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Costa Rica remains leader in health, but faces uncertain future

May 29, 2009

The fact that Costa Rica is in the top 10 among its Latin American neighbors in almost every health statistic – according to a recent report from the World Health Organization — is no surprise to medical experts here.

This little country of 4 million provides coverage to more than 90 percent of its residents, gives access to 100 percent of those living within its borders and caters to a population with a heightened concern about health. As a result, it has some of the lowest mortality rates among children under five, pregnant mothers and malaria patients; and ascends to the top of the list for access to improved sanitation and clean drinking water.

“It´s an excellent system,” said Isaac Waserstein, a leader in the pharmaceutical business, who has spent more than 30 years watching Costa Rica´s medical industry. “Results show that we have a health system that is working. Can it be more efficient? Sure. But we are doing a good job.”

Yet, in a medical landscape that is constantly changing, some wonder whether Costa Rica can maintain its successes.

Costa Rica´s population is growing older and technology is changing rapidly, two factors which drive up costs and make it difficult for the country to maintain its level of services. Insurance companies are beginning to set roots here, thanks to the Central American Free Trade Agreement with the United States, which adds a new dimension to the equation.

The country´s health system faces many challenges in the future, including providing private-level care on the public dime and keeping pace with technological advances, but, if Costa Rica maintains its public health system, Waserstein is confident the country will continue to top the list of health statistics.

“The theme of medicine in the world is that it is expensive. It´s not a penny business,” said Waserstein, president of Stein Inc., a pharmaceutical company. “What makes it more expensive today than 20 or 30 years ago is technology and the fact that more people are using the system. They are living longer so they are using the system more.”

At least one area that Costa Rica falls behind, according to the recent report, is in the number of its teenage girls who are pregnant. Statistics show that 63 of every 1,000 girls between the ages 15 and 19 are or have been pregnant – slightly above the average for the Americas as a whole (see chart).

This is more of a social issue than a medical one, said Waserstein, but he blames a loss in family values for adolescent pregnancies.

For the full World Health Organization report in English, click here.

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