertie, president of Kraft Healthcare Consulting, LLC (KHC), has attended healthcare delegations to China and multiple European countries that have government-run healthcare systems. While Scott was visiting the Republic of Cuba on a personal excursion earlier this year, he envisioned a trip where the activities would allow him to explore the country’s national healthcare system.

Scott believed a delegation to Cuba would be interesting and insightful -- not only for himself, but also for other members of the Middle Tennessee healthcare community. So he joined forces with insightCuba, a not-for-profit travel organization specializing in travel to Cuba for Americans, to customize the trip.

Scott was excited when 23 other participants, ranging from healthcare executives to providers, joined the delegation, including Caroline Young, president of the Nashville Health Care Council, and William Frist, M.D., former U.S. Senate Majority Leader. Other Kraft team members included Tracey LaFore and Katie Ballou of KHC and Glenn Perdue, managing member of Kraft Analytics, LLC.

The four-day delegation included visits to a variety of healthcare entities, including the Latin American School of Medicine and the Frank Pais Orthopedic Hospital, which also acts as a health tourism center. Delegates visited a local polyclinic pharmacy and a community center focusing on HIV/AIDS prevention and education. The participants listened to presentations and discussed their questions with local healthcare providers and governmental representatives.

During these interactions, the delegates discovered many differences between the U.S. and Cuba. One contrasting aspect is that, in Cuba, diagnosis codes are used for statistical analysis, but not for billing and reimbursement purposes. The U.S. is one of the only countries that uses diagnosis codes to determine reimbursement. Another difference is that healthcare insurance does not exist in Cuba.

Perhaps even more unusual is Cuba’s lack of technological advancements. One illustration of the deficiency of medical technology was the absence of automatic intravenous (IV) pumps in the medical facilities. One guide told the delegates that a nurse must actually hold the bag and properly time the distribution of medication.

The delegates also learned that working as a medical provider is not as lucrative as it may be in other countries. Wages are set by the government, and the annual salary for doctors in Cuba is approximately $40 (U.S. dollars) per month. However, the tourism industry is Cuba’s largest sector, and it gives people the ability to earn more than is possible in a government-regulated job. Thus, many well-educated people also have jobs as taxi drivers or restaurateurs.

Despite what some may classify as shortcomings, Cuba continues to boast one of the highest life expectancy rates in the Americas. One of the main reasons for the longevity is Cuba’s focus on preventative care and a high doctor-to-citizen ratio. Additionally, the majority of the Cuban population does not have cars, so the people are more active. There are less fatty foods available to the public, and very few fast food restaurants exist on the island. The delegates got to see firsthand many of these differences between the culture in Cuba and the U.S.

The trip was filled with educational seminars, thought-provoking discussions and behind-the-scenes tours of medical facilities, but the delegates were also able to enjoy a bit of local culture. One evening, a fleet of 1950s convertibles transported the group to dinner in Havana while the sun was setting, leaving just one of many lasting memories of the trip of a lifetime for many of the delegates.

For more information on KHC’s delegation to Cuba, visit