Health Care System of Costa Rica & U.S Essay Examples & Outline

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Health Care System of Costa Rica and the U.S

The health care system of the U.S has been the subject in national circles. On one extreme of this debate, there are people who argue that the system is the best in the world pointing to the state of art facilities and clear cut technology (Davidson, 2010). On the other extreme of this debate, there are people who argue that the health system is inefficient and fragmented. They point to the fact the America spend than any other country in terms of health yet still suffers from insurance and uneven provision of services.

To critically determine the basis of two extremes, necessitates understanding the U.S health care system. The private element over dominates the public element. Over 62% of non-elderly Americans received the private employer-sponsored insurance coverage with 5% purchasing from the private non-group. Only 15% enrolled to the public insurance providers such as Medicaid. Public Health insurers include programs such as Medicare that covers for individual aged over 65 years, as well as disabled ones. Medicare, on the other hand, covers for low income groups and disabled.

As a requirement of federal law states need to cover the insurance for very poor pregnant women, children and the elderly. Other include the S-CHIP for children, VA for the veterans in the military. The private insurance providers include the employer-sponsored. This forms the way in which Americans achieve health care. The private non-group provides the coverage for the self-employed. The health care system in America is financed from two streams of money.

The collection of the money after the provision of the services and reimbursements of the service providers. There is the cost sharing both by the government and the private insurance companies (Davidson, 2010). The United States spends more in health care in comparison to other developed countries. The US has a higher childhood deaths and low levels of life expectancy. Maternal mortality records 32% with the recommended being 5-15%. Disparities to accessibility of health care and insurance dominate the system in America.

Just like the American health care system, Costa Rica components of health care include both public and private sectors. The public sector is dominated by autonomous institutions charged with the responsibility of purchasing and delivering much of the health services in the Costa Rica. Caja Costarricense de Seguro Social (CCSS) is financed from the contributions made by the affiliates such as the employers and the state (La Forgia, 2005). It has extensive involvement in the management of maternity and illness, disability, the elderly and the non-contributive part of the society.

CCSS has the capability of providing the services within its own facilities but can contract the private providers. The private sector, on the other hand, encompass a broad range of services that offer both ambulatory and health care (La Forgia, 2005). The services are paid out of pocket with private health insurance firms contributing. The Ministry of Health remains the steward coordinating the functionalities within the public and private health care providers. With every standard in mind, Cost Rica has the best health care system in Latin America with new improvements in terms of infrastructural facility. Statistics from the WHO places Costa Rica as a top country in terms of high levels of life expectancy. Health insurance is made available to all Costa Ricans (La Forgia, 2005).

The affordability of the health care reduces the disparity in the access of the facilities. In comparison to the U.S private care, Costa Rica is relatively cheaper for the average visits. Dental work is relatively cheaper prompting a common term called medical tourism. Private hospitals are known for private practice by the doctor offer services at a cheaper rate than the U.S private practitioners (Langenbrunner, Cashin & O'Dougherty, 2009).

Despite the success in the provision of health care services in Latin America, Costa Rica public health system is in a dire critical condition. The public health care system is in the verge of collapsing due to financial illness (La Forgia, 2005). The social security system is also known as Caja had a deficit amounting to 82 million dollars risking the 1.4 million people enrolled to the system. The annual budget for Caja is 1.8 billion dollars.

Internal audits revealed that Caja had several shortcomings with overdue payments for the service providers and suppliers of medical equipment. This poses major challenges to the health care system if the creditors fail to do business with the Caja (Langenbrunner, Cashin & O'Dougherty, 2009). The financial woes for Caja worsened when the Ministry of Health ordered closure of operating rooms due to poor conditions that could compromise the safety of the patients. Ironically, the government even owe money to Caja. Money could not be blamed for the challenges faced by the Social Security Fund, rather the social changes that make the Caja not keep apace. Some of these changes include a decrease in life expectancy and lifestyle disorders such as diabetes and high blood pressure.

Unlike the lower rates of funding in the public health system of Costa Rica, the U.S healthcare system faces a myriad of challenges. There is diminishing access to healthcare facilities in the U.S unlike that of Costa Rica. 15% of American population live without any form of health insurance. The medical costs in U.S are on the rise with the country spending over than 15% of its GDP on the health. There are many bureaucracies in the health system with a high percentage of the money meant for healthcare spent on paperwork (Jonas, Goldsteen & Goldsteen, 2007).

