City Journal
For what it's worth, my wife visited Cuba in 1998 and confirms all of this. In those days you could rent a Toyota and drive anywhere in Cuba you liked, but you could not find a place to eat or get gasoline outside of the international zone. Ordinary Cubans were afraid to talk with or do business with you. She and her companion finally convinced a restaurant manager to let them eat there, but they had to sneak in the back way, and all they had to eat was rice, beans, and pork. They had 3 shifts of mechanics working on the rental cars but they didn't have any tools aside from a screwdriver and a pair of pliers.
Cuba has mass poverty, horrible living conditions, has one of the best medical care systems for tourists and elite, and one of the worst for common people. In all fairness people look to cubas medical care system and it is a joke, soviet russia actually had a better system with most facilities being clean and basically lacking basic medical supplies. Cuba on the other hand has very filthy facilities for common people, they lack supplies too.
Imagine needing an appendix removed but your doctor has a straw hut and a rusty scalpel to work with and no anesthetic, so the doctor gets a bottle of rum off the black market tells you to chug it and bite on a wood block. Their housing is just as bad as the soviet model, where in the soviet union a single 3 bedroom apartment would have 3 families living in it, and often standing room since the queu for apartments could be so long in some areas, children even after they get married would be forced to live with parents or grandparents until the state approved them housing.
Food issues are bad in cuba, they were bad in soviet countries but issues were lessened later in soviet russia, cuba however has a terrible system of collective farming, so much so that during the 90's there were mass epidemics of blindness due to malnutrition, rice and beans can sustain people for a while, but they lack the nutrition to do so indefinately without other food sources. Even now cuba rations food out, and relies on a black market to supply people with extra food or food missing, like for example pork may be missing for an entire month, next month they may recieve pork but no milk or eggs, etc.
Then you have tourist cuba and real cuba, tourist cuba employs people well above the states wages, and the people are selected by the state. They are instructed on how to act what to say and how to handle nosey tourists. Their plus side is they make way more than normal citizens plus tips, so anyone who gets that job is not going to defy the govt and lose it.