Transcription
The health system of Costa Rica is the best in all of Central America. It is even considered the fourth best in the world, according to the latest annual report of Global Retirement Index. But it is Panama that has the best hospital infrastructure. The state insurer is the Costa Rican Social Security Fund. 93% of citizens are incorporated, and the remainder, who cannot pay, are covered by the state. To have the privilege of being attended to without having to disburse a large amount of money at any time medical assistance is required, a percentage of their salary is deducted from all workers, and the employer is obligated to insure their subordinates. The contribution is divided into three parts: the employer contributes 4.92%, the worker 2.67%, and the state only 0.41%. From Latin America, Costa Rica is the third country with the highest life expectancy. It also holds the third position with the lowest infant mortality rate. These good standards are due to the nation investing more than 10% of its gross domestic product in health. But despite the outstanding health system, the high demand of people and the deficit of medical personnel overwhelm the Caja system. This translates into long waiting lines and little space for everyone, so those who can afford it opt to contract private medicine. It is no secret to anyone that the waiting times in the public sector sometimes cause many patients to seek options in the private sector. This is the San Vicente de Paul Hospital, the only one in the province of Heredia. On average, it receives 3,000 people per day. The emergency area is the one with the most patient flow, where 600 people are attended to daily, but it only has 15 doctors to attend to them. This forces them to have a restricted time to evaluate the person. Approximately, a doctor could attend to 10 per hour, meaning they dedicate an average of 6 minutes to each patient. From what was planned to what was granted, at least in human resources, there was a deficit, a deficit of around 160 people, which, as we Costa Ricans say, makes the hospital start off a bit "lame." In Central America, there are six hospitals that have been certified by Joint Commission International, which is the organization with the most experience in healthcare accreditation worldwide. All of them are private, and there are three in Costa Rica: Hospital Hotel La Católica, Hospital CIMA, and Clínica Bíblica. We will take this last one as an example to compare it with the public system. The person who chooses the private method pays for privacy, immediacy, and personalized attention. Clínica Bíblica receives an average of 2,000 people per day, and in the emergency service, about 200. But in this case, there is no deficit of professionals; quite the opposite, as it has about 300. If we compare it with the case of San Vicente de Paúl, we can see the difference in the number of people waiting for attention. Let's look at other differences. Although the public sector complies with all international sanitary norms, each inpatient ward has six or eight beds, while the private sector manages rooms where only one person is housed, even with a private bathroom. Regarding costs, the hospitalization cost at San Vicente de Paúl costs the Costa Rican Social Security Fund $500. At Bíblica, it costs the same, but that amount only covers food and nursing services. That is, if the patient needs medication or additional attention, the bill increases. A surgery that is done every day is the practice of a Cesarean section. In the public sector, this has a cost of $220 per person. The difference is quite wide in the private sector, where the cost is $400. In the case of cancer treatments, in the private sector, they can vary but are extremely expensive, while in the public sector, the complete treatment from the approach could be around $100,000. We could say that each dose can cost one and a half million, and there are patients who use three or six doses, so let's multiply one and a half million by each dose. The Caja wages a frontal fight against HIV. The person can present themselves at any time of the day and receive the result in a few hours. This test in the private center costs $60. Similarly, the delivery of the result is expedited. Okay, well, for the patient with HIV, or who properly suspects the disease of HIV, we here at the Caja have several ways to capture the patient. For example, here at the San Vicente de Paúl Hospital, we have the HIV patient confirmation clinic. It is a multidisciplinary care clinic in which the only thing we do not provide is the part of immunological treatment because we do not have an immunologist, but we offer all the rest of the multidisciplinary clinical care that the patient requires. Although the luxury of private facilities can be confused with a hotel, the director of the Heredia hospital assures that the technology available in the public sector is sometimes superior to the private sector. It is true that private medicine in Costa Rica is very good. What happens is that it is very likely that many very complex surgeries are not performed in private hospitals, only in ours. However, at least in my opinion, much of the technology that currently exists in the Caja is sometimes equal to or superior to some private centers. Of the total number of hospitals in Costa Rica, only 15% are private.