Caja Tightens Belt--Too Late?

Costa Rica's universal health care system (Caja) is finally tightening its belt. But, are austerity measures coming too late?

That is what many, inside and out of the institution, are asking themselves. The institution is cutting back payrolls -- including salaries as well as freezing hiring -- and slashing private security costs, rentals, overtime, travel, etc.

Most view the roots of the Caja's financial woes as being in the Arias Administration when the then-board of directors approved generous across-the-board salary hikes and generally played Santa Claus. (See previous articles.)

But linked with that are overly bureaucratic administration, inefficiency and wasteful practices that ordered medicines at higher than usual prices and lost track of warehousing. (See previous articles.)

The first steps in plugging the black hole into which misadministration has been tossing money, especially but not confined to the Arias years, are those that many will wonder why they were not made years before--unnecessary payment for non-essential courses for personnel and unnecessary consultations.

Sometimes, money is lost because the regulations are there but not followed -- coddling personnel and not inquiring into the validity of sick leave, for instance. The newspaper La Nacion, for example, found that employee illness spikes mysteriously during the World Cup soccer tourney.

As for employees, board member Jose Luis Loria told the newspaper La Nacion that with the present 48,000 employees, the Caja "can be much more efficient." This is a masterful understatement.

Personal note: Many years ago, this reporter took leave of journalism -- and probably his senses -- in order to become a minor bureaucrat in a federal welfare program in Oregon. Periodical conferences dotted the calendar, paid for by taxpayers.

There, we discussed "problems" pertaining to our duties--not solutions, mind you, just problems. We became so adept at taking apart and reassembling a problem that no one could tell we had even touched it...

By Rod Hughes, Fijatevos.com