Health in Costa Rica
Costa Rica's high-quality, low-cost health care is available for people from all over the world
Statistics from the World Health Organization's "The World Health Report 1995" place Costa Rica third in life expectancy in the world, sandwiched neatly behind Japan and France and ahead of Great Britain and the United States; and with a per capita income about one tenth that of the other four. Certainly, some reasons for this can be found in the Costa Rican less-than-frenetic lifestyle, the healthy, fresh, non-preservative laden foods of the country, the tropical climate--Costa Rica seems to be a healthy place to live. But if one looks simply at the life issues, so are many other places on the globe. Costa Rica is a healthy place to live because its government continues a long-time commitment to affordable access to one of the finest health care systems in the world for each and every citizen. In a United Nations study conducted in the 1980s, Costa Rica's medical system was first in Latin America and ranked near the United States and Canada among the 20 best in the world. Things are pretty much the same today.

Even though currently overburdened by needy citizens, the Costa Rican health care system is being utilized at less than 100%. The expensive medical equipment and high tech operating rooms stand idle everyday after mid-afternoon. While wealthier Costa Ricans and some foreign residents make appointments with their private physicians, their numbers are not great enough to keep the private offices and clinics overly busy. There is noticeable slack in the system, and it is this slack which serves the foreign tourist interested in the full spectrum of health care services offered.
For a country not usually thought of as a fully developed nation, Costa Rica's lack of a standing army and its historical commitment to the social and educational welfare of its citizens have provided the foundation for a "highly developed medical system, internationally speaking" asserted plastic surgeon Dr. Arnoldo Fournier. He continued, "It's not the surgeons who have provided this, but the entire history of our country that gives us this advantage."

Dr. Logino Soto Pacheco, Chief of Surgery at Hospital Mexico, premier cardiac surgeon in Costa Rica and one of the foremost in the world, claims that Costa Rica is unique in its world position in health care. "I have studied every health care system in the Americas, and I can assure you that nowhere else can compare to what Costa Rica offers its citizens," he stated emphatically. Who would doubt these words from the man who assembled the Costa Rican surgical team which performed the first successful heart transplant in Latin America.

With a government-sponsored network of 29 hospitals and more than 250 clinics throughout the country, the Caja Costarricense de Seguro Social (CCSS) has primary responsibility for providing low cost health services to the Costa Rican populace. Though presently somewhat overburdened, like most of the Costa Rican infrastructure, this system has worked well for Costa Ricans for the past 50 or so years. Open not just to Ticos, the CCSS provides affordable medical service to any foreign resident or visitor. Foreigners living in Costa Rica can join the CCSS by paying a small monthly fee--based on their income-- or they can buy health insurance from the State monopoly Instituto de Seguro Nacional (INS) valid with over 200 affiliated doctors, hospitals, labs and pharmacies in the private sector.

The caring expressed by the doctors and dentists throughout the country is noteworthy in its extreme
Many of the country's highly trained physicians and some dentists work in the mornings for the CCSS and have their own office and clinic hours in the afternoons and evenings. While private care is more expensive than that offered by the same doctors and surgeons through the CCSS, the price is still way below that of the average office visit in the States. For example, a private office visit to almost any medical specialist costs around US$30. Continued treatments for diagnosed problems will vary but will almost always be considerably less than comparable treatment in the United States. Dental work, such as simple fillings run between $12 and $15. I recently had opportunity to compare costs for periodontal services in the States and here. For considerable work in the States, the patient was quoted $7,000; the same work performed in Costa Rica by a U.S.- and French-trained periodontist using the same materials and techniques was $1,500.

Two well-known private hospitals, Clinica Biblica and Clinica Catolica, where many CCSS doctors practice in the afternoons and evenings, offer first-class, ultra-modern services. Affiliated with U.S. hospitals, these two private providers have costs somewhat higher than the public providers but still way below anything found in the States.

It is not uncommon to find a Costa Rican doctor or dentist speaking several languages, all learned while pursuing advanced degrees in foreign countries.
Most Costa Rican doctors and dentists receive their basic medical training in Costa Rica. From here, they travel far and wide seeking specialized training from the finest teaching hospitals in the world, often becoming certified in their specialities in the countries where they receive their advanced training. It is not uncommon to find a Costa Rican doctor or dentist speaking several languages, all learned while pursuing advanced degrees in foreign countries. Perhaps it is the CCSS work or the varied travel and study that does it, but the caring expressed by the doctors and dentists throughout the country is noteworthy in its extreme.

In 1991, two economists from the University of Costa Rica conducted a survey of visitors to this country. Their findings, documented in the study, indicated that 14.25% of all visitors came for the express purpose of receiving medical care of some type. Over the years, Costa Rica has attracted those in search of uplifting cosmetic surgery. People from around the world arrive daily to partake of the healing waters in over 100 thermal and mineral springs located here. Dental work, from fillings to implants, is done routinely on people from every corner of the world. Many people from Latin America plan for their medical needs--from hip replacement to heart valve replacement--to be taken care of by the well-trained and skillful physicians in Costa Rica rather than in their native countries. Clearly then, not only does Costa Rica offer universal health care coverage to its citizens, but that same high quality care is available for people from all over the world.

According to Dr. Soto, a heart valve replacement done in the States will cost the patient (or the insurance carrier) over $50,000 for the surgery alone. The same surgery in Costa Rica, using the same valve, performed in a surgical theater equal to those found in the States, by doctors and nurses internationally trained and highly skilled, will cost around US$15,000, including pre- and post-operative care in pleasant surroundings.

