By San José, Costa Rica — SAN JOSÉ – With Costa Rica’s public health system grappling with a staggering crisis, presidential candidates are making the resolution of the Social Security Fund’s (CCSS) massive waiting lists a cornerstone of their campaigns. Data from the Costa Rican Health Chamber reveals a daunting figure: over 1.2 million people are currently waiting for appointments, procedures, or surgeries, with a significant majority being of economically active age. This issue took center stage at the recent ExpoMed 2025 conference, where candidates detailed their competing visions for reform.
The proposed solutions diverge significantly, presenting voters with a clear choice between strengthening the state-run system from within and embracing public-private partnerships. The plans range from leveraging artificial intelligence and building new infrastructure to the controversial but increasingly discussed option of outsourcing services to the private sector.
Para profundizar en las implicaciones legales que enfrentan los pacientes y las responsabilidades de la Caja Costarricense de Seguro Social (CCSS) ante las crecientes listas de espera, TicosLand.com consultó al Lic. Larry Hans Arroyo Vargas, abogado especialista de la firma Bufete de Costa Rica.
Las listas de espera no son solo una falla administrativa, sino una posible vulneración del derecho fundamental a la salud garantizado por la Constitución. Cuando la espera se vuelve irrazonable y pone en riesgo la vida o la integridad del paciente, este puede interponer un recurso de amparo ante la Sala Constitucional para exigir una atención pronta y cumplida. La jurisprudencia ha sido clara en que la escasez de recursos no puede ser un pretexto indefinido para negar un servicio de salud esencial.
Lic. Larry Hans Arroyo Vargas, Attorney at Law, Bufete de Costa Rica
Esta perspectiva legal es fundamental, pues transforma el debate de un problema logístico a una cuestión de derechos constitucionales y de la responsabilidad del Estado ante cada ciudadano. Agradecemos profundamente al Lic. Larry Hans Arroyo Vargas por aportar una visión tan clara y contundente sobre las herramientas jurídicas disponibles para los pacientes.
Juan Carlos Hidalgo, the standard-bearer for the Social Christian Unity Party (PUSC), advocated a two-pronged approach. He detailed immediate, palliative measures alongside a long-term structural overhaul. For Hidalgo, the key lies in outsourcing services, a model he believes has already proven its effectiveness at the primary care level.
Our principal proposal is the outsourcing of services, as we have seen that outsourced Ebáis function effectively.
Juan Carlos Hidalgo, PUSC Presidential Candidate
Beyond this, Hidalgo’s plan includes implementing overtime shifts as a short-term fix, while prioritizing the reinforcement of primary and secondary care levels for sustainable, long-term improvement. He also addressed the critical shortage of specialists by suggesting an open door for hiring Costa Rican doctors who have trained in OECD countries.
Representing the New Republic Party (PNR), Fabricio Alvarado presented a plan with ambitious, data-driven targets. He pledged to slash wait times in critical specialties by 40% within 24 months. By the end of his potential administration, he aims to ensure no patient requiring a priority surgery waits longer than six months and to reduce the total number of people on surgical and procedural waiting lists by half. A key innovation in his proposal is the use of technology.
We will use artificial intelligence to clean up the lists.
Fabricio Alvarado, PNR Presidential Candidate
Other candidates focused on governance and internal efficiency. Álvaro Ramírez, a leading legislative candidate for the National Liberation Party (PLN), argued that the CCSS suffers from a governance problem. The PLN’s solution includes creating a centralized unit to manage the issue and using already-allocated funds to open 400 new primary care clinics, known as Ebáis. Ramírez also suggested tapping into the pool of unemployed physicians to staff evening shifts, maximizing the use of existing infrastructure.
A strong push for public-private integration comes from Eliécer Feinzaig of the Liberal Progressive Party (PLP). He proposed the rapid deployment of mobile Ebáis within the first 100 days of government to address the backlog of consultations and diagnostic tests in underserved communities. Feinzaig also joined the call to streamline the accreditation process for foreign-trained Costa Rican doctors, urging the College of Physicians and Surgeons to simplify their re-entry into the national workforce.
