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A View on Costa Rica Public Healthcare

Costa Rica News – This is a subject dear to my heart and one of the biggest prides I talk about whenever I want to brag about the many benefits that Costa Ricans enjoy. Please note that besides Costa Rican I also have a Dutch nationality and have vast experience of medical care received in many of the countries where I have lived.

Caja_Seguro_Social_Costa_Rica-43186_400x345In CR itself, I have had the opportunity of receiving top private health services as well as public. These clarifications serve as an attempt, dear reader, of trying to show you that I speak from a bit of knowledge. When I talk about the amazing public services that this country enjoys, I’m not doing it from an ignorant and one sided view.

For the past five years and a half, I have lived in CR on a permanent basis. I have paid for public health care and insurance on a monthly basis ever since and I can honestly say, that whatever the amount is that I get removed from my salary, it’s never enough compared to what this institution has done for me and for my country. Yes, I know I may sound very patriotic, but you know what? I have had two surgeries done in a public hospital and one of them actually saved my life. Both times, I was treated respectfully, kindly and had a very satisfactory service.

My uncle recently got a triple bypass in a public hospital that saved his life. My father got treatment for his terminal cancer for the last three years of his life and nobody went bankrupt. I currently live in middle class Tibas where just last week, I received a visit from a nurse who gave me the Tetanus shot, set up two appointments for future check-ups and no pennies left my wallet. And to end my case, I Mariana den Hollander, live with the peaceful thought that if I ever get cancer, have a terrible accident or get infected with AIDS, my family will never go bankrupt for paying my hospital bills. I dare many of you, citizens of those so called “first world countries,” to tell me that you have the same security I do.

Now, it is true that La Caja Costarricense del Seguro Social is an institution with a lot of debt, bureaucracy and issues that need emergency actions. It’s in a very fragile state and something has to change or it will die. If you have been in CR for the past three months, then you must have heard about the scandal were doctors’ high salaries were said to be the reason for La Caja’s debts and problems. If you’ve ever been in an emergency room in CR, you will easily note that doctors are overworked. If your life has ever been saved by a doctor from La Caja, you will know that NOTHING will ever repay her job. Most of important of all, if you read a little bit about the history of La Caja, you will find that its problem is decades of terrible management.

Remember, La Caja doesn’t make any governor rich. The Costa Rican aristocracy in general, go to private hospitals, unless they’re in life threatening situations. But, going straight to the point; no one in power, has ever really cared about making La Caja an efficient and self sufficient institution. Its management has always been poor. Rich private companies owe thousands of dollars to La Caja. For its congresses and meetings, La Caja rents hotel conference rooms on a weekly basis, even though they have the infrastructure to do them in their premises. The list of examples of mismanagement goes on and on.

So no, the doctors’ salaries, which I’ve heard is only 8% of its expenses, are not the reason for La Caja’s deep wounds.

In my humble and worried opinion, La Caja needs management that genuinely understands the jewel that it is for Costa Ricans. Maybe our governors need to visit the public hospitals in the two countries neighboring us, to understand that we are very lucky to have such an amazing institution at the service of ALL of its citizens. Or maybe, just maybe, what we need is a miracle.

La Caja needs saving and I just hope that us Costa Ricans, stop complaining about it and start organizing to defend its roots as if our lives depend on it.

But wait!

Don’t they?

By Mariana den Hollander

Mariana den Hollander is a native Costa Rican artist and published writer. She majored in Fine Arts in The Hague and has resided in the US, Nicaragua, Honduras and Canada. She currently lives in San Jose and recently changed her life to be able to dedicate to painting, writing, promoting musicians and producing music events. Art page: E-mail:info [at]

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