Reply to Carmelo Mesa-Lago’s Comments on My Review

Apparently, Carmelo Mesa-Lago misunderstood the purpose of my review. I was specifically reviewing his recent book published in 2025 comparing Cuba, China, and Vietnam, and was certainly not attempting to evaluate his life’s work. Nevertheless, I did acknowledge, at the beginning of my review, some of his most important contributions and my intellectual debt to his Cuba scholarship.

Regarding Mesa-Lago’s evaluation of the Chinese and Vietnamese regimes, it is evident that he adopts an interpretation of those two countries that almost ignores the degree to which their economic and political aspects are integrated into a single whole. That is why the undisputable rise of Chinese economic power cannot be separated from its political system that, as has been widely recognized, has historically suppressed domestic consumer demand. The regime has also seriously curtailed economic and social rights through its elimination of independent trade unions and the establishment of the houkou system that prevents the masses of internal immigrants, especially in the big cities, from claiming social benefits reserved for its permanent urban residents. In other words, Chinese economic success is not separable from its capital accumulation regime made possible by its massive suppression of political and social rights. Moreover, this overall Chinese socio-economic and political system has prevailed regardless of the varying degrees of centralization of its economic planning, which seems to play a central role in Mesa-Lago’s analysis of China.

Moreover, when I criticized the Cuban political current that advocates the Sino-Vietnamese model for Cuba, I did not particularly have Mesa-Lago in mind. However, I was not aware at that time of Mesa-Lago’s reply to another critic that appeared in the Cuban dissident journal El Toque on February 22, 2023. In that reply, Mesa-Lago expresses a clear preference for political democracy in China and Vietnam, but at the same time concedes that “if there was a choice between the present situation in Cuba and a change towards a market socialism with an improvement of the standard of living of the Cuban people, but without democracy, I would lean towards that kind of change, because the terrible situation which the Cuban people are suffering, hurts me.” Although I recognize Mesa-Lago’s sincerity in supporting political democracy in Cuba, I would submit that his political concession weakens the struggle against dictatorship and authoritarianism in Cuba.

Health Care

In his reply, Mesa-Lago insists on the desirability of a more efficient universal and unified public health system, which according to his new book, would be in competition with private medicine. But, as I pointed out in my review, Mesa-Lago himself acknowledged in the book under review that in Vietnam the public health system involves long waiting lines while the private system does not. This is hardly surprising when you have a health system that only the more affluent sections of the population can afford, and another system for everybody else. The division in health care that Mesa-Lago advocates is bound to diminish social solidarity and strengthen a “look out for number one” individualistic mentality. In a single health care public system, the whole population would have a vested interest in defending the system from budget cuts and the encroachment of hostile governments. This has been the case in both Britain and Canada where there is overwhelming public support for their respective versions of socialized medicine notwithstanding creeping privatization, repeated past budget cuts, and the serious health crisis produced by the Covid pandemic resulting in long waiting times. Otherwise, you would have a situation like that of Medicaid and Medicare in the United States where the former service for the poor has far fewer defenders than Medicare’s universalistic service for those 65 years and older.

Finally, any single public health system would need to be democratically planned, although not necessarily by the central government. Instead, duly elected representatives of the various sectors affected by the medical plan, from providers to consumers, would decide the policies of the public medical program. Among other things, they would have to make sure that the existing facilities and resources are equitably distributed throughout the country. Otherwise, we would have something like the primarily “free market” system of pre-revolutionary Cuba where the 21 percent of the population who lived in the Havana metropolitan area had access to 60 percent of physicians, 62 percent of dentists, and 80 percent of hospital beds in the whole of Cuba. At the time, public medicine in Cuba compared poorly with private medicine, even though the latter also varied in quality. The Cuban press frequently provided exposés of the miseries of public hospitals, especially in the case of Mazorra, the notorious institution in charge of treating the mentally ill. (See Jennifer L. Lambe’s excellent Madhouse: Psychiatry and Politics in Cuban History, Univ. North Carolina Press, 2017).

Retirement

Mesa-Lago points out that several countries have higher ages of retirement than France where massive protests took place against raising the age of retirement in 2023. This is true but misses the critical fact that France’s lower age of retirement was not a chance event but the product of more advanced working-class and popular struggles. Thus, the 2023 mass movement was an attempt to prevent the erosion of previous gains in the French retirement’s system. Although not related to Mesa-Lago’s arguments, I am reminded of my Cuban youth when conservatives bragged about Cuba being more socially and economically advanced than most Latin American countries with the implication that people should not have been complaining too much. In any case, in November of 2025, with the continuing public pressure and with the survival of the present French government at stake, the government announced that it was suspending the application of Macron’s 2023 change of the age of retirement.

