Venezuela's Hugo Chavez is going back to Cuba for chemotherapy treatment. As in the former communist states, Cuba has a differentiated medical system affording first-class care for the elites and less cutting-edge treatment for the masses. Cuba has also opened private clinics as a foreign-currency earner.

Therefore it is likely that Mister Chavez will get excellent medical treatment as well as VIP treatment. By offering Cuba cut rate energy supplies, the Venezuelan leader not only lionized the Castro regime ideologically but also subsidized it economically.

There is nothing amiss about a leader going abroad for medical treatment. The late King Hussein of Jordan went for cancer treatment at the Mayo Clinic in the United States while former Egyptian President Hosni Mubarak preferred the German hospitals. It does beg the question of why the" Bolivarian Revolution of Chavez" has failed to produce first rate care at home.

While Chavez expressed optimism in the success of the treatment, it is a new stage in Venezuelan politics. Part of the Chavez political style is a frenetic omnipresence in the country and his ability to appear on television with 8 hour-long speeches to speak his mind on whatever subject captures his fancy. Now he has to delegate some powers to his subordinates – in itself a comedown -- and it is not certain whether he will be able to resume the pace of activity that would have challenged even a healthy person.

Hugo Chavez has ruled as a larger-than-life figure and someone who is irreplaceable, he has not made any allowances for a succession, and Venezuela is now plunged into uncertainty. If Chavez were to follow the Cuban model, his brother Adan could emerge as the Venezuelan analogue of Raul Castro if his care is protracted.

There are other power centers in the regime and it is still not certain that if a succession crisis emerges that they can agree on a common candidate. The acid test of a political movement is its ability to pass on the mantle of leadership from a charismatic leader to a less exciting successor.

It is not only Venezuela that is affected by Chavez' failing health but other countries in the region and beyond. Bolivia, Ecuador, Nicaragua and perhaps Peru drew inspiration from Chavez' style of leadership and the challenge that he posed to the United States.

For Iran and Hezbollah, already preoccupied with the crisis of the Assad regime, a change of leadership in Caracas would also pose a blow as Chavez has proven to be an ally and facilitator to the Shiite forces.

Chavez has also been a major client of Russian arms precisely at a time that even Dmitry Medvedev is telling Russia's armed forces to import weapons if they continue to receive shoddy products at inflated prices from the domestic arms industry.

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