Essay Sample on Costa Rica & US Health Care: A Comparative Analysis

Introduction

All states have their history, difficulties, and goals that have collectively contributed to their present state of their health care system. The World Health Organization (WHO) ascertains that every individual has the fundamental rights to the highest achievable standard of health (Berchick, et al, 2018). The two specific health systems of interest are those of Costa Rica and the United States. Although the arrangement in both countries is unique, there are primary components that can be attributed to the key models known as "welfare states." A welfare state is a group of policies that a state forms to protect the minimum of welfare to its citizens to reduce poverty and inequality (Singh, Rodriguez-Lainz, & Kogan, 2013). For instance, some of the models emphasize on giving aid to more impoverished populations, while others believe that there should be a universal approach in welfare distribution. The United States of America and Costa Rica follow different welfare state models that have led to the growth of two different health care systems.

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There are three primary welfare state models, which include social-democratic, liberal, and corporatist-statist. The United States of America utilizes the progressive model, while Costa Rica utilizes the social-democratic model. The social-democratic model emphasizes on universal health care systems. It concentrates on equality in the provision of health care services (Singh, Rodriguez-Lainz, & Kogan, 2013). On the other side, the liberal model responds to social stratification rather than actively working to limit them. There is minimized assistance to marginal groups because they are expected to rely on the market to secure their welfare compared to the state government. This includes authorization to health insurance coverage to reduce out-of-pocket costs in a privatized model of the health care system.

Although the two states have different health care approaches, both nations have similar strategies to the health care needs of immigrants. The reason being is that pregnant immigrant women hold a unique position. They can access specific levels of care that other immigrants groups are barred from accessing due to the values that both states place on child health and maternity. Immigrants are typically perceived as burdens on the health system because they take away resources from birthright citizens. Nonetheless, some laws are enacted to protect immigrants' health, but they are not adequately enforced thus detrimental to the health of the afro mentioned group.

Costa Rica state is a step ahead of the United States in terms of health care reforms. The former imposes increased taxes to accommodate its well-known partial-universal policy system. The establishment of the Costa Rica Social Security Funds (CRSS) which is financed by increased taxes has led to improved health care systems in the nation. The more impoverished population has full coverage insurance that is provided by the state government as it pays for physician appointments, pharmaceutical, and hospital visits (Berchick, et al, 2018). Additionally, Costa Rica's stable economy and biodiversity have made the nation an ideal location to conduct medical research, thus providing citizens with innovative medical technology and drugs. Unfortunately, hiked taxes can no longer keep up with the financial demands of Costa Rica Social Security Funds (CCSS) and other health care reform segments. However, due to the similarities between Costa Rica's health care system in the present situation and the direction that the United States health care system seems to be heading in the future. The former may serve as a benchmark for the latter health care reforms to improve its health care systems.

Structure of Costa Rica Health System

Costa Rica state has a universal health care system that is firmly attributed to providing first care that secures a majority of its citizens and generally perceived quite positively within and worldwide. In 2014, 97% of Costa Rica's citizens were acquired by the national health insurance system, which is under the Common Core State Standards (CCSS). CCSS, which is as well depicted as La Caja, is an institution that administers public health services in Costa Rica (Singh, Rodriguez-Lainz, & Kogan, 2013). It is built upon five principles, which include mandatory, social involvement, solidarity, universality, and equity. To execute these elements, La Caja is integrated into levels of attention that become more special and unique with each succession. The initial tier is the most general form of care and constitutes the underlying integral health care team. The second tier represents regional hospitals and large clinics. Lastly, the highest level consists of five specialized hospitals and three national health care centers that treat the most challenging patient situations.

The initial tiers form the framework of Costa Rica's health care system. People are assigned to first-tier depending on their area of residence, with one location serving at least 1,000 households in its neighboring setting. The first tier which is similarly known as EBAIS (Equipos Basicos de Atencion Integral en Salud) consists of a physician, nursing practitioner, pharmacy technician, health care assistant, and ATAPS (Asistente Tecnicos de Atencion Primaria). However, the variation of the multidisciplinary team depends on ones setting. According to (Pesec et al., 2017), ATAPS are the most significant interdisciplinary members because they make visits to people's households to establish healthy practices at home, a setting in which citizens engage most of their well-being behaviors. On the other side, EBIAS participates in family planning, outpatient services, and vaccinations to society at large.

