Amie Gonzalez

Writing Sample
This writing sample is an excerpt from a research design I completed for my Political Science
class Comparative Politics. I included the first two parts of my assignment, the introduction
and literature review.
Introduction
Conventional wisdom has it that the United States healthcare system produces better
health outcomes when compared to other healthcare models. Among many healthcare and
academic professionals, the flexibility and competition of the United States market-oriented
healthcare system prevails over nationalized-healthcare models (Tanner 2008, p.2). Despite these
popular assumptions, Canadas socialist healthcare model has proven more effective in achieving
success among their health indicatorsspecifically infant mortality rate (per 1,000 deaths). In
2014, Canadas infant mortality rate (per 1,000 deaths) of four outnumbered the U.S.s infant
mortality rate of six (World Bank Group n.d.). The Canadian healthcare systems success in
attaining a lower infant mortality rate than the United States is a puzzle in need of further
investigation.
Existing literature on socialized medicine offers explanations as to why socialisthealthcare models are often more effective in achieving better health outcomes. Most of this
extant research, however, does not investigate the quality of healthcare among the socialisthealthcare models and the institutional impacts on their health outcomes. This paper aims to
provide a deeper understanding as to why socialist-Canada has a lower infant mortality rate than
the capitalist-United States by drawing on research from an outside case study. In doing so, one
inevitably stumbles upon the policy implications that underlie this political puzzle. Should
capitalist-healthcare nations strive to implement universal healthcare? Should developing,
socialist countries aim for the capitalist healthcare model when structuring their healthcare

systems? This paper builds off of past research on the socialist-healthcare model in order to
determine why Canada has a lower infant mortality rate the United States. More importantly,
however, this paper suggests that the socialist-healthcare models successful health outcomes are
influenced by the following factors: its emphasis on preventative care, the collaborative
relationships among medical professionals and the community they serve, the required medical
education and training systems, and the integration of medical care and public health.
This paper proceeds as follows. The second section of this paper presents existing
research on the socialist-healthcare model. The third section presents this papers main argument.
In the fourth section, this paper proposes a specific methodological approach. Lastly, this paper
concludes with a discussion on the policy implications that develop from its investigation and
suggests directions for future research.
Literature Review
Universal healthcare coverage is defined as a system that ensures that its entire
population within its respected country can use the promotive, preventative, curative,
rehabilitative, and palliative health services they need, of sufficient quality to be effective, while
also ensuring that the use of these services does not expose [them] to financial hardship (World
Bank Group n.d.). Countries with nationalized healthcare systems aim to offer their entire
population not only equal access to healthcare but also aim to offer equal healthcare quality.
Within a socialist healthcare system, specifically single-buyer model, the government is the sole
insurer (Gorin 1992, n.p.). This healthcare system is publically funded and administered by the
government. Cuba has a single-payer healthcare system and, in 2014, had an equal infant
mortality rate per 1,000 deaths of four (World Bank Group n.d.). This paper will review existing

literature on Cubas socialist-healthcare model in an effort to understand the socialist models

success in achieving low infant mortality rates.
Political scientists like Karen Saucier Lundy and Sharyn Janes assert that the Cuban
healthcare systems emphasis on illness prevention and health promotion is a characteristic that
contributes toward its achievement of successful health conditions. By focusing on educating the
populace at large about disease prevention and health initiatives, the Cubans rely less on
medical supplies to maintain a healthy population (Drain, Barry 2010, p.573). The contrary is
suggested about capitalist-focused healthcare systems among other political scientists as they
claim that theses systems rely heavily on medical supplies and technologies to maintain a
healthy population at very high costs (Drain, Barry 2010, p.573).
Many studies also suggest that Cubas focus on primary-care medicine has created a
health care infrastructure to support it, which also contributes to their national health outcomes.
Cubas healthcare institutional design consists of a system of community-based polyclinics,
which provide primary-care services, specialty services, and laboratory and diagnostic testing,
and consultorios, which are even more local neighborhood-based family medicine clinics
(Drain, Barry 2010, p.573). Simply put, a polyclinic serves as the organizational hub for twenty
to forty consultorios.
Political scientists suggest that this community-based structure allows medical
professionals to tailor their healthcare initiatives and promotions to their local communities
(Lundy, Janes 2002, p.112). Lundy and Janes thus make the conclusion that the Cuban healthcare
systems communitarian structure and sensibilities produce good health outcomes, which include
low infant mortality rates. Political scientist Jay Nordlinger, however, suggests that this structure

actually has a negative effect on the Cuban healthcare system, claiming that quality among
clinics and hospitals begin vary greatly (Nordlinger 2007, p.38).
Many academic scholars also conclude that Cubas medical and training programs are
also key factors that contribute toward its health achievements. All [medical professionals] are
expected to work in underserved areas for two years immediately after graduation (Lundy, Janes
2002, p.111). Lundy and Janes suggest that these mandatory requirements of medical
professionals not only provide them with invaluable experience but also improve and maintain
the overall health of the Cuban population.
Another prevailing claim about the Cuban healthcare system, as summarized by political
scientist Paul Erwin, is that its integration of medical care and public health is a major
contributor to its health outcomes. In Cuba, the Ministry of Public Health is in charge of the
family medicine physician and nurse teams, polyclinics, and hospitals, and is also in charge of
the curriculum for medical, nursing, and dental schools, as well as the national school od public
health (Erwin 2015, p.1510). Many scholars consider this integrative system to be a major
factor in the Cuban systems success.
Despite this attention to systematic factors of the Cuban healthcare system, there has been
little research seeking to investigate the degree of which the hospitals and clinics among the
Cuban healthcare system offer equal quality of healthcare.