July 14, 2024

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Positives point to concern about unequal access to health care through copayment methodology

Positives point to concern about unequal access to health care through copayment methodology

San Jose, November 11 (elmundo.cr) – On November 7, 2023, Marta Esquivel, CEO of the Costa Rican Social Security Fund (CCSS), presented The Healthy Way: Less Waiting, Better Services.

Given this, members of Positivxs, an organization for people living with HIV and STDs, expressed their concerns in the following five points:

Point 1

We are concerned that the Healthy Path does not offer union representation on La Caja’s Board of Directors, because we believe that an institution that is based on the inclusion of all people must listen to the concerns of all sectors. Before making decisions.

Any action that conflicts with due process is considered an assault on all insured persons.

Point 2

Regarding copayment, we are concerned about unequal access to health care. The country has people who can barely meet their basic needs on their salaries, many with HIV, STDs, members of the LGBT community, and people who are unable to financially afford part of the treatment they need.

This goes against the principle of protecting all people that La Caja has been advocating for 83 years.

Point 3

In addition, with regard to the co-payment method, we express our concern about the process that will be followed to contract the services of private medical institutions. This process is not mentioned in the way and we believe that as citizens we have the right to inform ourselves and have a full view of what is being done with our resources.

We are particularly concerned about the vested interests of certain companies.

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Point 4

We are hesitant about the alternative of bringing in specialists from other countries, because we realize that many La Caja salaries are not qualifying salaries and also that the conditions in which many health workers work are not ideal.

The import of specialists from other countries must be accompanied by improving the salaries of the organization’s employees, as well as the working conditions and materials with which they work.

Point 5

We express our lack of confidence in the World Bank’s advice on La Caja’s financial situation, and we believe that sufficient evidence from unions and citizens has shown that La Caja is not bankrupt.

If this is the case, directing resources to a consulting company worth 200 billion colones from the World Bank is not the solution to solve the problem. The state must ensure that the debts it owes to the institution are paid.

“Given these concerns, we want to make clear that we firmly believe that the solution to the situation in La Caja should not be based on improvised or authoritarian decisions,” they explained.

For this reason they believe that:

a path

We believe that the Foundation’s more than 80 years have not been in vain and respond to the fact that due process protects the interests of all taxpayers and therefore the same process must be followed before making decisions on how to resolve the challenges it faces. Social security of the country.


We believe that co-payment is not the alternative to settle the debts owed by La Caja with citizens in relation to its waiting lists. The presentation of alternatives must respond to technical and scientific criteria that should be common knowledge. The Executive Presidency did not announce these criteria.

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We believe that the decision to use third parties to provide health services should be made after extensive studies of feasibility and risks, and should not serve vested interests over collective well-being..


We also believe that La Caja should make a greater effort to make contracting processes that can be carried out by a co-payment method generally available, transparent and known..


We believe that the solution to the problem of the shortage of specialists is in the long term through increased investment in education. It is necessary to address educational opacity so that more people can attend universities.

¡Well, access to quality education is part of the public health response!


We believe that before bringing in specialists from other countries, the material, working and salary conditions of health workers working in La Caja must be improved..


Finally, we believe that the main solution to La Caja’s situation is for the state to pay off its debt of about 3 billion colones. This money means improved conditions that the institution urgently needs.

“Given all of this, we, who live with HIV and STDs and are regular Positivxs, will remain vigilant to ensure that improved overall well-being is achieved,” they concluded.