From what I've heard Cuban on average have better health than Americans at a fraction of the cost. The may not have all the high tech we have in the US but the do a good job with what they have. I don't know about Venezuelans. But I was talking mostly about countries comparable to the US like Canada, most of Europe, Japan and Australia.
The Keystone XL pipeline would employ less that 50 people after it's built. It would provide maybe 5,000 or 6,000 jobs during construction. It's not that significant a job creator. The oil in that pipeline is set for export to other countries although it might be partially refined in Houston to make it easier to transport. Personally I think the Canadian tar sands production should be shut down. It's one of the dirtiest ways possible to get oil.