Trade routes predate capitalism by many thousands of years. People travel. They trade. They exchange ideas and goods. Communist countries have (almost) always sought to participate in the world economy. Its always been the capitalists who shut down all peaceful avenues for cooperation.

So does communism require a capitalist big brother? No. But every single country exists in a geopolitical context. When the behemoth economic and military superpower 90 miles away spends over half a century trying to destabilize your island nation that was already dependent on imports… It’s gonna cause some problems.

Also, just compare Cuba to its peers in the Caribbean and latinam. It does better in some areas, it does worse in others. It’s not an outlier in anything, except like medical science where it’s always been a leader in latam. The areas where it does worse are usually directly related to the blockade

Cuba would have a lot less problem if the US just stopped doing Terrorism in Cuba and the US wouldnt block anyone from doing trade with the US when they where to Cuba in the last 90 days.