Health Insurance

Juliana Martínez Franzoni.

The problem: income, yes, but also why and how they are used. The trigger for the crisis in the Costa Rican Social Security health insurance is no money to meet its obligations. This no doubt reflects serious problems in income but also in spending. That said, the problem is a matter of the box that "closed accounts"? People who use or study of the Cash services know no. Rows, waiting times, abuse, lack of equipment and professionals that offer "the moon and the stars" across the street in their own offices, private purchases disorderly, excessive and places in a side lacking in others, indicates that it is urgent improve revenue management and performance.

Opportunity: less opacity, transparency, better services. Not all crises are opportunities. However, this can provide very valuable. Most of diagnosing problems is imposed there and make decisions. However, required to act accordingly "muscle" social and political. Generally only promote those changes have something to gain from them. In the case of the Fund, the reforms have been locked inside the institution, where for every action there is a reaction and each potential winner and a loser, thus neutralizing the action. So too for good people to promote change from within is crucial that society looks back at its health system, making demands and ensure compliance actions.

The main threat: the business of health. Today they turn their gaze to the Fund as those who bet on better service, solidarity and universal as those seeking to profit from the social security funds. Once again we hear that those who know it should be administered, and therefore offer the gentle care of free choice. Corporations health (or rather of the disease), pharmaceutical corporations and the financial system, now engaged in the business of insurance, including health, rubbed his hands before the crisis. Solidarity is not a business and may soon face major dilemmas like what is covered and what is not, copayments, including some people and excluding others. The change management model and would involve a change in the practice of solidarity and universality.

The main strength: separating wheat straw. The Promised Land, the paradise of the private provision of services is attractive to middle tired of not using the services of the Fund. Is also attractive to jaded dating popular sectors that do not reach. Before an ambivalent public opinion and powerful players who can only gain from the disarray in the management of social security, will we be announced at the death of a poor donkey tied fast in front of a loose tiger?
The only way to cope is that different sectors of society separate the wheat from the chaff. The responsibilities are not shared equally but the sum of doing things, and even unexpectedly, it would be refounded. Unions denounce labor inefficiency, professional prioritize the common good over the sole of its affiliates / as, business chambers that are separated from defaulters and evaders who are in their ranks; government to honor debts; users / stop order as several times the same drug. Consequently we can tidy the house and hold accountable pharmaceutical mafias and other powers.

Mysticism and ethics. He says the problem is very complex. At day's end, however, things are relatively simple. People need to have an adequate supply of services, timely and quality, both in specialized care such as proper manners that is provided. To do this country 70 years ago created a "common pot" that finances and organizes, under the criterion of right now the leading countries in the world are trying to create or preserve. Health fund that has problems and required solutions. The ideas do come from many minds and energies. Maybe there, in the mystique of the transformation is also the idea so simple yet so elusive at times of doing things right.


* Sociologist, Researcher at the Institute for Social Research, UCR.




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