Provide a Response to the following discussion post:
The purpose of this posting is to compare the US health care system with the Costa Rica health care system. Costa Rica was ratified as the 38th member of the OECD on May 25, 2021 (OECD, 2021). Knickman et al. (2019) describe the United States healthcare system as a patchwork of fragmented coverage including a social insurance system in the form of Medicare which was enacted in 1965 for disabled persons or those 65 or older, a social welfare program in the form of Medicaid which was enacted in 1965 for qualifying individuals with limited financial resources, employer-sponsored private health insurance plans for eligible employees, and access to socialized medicine programs based on certain qualifying criteria such as the Veteran’s Health Administration. In 2010, the ACA was passed and aimed to improve the affordability of health insurance, requiring Americans to acquire health insurance, and helping with paying for health insurance for low-income individuals and families.
In comparison, Costa Rica provides universal health coverage through the Caja Costarricense de Seguro Social (CCSS) which was enacted in 1941 to provide health insurance for salaried workers and was gradually expanded until all citizens of Costa Rica were made eligible in 2010 (Columbia, 2021). In addition to the CCSS, Costa Rica has a voluntary private sector with coverage options available that provide health insurance plans to approximately 30 percent of the population (Columbia, 2021). Costa Rica has a Ministry of Health that is responsible for health planning, regulation, and research and development (Columbia, 2021). In 1994, Costa Rica developed a system of multidisciplinary teams known as the Equipo Básico de Atención Integral de Salud (EBAIS) that are assigned to specified geographic regions and tasked with the delivery of primary healthcare and the provision of preventive care to that region consisting of doctors, nurses, and at least one public health professional (Pesec et al., 2017). This model increased access to primary health care services from 25 to 93 percent and resulted in a decrease in the infant mortality rate by 8 percent and adult mortality rate by 2 percent over the first seven years of implementation (Pesec et al., 2017).
Regarding healthcare expenditures, US health expenditures account for 17.2 percent of the country’s gross domestic product as of 2016 (Knickman et al., 2019). In comparison, Costa Rica’s health expenditures as a percentage of the country’s gross domestic product were 7.56 percent as of 2020 (Columbia, 2021). In sum, Costa Rica’s healthcare system is understudied in comparison to the United States health care system but has experienced success in several reform efforts such as the delivery of primary care through EBAIS. Such efforts may prove helpful as models for healthcare reform in other countries.
References
Columbia University. (2021). Costa Rica: Summary. Comparative Health Policy Library. Retrieved June 7, 2022, from https://www.publichealth.columbia.edu/research/comparative-health-policy-library/costa-rica-summary
Costa Rica. OECD. (2021). Retrieved June 7, 2022, from https://www.oecd.org/costarica/
Knickman, J., Elbel, B., Jonas, S., Gusmano, M. K., & Rodwin, V. G. (2019). Comparative Health Systems. In Jonas & Kovner’s health care delivery in the United States (12th ed.). essay, Springer Publishing Company.
Pesec, M., Ratcliffe, H. L., Karlage, A., Hirschhorn, L. R., Gawande, A., & Bitton, A. (2017). Primary health care that works: The Costa Rican experience. Health Affairs, 36(3), 531–538. https://doi.org/10.1377/hlthaff.2016.1319