HAVANA (AP) — Cuba's system of free medical care, long considered a birthright by its citizens and trumpeted as one of the communist government's great successes, is not immune to cutbacks under Raul Castro's drive for efficiency.

The health sector has already endured millions of dollars in budget cuts and tens of thousands of layoffs, and it became clear this month that Castro is looking for more ways to save when the newspaper voice of the Communist Party, Granma, published daily details for two weeks on how much the government spends on everything from anesthetics and acupuncture to orthodontics and organ transplants.

It's part of a wider media campaign that seems geared to discourage frivolous use of medical services, to explain or blunt fears of a drop-off in care and to remind Cubans to be grateful that health care is still free despite persistent economic woes. But it's also raising the eyebrows of outside analysts, who predict further cuts or significant changes to what has been a pillar of the socialist system implanted after the 1959 revolution.

"Very often the media has been a leading indicator of where the economic reforms are going," said Phil Peters, a longtime Cuba observer at the Lexington Institute think tank. "My guess is that there's some kind of policy statement to follow, because that's been the pattern."

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