To Your Health

Medicine in Costa Rica

by Ed Underwood

Statistics from the World Health Organization's "The World Health Report 1995" place Costa Rica third in life expectancy in the world, sandwiched neatly behind Japan and France and ahead of Great Britain and the United States; and with a per capita income about one tenth that of the other four. Certainly, some reasons for this can be found in the Costa Rican less-than-frenetic lifestyle, the healthy, fresh, non-preservative laden foods of the country, the tropical climate--Costa Rica seems to be a healthy place to live. But if one looks simply at the life issues, so are many other places on the globe. Costa Rica is a healthy place to live because its government continues a long-time commitment to affordable access to one of the finest health care systems in the world for each and every citizen. In a United Nations study conducted in the 1980s, Costa Rica's medical system was first in Latin America and ranked near the United States and Canada among the 20 best in the world. Things are pretty much the same today.

Even though currently overburdened by needy citizens, the Costa Rican health care system is being utilized at less than 100%. The expensive medical equipment and high tech operating rooms stand idle everyday after mid-afternoon. While wealthier Costa Ricans and some foreign residents make appointments with their private physicians, their numbers are not great enough to keep the private offices and clinics overly busy. There is noticeable slack in the system, and it is this slack which serves the foreign tourist interested in the full spectrum of health care services offered.

For a country not usually thought of as a fully developed nation, Costa Rica's lack of a standing army and its historical commitment to the social and educational welfare of its citizens have provided the foundation for a "highly developed medical system, internationally speaking" asserted plastic surgeon Dr. Arnoldo Fournier. He continued, "It's not the surgeons who have provided this, but the entire history of our country that gives us this advantage."

Dr. Logino Soto Pacheco, Chief of Surgery at Hospital Mexico, premier cardiac surgeon in Costa Rica and one of the foremost in the world, claims that Costa Rica is unique in its world position in health care. "I have studied every health care system in the Americas, and I can assure you that nowhere else can compare to what Costa Rica offers its citizens," he stated emphatically. Who would doubt these words from the man who assembled the Costa Rican surgical team which performed the first successful heart transplant in Latin America.

With a government-sponsored network of 29 hospitals and more than 250 clinics throughout the country, the Caja Costarricense de Seguro Social (CCSS) has primary responsibility for providing low cost health services to the Costa Rican populace. Though presently somewhat overburdened, like most of the Costa Rican infrastructure, this system has worked well for Costa Ricans for the past 50 or so years. Open not just to Ticos, the CCSS provides affordable medical service to any foreign resident or visitor. Foreigners living in Costa Rica can join the CCSS by paying a small monthly fee--based on their income-- or they can buy health insurance from the State monopoly Instituto de Seguro Nacional (INS) valid with over 200 affiliated doctors, hospitals, labs and pharmacies in the private sector.

The caring expressed by the doctors and dentists throughout the country is noteworthy in its extreme

Many of the country's highly trained physicians and some dentists work in the mornings for the CCSS and have their own office and clinic hours in the afternoons and evenings. While private care is more expensive than that offered by the same doctors and surgeons through the CCSS, the price is still way below that of the average office visit in the States. For example, a private office visit to almost any medical specialist costs around US$30. Continued treatments for diagnosed problems will vary but will almost always be considerably less than comparable treatment in the United States. Dental work, such as simple fillings run between $12 and $15. I recently had opportunity to compare costs for periodontal services in the States and here. For considerable work in the States, the patient was quoted $7,000; the same work performed in Costa Rica by a U.S.- and French-trained periodontist using the same materials and techniques was $1,500.

Two well-known private hospitals, Clinica Biblica and Clinica Catolica, where many CCSS doctors practice in the afternoons and evenings, offer first-class, ultra-modern services. Affiliated with U.S. hospitals, these two private providers have costs somewhat higher than the public providers but still way below anything found in the States.

Continue to page 2 of this article.

And here is even more information concerning the Costa Rica health care system.