During my time here I’ve learned a lot about the healthcare system in Costa Rica. Costa Rica has universal healthcare for everyone, but this doesn’t mean that healthcare is free like some people believe. In reality the majority of healthcare is paid for by the taxes of working people. It is a system of solidarity, which means that the people who can afford taxes pay for the people who cannot pay so that they can still receive care.
In Costa Rica there is a system called Caja, which is in charge of the public sector of health of Costa Rica. The CCSS (Costa Rican Social Security) is the public entity that provides health services for the population. Healthcare here is broken down into three levels of care. At the first level there is primary care, where people go to a health center in their community. The health center is called an EBAIS, which stands for Equipos Básicos de Atención Integral en Salud. In English this means “Basic Comprehensive Teams.” All people in Costa Rica are assigned to an EBAIS, and that is their first point of care. There are EBAIS in all different parts of the country, and people go to a specific EBAIS in their community for primary care. If they need to go to the next level of care, they will get a referral from the EBAIS for a regional hospital or clinic. The next level of care is specialized, and this includes three national hospitals and five specialized hospital where patients need to be referred to go to.
As a part of the Healthcare in Latin America Program, we went into the community and each interviewed individuals about their opinions of the healthcare system here. I think that overall people seemed satisfied with the care they were receiving, but the wait times is what people were most concerned about. For example, if a person wants to go to their EBAIS it is common that they need to go to the EBAIS around 4 or 5 am to wait in line to ensure that they can be seen that day. Another issue is waiting to see a specialist. Often to see a specialist a person has to wait around 6 months, and sometimes longer. In more rural communities, people need to consider travel time because they are not always close to a regional hospital or clinic. Even with universal healthcare, people still face many barriers. Healthcare and access to healthcare in every country is complicated and needs to be continuously reformed.
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