IESET.
Hypotheses·healthcare·cuba_health_outcomes_vs_advanced_market_peers

If Cuba's socialist health-system superiority story really travels beyond a friendly regional pool, Cuba should remain at least mid-pack against a small advanced-market subgroup of non-socialist health performers by 2000; if it ranks near the bottom even after adjusting expectations for lower income, the universal version of the Marxist-Leninist claim is overstated.

REFUTEDengine/runs/cuba_health_outcomes_vs_advanced_market_peers

REFUTED — Cuba does not clear the advanced cutoff in the 7-country advanced-market subgroup. Ranks: LE #6/7, IMR #7/7, income #7/7; mean-health-vs-income gap 0.5.

confidence cueThis test cuts against the claim as written or misses its pre-declared threshold.

policy briefNeeds review

In ordinary language

Over a long period, do more market-oriented institutions translate into higher income or productivity, once the comparison looks beyond a single success story?

plain answer

The data did not support the prediction. Cuba does not clear the advanced cutoff in the 7-country advanced-market subgroup.

why it matters

This matters because healthcare claims should change belief only when they survive a pre-declared empirical test.

how the test works

It compares 7 country or place units from 1960 to 2000, using a descriptive design.

what was measured
What changed
  • Cuba socialist indicator
What we checked
  • Life expectancy at birth
  • Infant mortality per 1000
what this does not prove

A single test is not the whole truth. It narrows the claim under a specific sample, time period, and method. Strong policy conclusions need the pattern to survive nearby tests, alternative data, and serious objections.

verification

No evidence packet has been generated yet.

Results

engine/runs/cuba_health_outcomes_vs_advanced_market_peers
Loading chart…

Who has skin in the game — schools predicting on this

7 schools list this hypothesis as a test of their position. The chips below are school-level scoreboard outcomes, not a second hypothesis verdict.

hypothesis verdict vs scoreboard outcome

The banner verdict judges this hypothesis as written. The scoreboard asks whether each school's polarity-corrected prediction was right. Raw status is not a school win: SUPPORTED supports schools that needed SUPPORTED, but refutes schools that needed REFUTED.

Pre-registration

pre-registered
first-spec commit 4c8ce8e · 2026-07-18T22:11:21Z

If Cuba's socialist health-system superiority story really travels beyond a friendly regional pool, Cuba should remain at least mid-pack against a small advanced-market subgroup of non-socialist health performers by 2000; if it ranks near the bottom even after adjusting expectations for lower income, the universal version of the Marxist-Leninist claim is overstated.

Falsification criterion — what would disprove this

set before the run · honoured after

This hypothesis is considered falsified if:

PRIMARY 1 (life expectancy rank, dispositive): within the fixed 7-country subgroup {CUB, ESP, PRT, GRC, ISR, JPN, KOR}, Cuba's life expectancy at birth in 2000 must rank in the upper half of the pool (rank <= 4 of 7, rank 1 = best). PRIMARY 2 (infant mortality rank, dispositive): Cuba's infant mortality rate in 2000 must also rank in the upper half of the same pool (rank <= 4 of 7, lower = better). PRIMARY 3 (health-vs-income overperformance): Cuba's mean health rank across {life expectancy, infant mortality} in 2000 must beat its GDP-per-capita rank by at least 1 place. SUPPORTED if all three primaries hold. PARTIAL if exactly two hold. REFUTED if zero or one holds. INFORMATIVE: report 1960 ranks and 1991-2000 post-Soviet-subsidy trajectory. METHOD_VALID: requires coverage for Cuba plus all 6 non-Cuban comparators at the 2000 endpoint for life expectancy, infant mortality, and income-rank context.

formal test & threshold
test:      cuba_advanced_market_subgroup_rank_2000
threshold: PRIMARY: LE_rank_CUB_2000 <= 4 of 7 AND IMR_rank_CUB_2000 <= 4 of 7 AND income_rank_CUB_2000 - mean(LE_rank_CUB_2000, IMR_rank_CUB_2000) >= 1

Method

Template
descriptive
Sample
7 countries · 19602000
Evidence type
associational

Descriptive rich-comparator subgroup test. This is not a causal socialism-vs- capitalism design; it is a credibility stress test of the stronger rhetorical claim that Cuba's health outcomes remained competitive even against high- performing market economies. The signal is rank position, not a structural estimate.

