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INSIDECOSTARICA.COM | COSTA RICA  NEWS |   Friday 04 November 2011

Caja Tells Patient: Come Back in 7 Years

After suffering painful chronic gastritis for 10 years, Osa district policeman Wilberth Villalta went to the closest public hospital, Hospital Escalante Padilla in San Isidro de El General, three months ago. He was given an appointment for a gastroscopy examination - seven years from now.

The date for the procedure, Sept. 26, 2018, could be a typographical error, but those who have watched the public health system in Costa Rica for years aren't counting on it. Villalta certainly doesn't believe it.

"This is the last straw!" Villalta told the daily La Nacion, which broke the story, "My contribution to the Caja has been deducted promptly in every paycheck. How is it possible that they try to do this to me?"

Fantastic scheduling has been a chronic disease of Caja Costarricense de Seguro Social (CCSS) administration for years. Showing the benefits of the free press, stories have popped up like this in every corner of the media from the English-language media to scandal sheets like Diario Extra.

In the 1990s, callous Caja bureaucrats scheduled operations and exams well into the 21st century with cheerful disregard for medical realities. It was not uncommon for patients requiring immediate surgery to die before the date for the operation rolled around.

Caja director Ileana Balmaceda, consulted by La Nacion, expressed complete disagreement with the situation, although she claimed not to be familiar with Villalta's case. She said that one of her orders to new Caja officials is to speed up such appointments.

(The institution has recently done some personnel housecleaning after a Legislative Assembly investigating committee and government officials have put the Caja under a microscope for inefficiency and overspending its budget.)

Hospital Escalante Padilla medical director, Dr. Alexis Rodriguez, seemed unmoved by Villalta's dilemma. He explained blandly to the newspaper that three kinds of such exams were scheduled, emergency, for interned patients--required quickly to test for cancer - and non-emergency.

"The time (needed) to make an examination depends on the doctor's diagnosis... It appears to me that the police officer's case is not one for an urgent examination," Rodriguez said. He added that the hospital has but one gastroenterologist.

It is unlikely that Rodriguez's explanation will assuage the furious Villalta. "I can't wait until the the date they set for an examination, I''ll have to see what can be done," he said.

Commentary: It appears characteristic of the lack of confidence in the public health care system here that the National Insurance Institute (INS) does not entrust its patients to the tender mercies of the Caja. Instead, with a goal of getting their patients back to work as soon as possible, they contract a private clinic, Clinica Catolica, and their own doctors for care.

Neither does the country's presidenta, Laura Chinchilla trust the public health system, opting for her surgery recenlty at a private hospital. See story "Costa Rica's Presidenta Prefers Private Hospital Over Public".

Although many individual nurses and doctors in public clinics and hospitals are sincere, the system often seems set up for the comfort of the staff more than care for patients.


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