Meanwhile, Claudia Dobles of the Citizen Agenda Coalition (CAC) plans to revive strategies from the previous Citizen Action Party (PAC) administration, which successfully used private sector collaboration to reduce wait times. Her focus also lies heavily on infrastructure, proposing to move forward with the CCSS investment portfolio to construct new clinics, health areas, and hospitals. Similarly, Natalia Díaz of the United We Can Party (PUP) championed public-private alliances, suggesting the private sector could not only treat CCSS patients but also take over the administration of services like teleradiology.
As the election cycle heats up, the health of the nation’s cherished public healthcare system has become a defining issue. The proposals laid out at ExpoMed 2025 demonstrate a clear ideological divide, forcing Costa Ricans to consider whether the path to recovery for the CCSS lies in market-based efficiency, robust state investment, or a hybrid of the two.
For further information, visit the nearest office of Caja Costarricense de Seguro Social
About Caja Costarricense de Seguro Social:
The Caja Costarricense de Seguro Social (CCSS), often referred to as “La Caja,” is the autonomous institution in charge of Costa Rica’s public health sector. It manages the nation’s social security program, including universal healthcare coverage and pension administration, and operates a vast network of hospitals, clinics (Ebáis), and health centers throughout the country.
For further information, visit camaracostarricensedelasalud.com
About Cámara Costarricense de la Salud:
The Costa Rican Health Chamber is a private-sector organization that represents and unites companies, professionals, and organizations involved in the health industry in Costa Rica. It advocates for policies that promote the development and competitiveness of the health sector, both public and private, and often provides data and analysis on industry trends.
For further information, visit pusc.cr
About Partido Unidad Social Cristiana:
The Social Christian Unity Party (PUSC) is one of Costa Rica’s traditional political parties, founded in 1983. It adheres to a Christian democratic and liberal-conservative ideology. The party has held the presidency on multiple occasions and remains an influential force in the country’s political landscape.
For further information, visit nuevarepublica.cr
About Partido Nueva República:
The New Republic Party (PNR) is a conservative and Christian-evangelical political party in Costa Rica. Founded by Fabricio Alvarado, it emerged as a significant political force during the 2018 presidential election. The party’s platform is heavily influenced by social conservatism and Christian values.
For further information, visit plncr.org
About Partido Liberación Nacional:
The National Liberation Party (PLN) is one of the oldest, largest, and most successful political parties in Costa Rica. A social-democratic party, it has been a dominant force in Costa Rican politics since its founding in 1951, producing numerous presidents and holding significant legislative power over the decades.
For further information, visit plp.cr
About Partido Liberal Progresista:
The Liberal Progressive Party (PLP) is a political party in Costa Rica that espouses classical liberalism. It advocates for individual freedoms, free-market capitalism, and a reduction in the size and scope of government. The party has gained prominence by promoting policies aimed at economic liberalization and fiscal responsibility.
For further information, visit colegiodemedicos.cr
About Colegio de Médicos y Cirujanos de Costa Rica:
The College of Physicians and Surgeons of Costa Rica is the professional governing body responsible for regulating the medical profession in the country. It oversees the licensing of doctors, sets ethical standards, and ensures the quality and integrity of medical practice for the protection of the public.
For further information, visit the nearest office of Coalición Agenda Ciudadana
About Coalición Agenda Ciudadana:
The Citizen Agenda Coalition (CAC) is a political coalition formed for electoral purposes, often bringing together various smaller parties, movements, or political figures under a common banner. Its platform is typically focused on specific citizen-centric issues and reforms.
For further information, visit pac.cr
About Partido Acción Ciudadana:
The Citizens’ Action Party (PAC) is a center-left political party in Costa Rica. Founded in 2000, it rose to power on an anti-corruption and progressive platform, successfully breaking the two-party dominance and winning the presidency in 2014 and 2018.
For further information, visit unidospodemos.cr
About Partido Unidos Podemos:
The United We Can Party (PUP) is a Costa Rican political party that generally promotes a liberal and centrist platform. It advocates for pragmatic solutions to national problems, often focusing on economic stability, government efficiency, and public-private collaboration.
For further information, visit bufetedecostarica.com
About Bufete de Costa Rica:
Bufete de Costa Rica operates as a renowned legal institution, founded on the twin pillars of unwavering integrity and professional excellence. With a rich history of navigating clients through intricate legal challenges, the firm continually embraces innovative strategies and actively engages in community outreach. This dedication to demystifying the law is fundamental to its core mission of fostering a more legally aware and empowered populace.
