Unique Health Care System in Costa Rica

In my blog post earlier this year regarding Covid-19 (March 15, 2021), the numbers indicated that Costa Rica was doing better than Canada and the United States. The focus was on mortality. If you caught Covid-19, what were your chances of survival compared to Canada or the United States? It appears that Costa Rica continues to do better.

As the table below indicates, this continues to be the case:

Back in March, I speculated that this might be because on average those who live in Costa Rica spend more time exposed to outside air than those who live in Canada or the United States. I did not clarify, but I had in mind that one or the other or both of central air conditioning and central heating is relatively common in both countries. This might not provide a particularly healthy environment for controlling the spread of the virus.

Now comes to light another possible reason why Costa Rica has been faring better. It has a unique health care system. Specifically, Costa Rica has a health care model which combines a tiered universal medicare system with an unrestricted private care system: see Atul Gawande, "Costa Ricans Live Longer Than Us. What’s the Secret?”, The New Yorker magazine, August 23, 2021.

While Canada has a universal medicare system, it is not tiered like that in Costa Rica. Moreover, Canada severely restricts the services which can be provided by private enterprise. In the United States, the private care system is essentially unrestricted as it is in Costa Rica. However, while the United States has a medicare system, it is restrictive and far from being universal. Neither Canada nor the United States has a health care system which reaches down to individual households in a proactive manner as described by Atul Gawande.

We have experienced the proactive approach in Costa Rica. Two examples: (1) as described in my blog post on March 19, 2021, Lance got a personal telephone call out of the blue from a doctor at our local EBAIS to schedule an appointment for our first of two Covid-19 shots. I might be wrong, but I doubt that any person in Canada or the United States ever got such a call from any health care authority. (2) shortly after moving to Grecia/Hacienda El Paseo in 2018 and signing up with our local EBAIS, we were surprisingly visited by two medics.

As the New Yorker magazine article indicates, these medics are referred to as “ATAP" (Asistente Técnico en Atención Primaria) - trained community health care workers. They wanted to give us flu shots which we respectfully declined because neither of us had ever had flu shots (or ever had the flu over a period of decades). They also gave us pills for intestinal parasites - very common in tropical countries.

They also inspected our property indoor and out for cleanliness, etc. Their only recommendation was that we get rid of an outdoor pool of water which could provide a breeding ground for some mosquitos that are responsible for dengue fever - a fever which is survivable but not pleasant. We got rid of the “pool”. The pool was a relatively small plastic, rectangular container on the ground filled with water (usually rain water). Various species of birds found the pool and relished the opportunity to take a bird bath. That’s why we kept it until advised by the medics not to do so.