Universal Health Care - What's the Catch? by Sarah Nuss

            During my time at La Selva Research Station, I have been lucky enough to learn a little more about the Costa Rican health care system. Universal health care that is essentially free – what more could you ask for out of a health care system? And why aren’t we all following suit? At least that’s what I was asking myself after our first few lectures. Not only do you get close to free health care insurance here, but the government spends almost a fraction of the cost of what the US spend on health care to produce comparable if not better health outcomes. Even foreigners travel to Costa Rica to get expensive medical procedures done affordably and with comparable outcomes to the US. So, what’s the catch?      

We recently visited an EBAIS clinic nearby La Selva Research Station, which are the local primary health clinics throughout the country that work to bridge the gap between communities and healthcare. This visit gave me a little more insight into the intricacies of the Costa Rican health care system. While yes, everybody is covered under “la caja,” or the universal health insurance in Costa Rica, in order to get a basic appointment at one of the clinics it could take ten or more hours of standing in a line with no guarantee you will get in that day. While public medical schools are free and there is a one year service requirement for all prospective doctors, many doctors are still being turned away from residencies because of stringent test score requirements, creating a shortage of doctors (especially specialized ones). Local EBAIS clinics have great aspects such as community health workers who help do health promotion and primary care within a community itself, helping to focus on prevention and promotion and steering away from relying on emergency care. However, the EBAIS clinic that we visited (and I imagine many others), are not equipped and staffed to deal with more complex cases.

Although there is still much that I don’t understand about both the Costa Rican and US health care systems, it was an interesting comparison for me to make. Which style of care is more effective? What is more important in health care – coverage of all people and recognition of health care as a right, or the ability to treat each patient that walks through the door no matter how complex their health problem is? Or is there a middle ground between these two dichotomous health systems? Is there a way that they could learn from each other to find solutions to the health challenges that each country currently faces?