The rising cost of the medical bill makes many people bankrupt. A survey done in 2006 indicated that more than 25% of Americans experience difficulty in paying the medical bill. The ranking of the health care system of the U.S is 37 in the world with sub-optimal care given. This is indicated by low life expectancy and high infant mortality. The health care system seems to be minting huge profits at the expense of provision of equitable care. The system is confusing to the citizens with many people in the mix not knowing what to choose that will be beneficial in the long run. This relates to health insurance premiums both at the private and public sector (Jonas, Goldsteen & Goldsteen, 2007).

The pros of American Healthcare systems reflect in the public health sector where there are initiatives such as Medicaid, Medicare, VA, and Affordable Care (Naden, 2010). Programs such as Medicaid ensure that old people and the disabled have access to healthcare while Medicare ensures that the people reigning from the poor background can access health. Initiative such as VA takes the interests of military veterans in provision of healthcare. Affordable Care is a recent promising health care for the low income groups.

This will guarantee health coverage to these groups that are not insured. People will be capable of accessing basic preventive care before the full-blown illness (Naden, 2010). The cons of the system are that a huge stake is run by the private sector. Disparity in health care has risen with many people unable to access basic health care. Opponents of the universal health care argue that people should pay in order to obtain the service. It is also difficult to guarantee the types of services to be rendered under the public health system. Opponent argues that the above initiatives will lead to moral hazards since people understand that there is guaranteed health coverage (Naden, 2010).

The biggest advantage of the Costa Rican health care system is that it is low cost. Contribution to the healthcare entails as little as 10-11.5%. Unlike the American Healthcare system, it is available even in small clinics and other health care centers. Caja has excelled majorly in the provision of preventative medical care. This entails regular checkup for diseases such as blood tests and mammograms. Caja acts as a Social Security Fund with customers automatically qualifying for pension when they reach the age of 65 and above. The main disadvantage of the system is a long wait time (Davidson, 2010. At the local clinics, people have to arrive one hour earlier to access the medical care. The prescription drugs used in Caja are of generic origin. Furthermore, with Caja people are limited in the choice of the medical provider.

In Costa Rica, the health insurance coverage reached 87.6% of the whole population in 2009 with the percentage remaining constant in the later years (La Forgia, 2005). This comprises of 61.9 per cent economically active persons and 53.6 per cent relying on the pension insurance. The number of uninsured citizens represents 390,000. In the U.S, the number of uninsured people represents 15% of the population. As of 2012, the number of uninsured American fell to 15.4 per cent. This represents 48 million of the population proportion that is high in comparison to the Costa Rican (La Forgia, 2005).

The government in the two countries have an important role to play in ensuring workable health care system. Since the market cannot adequately support the health care needs of the citizens, the government should intervene and bridge all the gaps that exist in situations where there is unfairness.

The government should have a huge concern in creating the necessary environment for partnership Jonas, Goldsteen & Goldsteen, 2007). Other Government-based intervention include decentralized delivery systems, developing health care workforce and evaluating the adopted technologies and practices (Davidson, 2010). The government shoulders the responsibility of ensuring that the health care is readily available and affordable by cutting down the budgeted money on the sector. The government in Costa Rica has the role of creating a level play field that will ensure that the country can get sufficient funding for the Caja. The custodian of health that is the Ministry should be capable of getting extra funding for the running of Caja.

Costa Rican Health Care system is the best among the two. Despite the country being behind the U.S in terms of economy, it has made huge strides in health (Naden, 2010). The choice is based on the low percentage of the population that is uninsured compared to the American. A good health care system should ensure accessibility and affordability. The Costa Rican health care system is accessible and affordable to many citizens unlike in the U.S where there is huge health disparity (Jonas, Goldsteen & Goldsteen, 2007).


Davidson, S. (2010). Still broken (1st ed.). Stanford, Calif.: Stanford Business Books.
Jonas, S., Goldsteen, R., & Goldsteen, K. (2007). An introduction to the U.S. health care system (1st ed.). New York: Springer.
La Forgia, G. (2005). Health system innovations in Central America (1st ed.). Washington, D.C.: World Bank.
Langenbrunner, J., Cashin, C., & O'Dougherty, S. (2009). Designing and implementing health care provider payment systems (1st ed.). Washington, D.C.: World Bank.
Naden, C. (2010). Health care (1st ed.). Tarrytown, NY: Marshall Cavendish Benchmark.