Government is a kind of medicine. It exists to treat symptoms of flawed human nature — violence, fraud, theft, exploitation and so on.

Like any medicine, government ought to be prescribed according to what is needed to restore or maintain health.

Not enough, and society grows ever sicker. Too much, and we hinder normal social growth and progress and create new symptoms, including dependency.

In the 1950s, Cuba had a revolution, putting in place a new team of social physicians. The island nation's symptoms included severe inequality, poverty, illiteracy, oppression and foreign interference. The new doctors prescribed heavy injections of medicine and radical surgeries.

Last winter, I spent several weeks in Cuba. The signs of decades of government overdose were everywhere. Yet so were signs that irresistible influences of the modern world were bringing change and symptoms of withdrawal. Cuba is a nation in flux.

My visit revealed some of the ways a people and a country have responded to totalitarian government, how such a government clashes with the world of 2018 — and, by comparison, a better understanding of what ails and gives strength to my own country, the USA.

You wouldn't detect political malpractice through first impressions of the Cuban people. In none of the 15 or so countries I've explored, have I ever met such an expressive, upbeat population. Under sunny skies along narrow, cobblestone streets of the historic, southern coastal city of Trinidad, fedora-wearing Cubanos played salsa music while out-and-about locals mingled. It felt like a holiday. Nope. Just another Thursday.

In the capital, Havana, I escaped even livelier streets by moseying into a studio, whose wide-open double doors lured me with a glimpse of the artist's Picasso-like paintings hanging inside. Downtown, steps descended from a sidewalk into a club presenting perhaps the most impassioned jazz I've ever seen performed.

In Cuba, chances were favorable that whenever I pointed my camera at a picturesque local, he or she would stop to pose.

The spirit of the Cuban people seems in great shape. Overmedication shows in their physical surroundings.

While Old Havana (La Habana Vieja) boasts stunning colonial and early-20th-century architecture, such charmed scenes clash with the main, tattered fabric of Cuban life. Across the country, horse-drawn wagons serve as commercial transport along potholed dirt and asphalt roads. Litter decorates city parks. Feral dogs wander in search of food by day; feral cats prowl at night. Both defecate (and die) where nature dictates.

Rusted sheet metal separates single-family dwellings in some neighborhoods.

Random blocks of prewar-style apartment buildings in Havana look as if they'd just been through an air raid — caved-in roofs, chipped plaster revealing brick walls, grass and weeds taking root atop. One wonders whether they've had any maintenance at all since La Revolucion took the city in 1959.

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Under state socialism there is essentially no private ownership of assets: buildings, cars, even horses and cattle. This inevitably reduces individual incentives to take good care of these things, yet it is impractical for a single entity (the government) to manage them all. Individuals forbidden to keep the fruits of their particular labors see little reward (and sometimes no opportunity) for spreading one's wings, creating new enterprises, and new wealth for themselves and their country.

State-operated media means journalists can't fully and critically cover the government. Nor can citizens express discontent or organize for change.

In exchange for all these sacrifices of freedom, Cubans enjoy universal education and universal health care, and an egalitarian society. If theirs were the only nation on Earth, things in Cuba might seem fine. Trouble is, many of those who haven't been OK with this trade-off have found a way to leave, despite severe emigration restrictions. And those who have departed have tended to be the ones responsible for technological and economic development, which built the universally available medical and educational institutions.

Innovators left Cuba for countries kinder to their dreams, while their home country's policies froze society in time. Phone booths and oxen-powered farming — both employed across Cuba today — represent historic moments in technological evolution, not a destination where a society wants to remain. Alongside horses clopping down city streets in Cuba, you see enough classic cars to think you're at the Back to the '50s Car Show at the Minnesota State Fairgrounds.

Visitors do love this retro aspect of Cuba, though. Cuba has widened the door for tourists in recent years to cope with economic struggle. But this flow of outside wealth disrupts the local economy as it comes ashore.

Cuban state employees, including most professionals such as doctors, attorneys, engineers and architects, are paid in the range of $50 to $80 a month. I paid my bicycle-taxi guy in Havana $5 for less than a half-hour of pedaling. According to my 50-year-old, bald, white-mustached taxi driver in Trinidad, as recently as five years ago transportation was also a state-controlled enterprise, drivers being paid a monthly salary comparable to the professionals mentioned above.

That sounds nice — fairy-tale nice. The reality was that ambitious drivers arranged under-the-table cash deals with foreigners. (Whether unlicensed retail sales from homes, or offers of houses to rent, I saw many examples of "side hustles" — cracks in the concrete of Cuba's communism from which capitalism sprouts to life.)

These days, my driver said with appreciation, he's no longer paid by the government. He is paid what he earns, and in today's Cuba this means he can easily make 10 times what a surgeon does. The same goes for other service industry jobs recently released from government control.

"See that waitress?" said Juan, a 30-year-old Cuban I met at a rooftop bar in Havana. "I graduated college with her. She was a mechanical engineer. Now she's here, because she makes more money."

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Even amid so much evidence of "medicine" overprescribed, much disagreement remains about the correct dose of government a society should have.

At my Havana hostel, quite the mix of nationals fell together: Swiss, Irish, Chilean, Argentinean, German, English, New Zealander and Swedish. Evenings found us in the lounge. Spanish and English words volleyed between explorers bonded by a common destination and fueled by doses of Cuban rum and tobacco.