Data

VariableSourceTransform
life_expectancy_at_birth
outcome
world_bank_wdi:SP.DYN.LE00.INtier 2
level
infant_mortality_per_1000
outcome
world_bank_wdi:SP.DYN.IMRT.INtier 2
level
cuba_socialist_indicator
treatment
constructed:indicator = 1 for CUB; 0 for the advanced-market comparator subgroup.tier 5
indicator
log_gdp_per_capita_maddison
control
owid:gdp-per-capita-maddison-2020tier 2
log

ready  ·  pending  ·  reconstruct-needed

Detailed result card

Cuba health outcomes vs advanced-market peers, 1960-2000

Verdict: REFUTED — Cuba does not clear the advanced cutoff in the 7-country advanced-market subgroup. Ranks: LE #6/7, IMR #7/7, income #7/7; mean-health-vs-income gap 0.5.

Primary thresholds

  • Life expectancy rank in 2000 must be <= 4 within the 7-country subgroup.
  • Infant mortality rank in 2000 must be <= 4 within the 7-country subgroup.
  • Cuba's mean health rank must beat its income rank by at least 1.0 places.

Cuba's standings

  • 1960 ranks: LE #5, IMR #2.
  • 2000 ranks: LE #6/7, IMR #7/7, income #7/7.
  • Mean health rank in 2000: 6.5.
  • Income minus health-rank gap: +0.5 places.

2000 rank table

| Country | LE rank | IMR rank | Income rank | Mean health rank | Income minus health | |---|---:|---:|---:|---:|---:| | JPN | 1 | 1 | 1 | 1.0 | +0.0 | | ESP | 2 | 2 | 2 | 2.0 | +0.0 | | GRC | 4 | 3 | 6 | 3.5 | +2.5 | | ISR | 3 | 5 | 3 | 4.0 | -1.0 | | PRT | 5 | 4 | 4 | 4.5 | -0.5 | | CUB | 6 | 7 | 7 | 6.5 | +0.5 | | KOR | 7 | 6 | 5 | 6.5 | -1.5 |

Soviet-subsidy sub-period

  • Cuba life expectancy: 73.8 in 1991 -> 75.9 in 2000.
  • Cuba infant mortality: 10.3 in 1991 -> 6.8 in 2000.

Method

This is the intentionally mean stress test. The comparator pool is restricted to Southern European and East Asian / Israeli market economies that are materially richer than Cuba and often cited as high-performing non-socialist health systems. The threshold asks for upper-half placement on life expectancy and infant mortality plus at least a one-place health-over-income overperformance. If Cuba still clears that bar, the claim has real reach; if it does not, the universal-superiority story is much weaker than the LATAM-only framing suggests.

Caveats

  • The Cuban health series still inherits official-reporting risk, and the rich-comparator pool is small enough that one-rank changes matter.
  • Income rank again uses OWID's Maddison GDP-per-capita series because the WDI PPP endpoint is missing for Cuba. That choice is transparent, but the ranking should be treated as contextual rather than dispositive in itself.
  • This subgroup test is descriptive, not causal. It is best read as a credibility stress test of broad Marxist-Leninist health-superiority rhetoric, not as a clean estimator of the effect of socialism.

Provenance

  • world_bank_wdi:SP.DYN.LE00.IN
  • world_bank_wdi:SP.DYN.IMRT.IN
  • owid:gdp-per-capita-maddison-2020

See manifest.yaml for exact vintages. Reproduces from replication.py.

Strongest opposing argument

Every hypothesis ships with its charitable opposing argument. The framework earns credibility by handling objections at their strongest, not weakest.

Notes

This is the intentionally mean companion to both the LATAM peer spec and the broader non-LatAm market-pool spec. It isolates a rich-country subgroup that is often invoked as evidence that good health systems do not require socialism: Spain, Portugal, Greece, Israel, Japan, and South Korea. The question is not whether Cuba matches Japan on income or technology, but whether it remains in the competitive upper half on the two flagship health metrics or instead falls toward the bottom once the pool contains only advanced-market health performers.

Authored framework. Read the transparency note.