Costa Rica Health Profile 2012

In 2007, the 14th Informe del Estado de la Nación en Desarrollo Humano Sostenible reported that 53.6% of the economically active population participated in a public pension system. In the same year, 61.9% of the economically active population was offered health care insurance. Both figures have been falling since 2000, when the respective figures were 56.8% and 67.1%. Nevertheless, these rates are sufficient to insure more than 90 percent of the population, because most people are related to an economically active person (and because the law requires hospitals and other health care institutions to help any person, whether legally in the country or not, seeking medical assistance). There are no provisions for unemployment benefits, the only major welfare state program not available in Costa Rica. Major anti-poverty programs are run by the Mixed Institute for Social Assistance (IMAS). This institution concentrates on helping Costa Rican families in extreme poverty (approximately 5% of all households). The other 15% of citizens living under the poverty line do not get transfer payments from IMAS, according to 2006 data.

There are several institutions designed to compensate for gross social differences. But the social welfare institutions of Costa Rica do not work as well as many would like. Though the rate of households in poverty decreased to 16.7% in 2007 from 21.2% in 2005, the average number of years of education completed is stuck around eight (it was 8.7 years in 2007). Pre-transfer rates of inequality have increased. Women and/or members of ethnic or religious minorities have near-equal access to societal assets such as education and employment, but women earn less than men on average, and the population of African-Jamaican descent in the province of Limón does worse on social indicators than the population at large.

HEALTH & DEVELOPMENT
Although Costa Rica has one of the highest rankings in the Americas on both the Human Development Index (HDI) and the Gender-related Development Index (GDI), it fell to 44th and 47th place, respectively, during the period 2000–2005. Access to drinking water is, overall, more than 94%; however, in 1995 it was 99.2% in urban areas and only 88.5% in rural areas. Over 90% of the population in urban and rural areas has excreta disposal services. The average illiteracy rate is 4.7%, but there is a slight gender difference in favor of females, and for each illiterate person in urban areas, there are three in rural areas. The crude primary schooling rate has steadily risen to 99%, while at the same time the dropout rate has fallen to 6.5%.
The country’s macroeconomic situation has had its ups and downs. Between 1992 and 1997, the economy grew by 5.8% in terms of GDP. However, between 1998 and 1999, it plummeted to 1.9%, falling to 1.5% in 2000. In 2003, it exhibited a 6.5% growth rate but fell to 4.1% in 2004 and 2005. In 2005, inflation was 14.1%, the highest in eight years and higher than the 10% goal set by the Central Bank. This was attributable to external factors and the impact of oil prices and the devaluation of the colón against the dollar, as well as to domestic factors such as Central Bank losses. The general election of February 2006 for the period 2006-2010 were won by the National Liberation Party (PLN), with only a 1.1% lead over the Citizen Action Party (PAC) and a 35% abstention rate, the highest in the country’s history. The Government was installed on 8 May 2006 without a majority in the Legislature, which means that it must negotiate critical issues such as the free trade agreements with the other parties. The bipartisanship between the PLN and the Christian Social Unity Party (PUSC) that had prevailed in recent decades became a tripartisanship in 2002 with the emergence of the PAC, which bumped the PUSC to third place in the last Government election. During the previous administration, the issue of corruption had dominated the political scene, and the Legislature did not pass any laws to improve public administration or undertake fiscal reform.

OPPORTUNITIES

CHALLENGES

• Reaching national agreements in the legislature
• Recharging the economy to sustain economic growth
• Reaching national agreements among the country’s different sectors
• Negotiating national agreements in the Legislature
• Provide sources of quality employment for new generations
• Generalize secondary education and reduce the dropout rate
• Consolidate the sectoral steering role in health
• Improve management in the health system
• Extend social protection in health to excluded groups
• Bridge the gaps in health
• Maintain and improve achievements in health
• Obtain sustainable financing for public health insurance