I think size is a perfectly valid reason that Cuba might make a poor example and, frankly this applies to Japan as well. The U.S. is geographically FAR FAR bigger than either of those countries which would probably affect some aspects of our infrastructure needs. I just don't think it's constructive to scoff and point to Cuba saying, "Hah! Look at their economic ruin. Why would we want to copy anything they do," when neither healthcare, nor even communism is the cause of their poor economy.