Regarding government subsidies, both conservative and Keynesian economic approaches assume as a matter of course that most of the economic surplus in any given economy is privately controlled by big private businesses and is therefore not directly available to subsidize social and economic priorities such as maintaining a lower age of retirement. Thus, although French president Macron may or may not be a “bad person,” that is not the important issue, but rather that he was working in an economic system and environment favorable to imposing restrictions on public services for the sake of the so-called economic stability of the private profit system, while reinforcing the notion that every program should in one way or another pay for itself. Obviously, not all products and services can be subsidized, in which case an economy would collapse. But things would be very different if the total economic surplus were available for society and its duly elected democratic representatives to make democratic decisions about its use, especially if economic productivity in the economy was relatively high. Even in crisis-ridden Cuba, the Cuban government manages to obtain an economic surplus, in great part at the expense of popular consumption. But instead of investing it in agriculture and industry to better feed the people and further develop the country and its general standard of living, it uses it to build an increasing number of luxury hotels, notwithstanding the near collapse of tourism. Even in the top tourist year of 2018, when close to five million tourists arrived in Cuba, the hotel occupation rate was approximately 50 percent. In any case, that governmental economic decision to use practically all available resources to build hotels was made without any input from the Cuban workers and people most affected by it.

Cuba at the Crossroads

Cuba is undergoing a very serious economic crisis, even worse than that of the 1990s following the collapse of the USSR. The current crisis, which has worsened since the publication, a year ago, of the book under review, includes a massive emigration of close to a million people since 2022, food shortages, inflation, a major energy crisis featuring frequent and major blackouts throughout the whole country, and the spread of diseases such as chikungunya and Dengue fever facilitated by a hot and humid climate and the near collapse of garbage collection mainly caused by the shortage of oil. The over sixty-year-old U.S. criminal economic blockade hardened by the Trump administration has doubtlessly played an important role in creating this situation, but it has been by no means the only or even principal factor producing the crisis as the Cuban government and its “campist” friends abroad would argue. It is the Cuban regime’s anti-democratic decision making from above that systematically creates and encourages a climate of economic indifference, neglect, and carelessness among both lower-level managers and workers. As was the case in Eastern Europe when it was ruled by the Communist regimes, the chronic shortage of agricultural and other consumer goods considerably worsens the situation facing Cubans.

Nobody knows what will happen after the historic revolutionary leadership passes from the scene. The three major surviving veterans of the rebel leadership of the 1950s who provide what is left of the regime’s political legitimacy (Raúl Castro Ruz, José Ramón Machado Ventura, and Ramiro Valdés Menendez) are all well into their nineties and are not likely to live for much longer. A likely inheritor of the central power in Cuba is GAESA (Grupo de Administración Empresarial, S.A.) the business branch of the Cuban armed forces that already controls a very large section of the Cuban economy, including such areas as tourism, banking, and foreign trade. Although large-scale protests against economic hardship and political oppression encompassing the whole nation broke out on July 11, 2021, with more localized protests taking place in the following years, no significant political groups have emerged from those numerous protests to politically oppose and challenge the government.

The Cuban exile community primarily residing in South Florida (there are other important concentrations of Cubans abroad such as in Spain) has been led and dominated by the hard political right that has for many decades been more than willing to trample on the civil liberties and democratic rights of any internal dissidents. This phenomenon has a very long history as reflected for example in the 1992 Human Rights Watch report titled “Dangerous Dialogue.” While this community showed some signs of political pluralism in the presidential elections held in 2012 and 2016 when Barack Obama and Hillary Clinton almost evenly split the vote with the Republican candidates, this has changed considerably since then with the politically aggressive organizing carried out by Trump’s Cuban-American followers, while Florida Democrats have characteristically done little or nothing to counteract it. It remains to be seen whether Trump’s willingness to treat Cuban refugees as badly as those originating in other countries will affect the results of the 2026 elections when three conservative Cuban American congresspeople will face the voters.

Thus, the prospects for a Cuban socialism that is thoroughly democratic and thus from below, are not good, at least for now. Even among democratic opponents of the regime, the reign of the market is taken as gospel truth. The issue if not whether there would be any private market and capital in a socialist and democratic Cuba, but whether that private capital and market would be dominant, instead of the economy being dominated by democratic planning with the maximum participation and control of those who labor to make it prosper.

That is why I have argued for the concrete benefits of public as opposed to private services, defending, for example, the necessity of a monopoly of public education, thereby limiting if not eliminating the hidden and not so hidden injuries of class and race at least during childhood and adolescence, although of course recognizing the right of a religious education for those who want it held in non-public facilities after their classes in public school. Along the same lines I have been arguing, as this article shows, the potential benefits of a public health service serving all Cubans. In turn, the preservation and radical improvements of such public services can also serve as stopgaps in the likely future struggle to prevent Cuba going completely capitalist, whether this capitalism is sponsored by GAESA in what could be a Putin-style Cuba, or one sponsored by a private capitalism strongly backed by U.S. and particularly Cuban-American capital.

Click here for Samuel Farber’s original review.

Click here for Carmelo Mesa-Lago’s reply to Farber’s review.