I was the only American. This wasn't surprising given the historic tensions (and travel restrictions) between the two countries. But a thaw has come in recent years. In December 2014, President Barack Obama and Cuba's President Raúl Castro opened relations between the two nations for the first time in over 50 years. President Donald Trump has reinstated some restrictions — largely regarding business ties — claiming their removal monetarily benefited Cuba's totalitarian rule. But Americans are still free to travel to Cuba. Around 300,000 did so the first six months of 2017. Direct flights are available, and the U.S. embassy in Havana — reopened by Obama — remains open.

Our diverse group socialized in the lounge of that hostel. The reliable cocktail party effect took hold when from out of the murmuring background my attention was drawn to words like "U.S.," "America" and "Trump."

These foreigners' concern for all things American struck me — as did their general disdain for my country.

A 24-year-old Indian-Englishwoman stated proudly: "I won't travel to America." She said she "wouldn't feel safe" in the U.S. following Trump's victory.

Then, a 28-year-old Chilean doctor directed his comments to me: "Your country doesn't care about the environment," he complained. "The U.S. pulled out of the Paris climate agreement."

This one jogged an insight — a difference in perspective between myself and others here.

I looked back at the Chilean.

"No," I responded. "The U.S. government pulled out of the climate deal. Americans and American companies are just as active as ever."

Being from a young country designed to get along with relatively little "medicine," I don't equate the U.S. government's direction with that of the American people. Being in Cuba, whose citizens have little alternative but to at least nominally embrace their government's choices, I realized how America's more individualistic political philosophy has defined it — for good and ill.

Perhaps because it's easier to point out the negative, perhaps because outspoken Americans tend to lean left, or perhaps because we take for granted the benefits we're used to, our country's struggle to enact effective nationwide social programs is seen as a prominent stain. America famously ranks lower than most of the wealthy world in measures of universal welfare: access to health care and education, work and retirement benefits, and environmental policy.

But the U.S. makes up for that with unparalleled opportunity for an individual to rise and create. With spacious freedom of expression and economic liberty, the U.S. has long attracted and produced innovative, adventurous minds — leaders in arts and entertainment, business and finance, technology and science, and more.

As my fellow travelers pointed out America's myriad shortcomings on the one hand, they often held in the other an iPhone, checking Facebook to share a Hollywood-inspired meme.

But in a similar spirit, I need to share more about upsides in the Cuban experiment.

Created as a collective society, Cuba's freedom and material wealth suffer. But community and equality shine. Wealth disparity is minimal. National, cultural pride radiates. Out at night, I've never felt safer in a developing nation; I never even heard a story about street crime. Homelessness is rare.

It's an unflattering mirror image of the U.S., with its exaggerated range of socioeconomic conditions, as well as high rates of mental illness, violence and incarceration.

The American way of life, I've come to understand, is high-risk/high-reward.

Meanwhile, seeing Cuban totalitarianism challenged in 2018 also helped reveal that today there are new forces and possibilities creating new ways to potentially bring together individualism and community.

"Think about economic aid," I said one night in the hostel lounge. "It used to be that taxpayers would give money to the government, who would offer an aid package to a developing nation, whose government would distribute that money and whose citizens would eventually get what was left. But today, I can raise my own money online, buy supplies myself, fly them to a destination and hand them directly to the people of another country."

I cut out the middlemen four years ago when bringing laptops to a village school in Tanzania, East Africa. I did so on this very trip to Cuba with school supplies for the children of the Trinidad neighborhood in which I stayed.

A faster, more connected world, better transportation, new financial instruments on the horizon (blockchain) — as well as waking up to the risks and inevitable failings of concentrated power — render large, centralized institutions less useful and individuals more empowered.

Cuba isolates its society. Cuban painters' works can't reach a global audience; Cuban musicians' songs and stylings can't be uploaded online. And Juan, from that rooftop bar, is a software developer in a country that disallows mobile and home internet.

In a world that will always need "medicine" to maintain health, individuals more and more can (and sometimes must) provide it.

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I noticed Jésus at a Havana city park near my hostel. What drew me to this man with light complexion, facial stubble and thick, shoulder-length hair was the logo on his sweatshirt: Minnesota State Fair.

"I'm from Minnesota," I said, approaching and pointing at his chest.

"I was there in August," he responded with a smile. And, yes, he had attended the Great Minnesota Get-Together.

"Crowds of people," Jésus recalled dramatically. "Plenty of food, drinking beer, having fun."

His favorite attraction was the farm animal exhibits.

"To see the farmers and their whole family take care of animals and people being proud of them," he recollected. "Their animals were beautiful."

Jésus visited Minnesota because he's a tour guide in Cuba and has some clients from the Twin Cities.

"Everybody in Minnesota was very friendly, nice and welcoming," he told me, adding that he'd like to share Cuba with more Americans.

Whether it's the slowly growing cracks in the Cuban system or the turmoil in our own government, I'm left hopeful that the political struggles of modern times will be overcome through a billion people performing a billion small acts, working together in ways more efficient and beneficial to the world.

"We are neighbors," Jésus concluded.

This statement's simplicity and truth struck me. A few generations of cold relations between the institutions in power has caused us to lose sight of who lives next door.

Brandon Ferdig is a writer, videographer and speaker. He shares his work at and can be reached at