Friday, February 9, 2007

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Costa Rica: Summary of Current Health System (I)

Organization
general
The public health services consists of:

- The Ministry of Health (MOH) , making the steering and monitoring sector, and promotes programs promotion and health prevention.

- The National Health Sector Council (CNSS), instance of agreement across the sector whereby action is taken to address problems and public health issues of national interest.

- The Social Security Fund (CCSS) , that is charged with ensuring of health that includes comprehensive medical care to people, cash benefits and social benefits;

- The Rican Institute of Aqueducts and Sewers (AyA) , which is responsible for providing and regulating the provision of drinking water and sewage disposal;


- The National Insurance Institute (INS) , that covers all risks and accidents and traffic;

- The University of Costa Rica : that is responsible for training health professionals in pre and posgrago in the country, and

- Municipal governments. MS

The part of the executive branch and in conjunction with the CNSS, is responsible for coordinating the sector. While CCSS, INS and AyA are decentralized and semiautonomous agencies, with law and its own, each directed by a Board and CEO.


The Assurance

The public health insurance.

By constitutional mandate and in accordance with Universal Law Health Insurance of 1961, the CCSS must provide health insurance and maternity benefits to all people, but since this is only compulsory for wage earners, from 1975, other forms developed to facilitate the incorporation of other segments Population:

- Voluntary insurance for self-employed persons created in 1975;
- The CCSS pensioners and special arrangements were incorporated in 1976;
- Insurance from the State to include the poorest families in 1984;
- Special Agreements collectively to ensure the combined independent workers union organizations in the mid-80's

Despite this, the 2000 population census revealed that only 81.8% of the population is insured, so that 18.2% of the population lacks formal health insurance. Although the uninsured can use public health services, in practice, this involves overcoming barriers of administrative and economic limits their access to these services.

required under their health insurance is financed on a tripartite basis according to the following amounts: 9.25% employers, workers, 5.50% and 0.25% State, for a total of 15%. In the other types of insurance contribution rates are much lower than 15% as employees and their employers are heavily subsidizing the other categories, which is consistent with the principle of solidarity, in all cases the insurance extends to the basic family unit.

Coverage of general insurance and maternity

public health insurance covers sickness and maternity benefits to all its population insured through 5 programs (as defined in the mid- nineties, in the context of health sector reform and the analysis of the national health situation which identified 12 priority needs) for children, adolescents, women, adults and older adults also include actions to promote protection and assistance activities to ensure the provision of basic and specialized medical services, both outpatient and hospital laboratories, provision of drugs and basic dental care through a network of establishments and contractors.

The supplementary insurance

cover the risks to the Traffic Accident and Occupational Disease State developed a complementary insurance system administered by the INS , with an additional cost citizens and whose coverage is limited by what spending peaked established, attention shifts responsibility to the CCSS . To ensure these coverages the INS has its own care but reduced response capacity, so you must buy services from private companies.



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