Dominican Republic and Cuba are our neighbors. They are independent and Puerto Rico is not. What are the pros and cons especially between Dominican Republic and Puerto Rico in quality of life? I have heard that Cuba has a higher standard of health than the USA. Puerto Rico seems to be in more of a deep hole than the other two countries but we have access to the USA market and benefits. Something seems wrong with this picture. Can someone give me some insight into this scenario? Cuba is at a disadvantage with freedom and funds but they are healthy. I think DR has the same freedoms of Puerto Ricans/Americans. We have US postal service and Medicare. Does DR have medical secvices to the needy?