The second tier provides inpatient and outpatient care via seven regional hospitals, ten primary clinics, and thirteen peripheral health care centers. Patients who desire more specialized care must first be referred to the EBIAS, which is networked with an adequate secondary facility before they are allowed in the second tier. The third and the highest level of the health care system entail the most sophisticated treatments and surgical procedures through the state general hospitals and specialized health care centers. The three-state hospitals include Hospital Mexico, Hospital Rafael Angel Calderon Guardia, and Hospital San Juan de Dios. The five skilled health care facilities concentrate on psychiatry, pediatrics, women's health, and gerontology (Pesec et al., 2017). All three state hospitals are situated in the province of San Jose since it is the most populous city in Costa Rica.

Although there are several private options, it is eminent that public health services are predominant in the nation with the CCSS as the primary service provider for individual health care services. The downside of the universal access criteria is that the wait time can be annual or even more depending on the nature of the medical procedure, thus coercing Costa Rica's s citizens to pay out -of -pocket money to private hospitals to receive rapid treatments. The out -of -pocket money spending has been on the rise in the state from 2001- 2016, increasing from $ 80 to $250, with a majority of this money spent on drugs and pharmaceutical consultations (Pesec et al., 2017). Due to increase in waiting times in recent years, there has been growth in private sectors that have their networks of insurance organizations, clinics, pharmacies, and hospitals. However, an increase in private sectors has led to social inequalities since individuals that have lower socioeconomic status find it challenging to afford the cost of services in private health care. In that regard, people that are more affluent with the private sector prices access to care more rapidly compared to their weaker counterparts.

The lengthy waiting period for medical procedures has become a challenge in universal coverage because clinicians have implemented an additional fee-for-services aspect to minimize the waiting times. In 2014, the average wait for surgery was more than 600 days, with a joint replacement averaging the longest waiting time of 1000 days (Lopez, Bialik, & Radford, 2018). Although the afro mentioned factors might not be life-threatening, they have an impact on an individual's ability to work and quality of life. A lot of Costa Rica's citizens have opted to directly go to health care emergency departments for immediate primary care, with approximately 65% of Costa Rican and 15% of American emergency room visits becoming non-urgent by 2010 (Lopez, Bialik, & Radford, 2018). There were state initiatives in 2014 to minimize the waiting period by over a year with implemented measures such as extending operational hours, specifying waiting periods, and the addition of personnel to monitor and regulate the wait times. Although the wait time is not the best strategy, Costa Rica's citizens pay into the system with the knowledge that they will receive the quality of care desired (Lopez, Bialik, & Radford, 2018).

Health services in the CCSS are covered by contributions from employers, workers, and the state, with the fees accrued depending on the employee's income, which must be above a certain level to be contributed to the health care system. The state operates under the single-payer National Health Service system, which means that a single public unit is in charge of financing health care for all citizens, with the state health expenditures accumulating to 9.3% of its gross domestic products. Therefore, less than 1% of Costa Rica's population have reported failing to seek medical care due to monetary reasons when compared to 22% of the United States population. The most deficient 20% receive about 40% of the public spending on health care services (Lopez, Bialik, & Radford, 2018). This type of distribution gives especially to the more impoverished citizens' access to much-desired health care that would otherwise be inaccessible and unaffordable.

To services the universal health care system approach, salaried employees, and their families provide 65%, self-employed individuals and their families contribute 30%, and the pensioners and their dependents contribute 20%. Within the salaried employees, the worker contributes 6.5% of income, the worker 10%, and the country 0.25 %. The self-employed workers must be earning above the minimum threshold to add to the system, which equates from 4% to 11% of their income (Lee & McKee, 2015). Lastly, pensioners contribute 7% of their pension to the maintenance of the health care system. The universality health care system is effective and reliable in Costa Rica because everyone collectively contributes to, and the benefit that comes from the health system is allowed to grow throughout the years. Additionally, there are several ways for immigrants to Costa Rica to obtain health care, making it a favorable option for a lot of families that must emigrate.

Structure of the United States Health Care System

The United States health care system is different from that of any other developed state due to its fragmented conglomeration of private and public coverage options. The majority of the U.S citizens, which is equivalent to 56%, utilize the private option because they obtain health insurance by their employer or an employed family member. U.S- born employees have doubled the prevalence of health insurance coverage when compared to the Central American and Mexica-born counterparts, although these employees work in the same state (Lee & McKee, 2015). Undocumented immigrants from both Central American and Mexica-born constitute a significant proportion of the United States workforce, but still, experience...