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For Cuba's supporters, health is the most commonly cited evidence of the socialist system's success. Even critics often concede that this is the country's saving grace. Cuba's health statistics are indeed extraordinary. This small island outperforms virtually all of its neighboring countries and all countries of the same level of economic development. Some of its health statistics rival wealthy industrialized countries. Moreover, these health outcomes have resulted against all odds.

Setting out to unravel this puzzle, the author finds that Cuba possesses an unusually high level of...