The heart valve operation is but one example of the cost differences between Costa Rican medical care and that same care found in a number of the more developed countries. Many orthopedic procedures, such as hip and other joint replacements, urological procedures, such as treatment of prostate problems including hi-tech laser surgery for prostate cancer, ophthalmologic procedures, such as cataract surgery, are done in Costa Rica professionally and successfully every day at affordable prices. For the vast majority of Costa Rican citizens, these procedures are available without cost.

Cosmetic and Reconstructive Surgery

Costa Rica has long been a selected destination for those in search of the Fountain of Youth. Although The Fountain of Youth has yet to be discovered, the talented plastic and cosmetic surgeons of this country, many schooled and board-certified in the United States and Europe, continue to provide the appearance of such to hundreds of satisfied, younger looking, people.

Of the "medical tourists" documented in the UCR study previously mentioned, a large percentage came for cosmetic surgery (dental and cardiovascular procedures were a close second). Doctor Carlos A. Centeno, well-known Costa Rican cosmetic surgeon, indicates that the number of medical tourists increases each year. Dr. Roberto Murillo, another established surgeon, related that each of the twenty-five to thirty registered plastic surgeons in Costa Rica averages seven to eight medical tourists daily.

The full range of cosmetic and reconstructive surgery is available here in several modern clinics. With the recent addition of contemporary laser technology the ability of Costa Rica's plastic and cosmetic surgeons to provide world-class services has been enhanced. Procedures routinely offered by plastic surgeons in Costa Rica include total and partial face lifts or reconstruction; tummy tucks; breast reduction, augmentation and reconstruction; liposuction; liposculpture; electrolysis for the permanent depilation of unwanted hair; removal of acne scars and other skin irregularities; and many other procedures to counteract aging, or enhance beauty. What nature has wrought, Costa Rican plastic surgeons are improving.

And they can improve nature's handiwork at a cost more affordable than in many other countries. For example, facial cosmetic surgery (face lift), according to Dr. Centeno the most commonly performed procedure here, can cost from $6,000 to $12,000 in the United States. Comparable surgery in Costa Rica will cost between $3,000 and $4,000 including clinic stay, medicines, nursing care and the surgery. Most minor procedures are done on an ambulatory-care basis requiring no hospitalization. Major procedures, such as some breast surgeries and "tummy tucks," can require overnight hospitalizations with the cost of the room included in the "package."

"Prices are sometimes 50% lower than in the United States," stated a staff person at Clinica de Cirugia Estetica, S.A., "but each case is different and prices are quoted on an individual basis after consultation with the surgeon." Even though each case is different, Dr. Murillo suggests that many surgeries are 60% to 70% less expensive here than in the United States.

Non-elective reconstructive surgery required as a result of an accident or illness leaving a patient disfigured is performed as well and as skillfully. Should this type of surgery be necessary, it is advisable that a patient check with his or her private physician and insurance carrier at home for coordination and financing.

Dental Procedures

From simple fillings to complicated multiple implants and periodontal work, Costa Rican dentists are as qualified and skilled as any to be found. The orthodontists have their own university programs here and the periodontists hone their skills at various teaching universities around the world.

Foreign patients seeking periodontal work and dental implants arrive in Costa Rica in greater numbers monthly. There is a group of about 20 dental specialists--periodontists, oral surgeons, root canal specialists, prosthedontists and orthodontists--working together to provide high quality, specialized dental care to Ticos and foreigners alike. Cost per implant is between $750 and $850. Laboratory work here is much cheaper, but the materials used are all FDA-approved and imported from the States.

On the Horizon

Exciting medical plans are now in the works for both Costa Rican and foreign patients. A new teaching hospital is to be built not five minutes from the Juan Santamaría International Airport. This hospital will be state of the art in every respect and should be open for business within the next two years. It will serve Costa Ricans and foreigners.

Costa Rica, that magical land in Central America, is a perfect place to visit and choose for medical care. Shopping the world for high quality health care now is as easy as shopping for a new car and Costa Rica offers highly competitive prices for the same "car." Throw in a tropical paradise--secluded beaches, protected biological reserves, alpine mountain retreats--and you've got a winning combination.

Corporación Turismo Salud, S.A. (Health Tourism Corporation), provides complete package services for the foreign patient. This corporation was formed six years ago by Dr. Oscar Padillo Sellen specifically to coordinate both the medical and tourism needs of people interested in Costa Rican medical care as well as visiting or touring our beautiful country. Totally supported by the Ministry of Health, Social Security (CCSS), the Association of Doctors and Surgeons, the Association of Dentists and Dental Surgeons, and the Costa Rica Tourist Board, Health Tourism Corporation will arrange all travel and lodging, provide medical coordination and cost comparisons, transportation while in Costa Rica, complete nursing care, and suggest a wide variety of tours and vacation choices.

More information on the services of Health Tourism Corporation can be obtained by contacting these numbers in Costa Rica: Tel (506) 231-2310, Fax (506) 231-6916; or email hlthtour@sol.racsa.co.cr Information can also be solicited by regular mail: Corporación Turismo Salud, S.A., P.O. Box 1439-1000, San José, Costa Rica.

Copyright © 1996 by Ed Underwood. All rights reserved.