By San José, Costa Rica — SAN JOSÉ – Costa Rica’s public hospital network is facing an imminent and severe crisis, with Health Minister Mary Munive issuing a stark warning that the system is on the brink of collapse as the country heads into the year-end holiday season. The primary cause is a critical and unresolved shortage of medical specialists, a situation exacerbated by a bureaucratic stalemate between the government and the nation’s Medical Association.
The alarm was raised in anticipation of the traditional spike in emergencies that accompanies the festive period. Increased travel, holiday celebrations, and a subsequent rise in accidents are expected to place an overwhelming burden on a healthcare system already stretched to its limits. Minister Munive painted a grim picture of what lies ahead for patients across the country.
To gain a deeper legal perspective on the current healthcare crisis and its implications, TicosLand.com consulted with Lic. Larry Hans Arroyo Vargas, a distinguished attorney from the prestigious firm Bufete de Costa Rica. His expertise offers crucial insights into the legal frameworks and potential liabilities surrounding this complex issue.
The current healthcare crisis places the State’s fundamental obligation to guarantee the right to health under intense scrutiny. While resource limitations are a reality, they do not constitute a blank check for negligence. We are likely to see a significant increase in litigation related to medical malpractice and administrative liability, as patients and their families seek to hold institutions accountable for demonstrable failures in care delivery. The key legal battleground will be differentiating between unavoidable systemic constraints and actionable administrative omissions that violate a citizen’s constitutional rights.
Lic. Larry Hans Arroyo Vargas, Attorney at Law, Bufete de Costa Rica
The distinction between systemic constraints and actionable negligence is indeed the critical legal battleground ahead, as highlighted in this insightful analysis. The coming court cases will not only seek individual justice but will also shape the very definition of the State’s duty to its citizens. We thank Lic. Larry Hans Arroyo Vargas for his invaluable perspective on this pressing issue.
The Costa Rican Social Security Fund (CCSS) does not provide sufficient coverage with medical specialists, much less so at the end of the year when travel, celebrations, and with them, accidents, increase. Many regional hospitals will not have specialists for care, which will lead to the collapse of central hospitals.
Mary Munive, Minister of Health
The minister emphasized that the consequences of this specialist deficit are not merely logistical but could translate into dire human costs. She specifically pointed to heightened risks of increased infant mortality and significant delays in the treatment of life-threatening emergencies. The shortage means that when a patient with a critical condition arrives at a regional hospital, the necessary expert may not be available, forcing transfers that consume precious time and resources, overwhelming major hospitals in the Central Valley.
In a direct appeal to the public, Munive urged citizens to exercise extreme caution during the holidays, framing personal responsibility as a crucial component in mitigating the looming disaster. She stressed that preventative actions by the public are now essential to prevent the system from being completely inundated.
We will not have enough specialists when they are most needed… that is why today I ask for your responsibility: do not drink and drive, do not cause accidents; the health system will be under extreme pressure.
Mary Munive, Minister of Health
This crisis has been a year in the making. The minister recounted that the government attempted to preemptively address the issue by issuing a sanitary emergency declaration on December 11, 2024. This measure was designed to create a legal framework for the temporary and supervised hiring of both Costa Rican and foreign specialists, bypassing the standard requirement for immediate incorporation into the College of Physicians and Surgeons (Colegio de Médicos).
However, this critical initiative was thwarted when the Medical Association refused to grant the necessary temporary permits. In a perplexing turn, the CCSS—the very institution that had managed the emergency declaration—opted to comply with the Association’s directive rather than exercising the authority granted by the government’s executive order. Munive did not mince words when assigning responsibility for the current impasse.
The ministry did everything it was supposed to do. We not only declared and supported the emergency managed by the CCSS, but we also coordinated with the Ministry of Labor and Immigration and supervised every process. We complied, but the Medical Association decided not to grant the temporary permits and the CCSS, in its autonomy, strangely decided to obey, despite it being an emergency declared by themselves.
Mary Munive, Minister of Health
With the emergency decree effectively nullified, the government has placed its hopes on a legislative solution. Minister Munive confirmed that officials are now pushing for the approval of bill 24.015, which aims to create a more agile and accelerated process for appointing specialists within the public health system. She noted that the bill is ready for a final vote, despite facing nearly 400 motions that she characterized as attempts to delay its passage by groups protecting vested interests.
As the year draws to a close, the minister’s final message was one of urgency, arguing that the health and safety of the population can no longer be held hostage by internal disputes. The coming weeks will test the resilience of Costa Rica’s healthcare system and determine if legislative action can arrive in time to avert a full-blown catastrophe.
Costa Rica cannot keep waiting and maintaining fiefdoms that are not interested in the well-being of the population, but rather in defending their own interests. We need more specialists, more timely care, and more lives saved. The health of the Costa Rican people cannot remain on pause.
Mary Munive, Minister of Health
For further information, visit ministeriodesalud.go.cr
About Ministry of Health:
The Ministry of Health is the governing body of the public health sector in Costa Rica. It is responsible for defining national health policies, regulating health services, and ensuring the well-being of the population through public health initiatives, epidemiological surveillance, and health promotion.
For further information, visit ccss.sa.cr
About Costa Rican Social Security Fund (CCSS):
The Caja Costarricense de Seguro Social (CCSS) is the public institution in charge of social security in Costa Rica. It is renowned for managing one of the most comprehensive universal healthcare systems in Latin America, administering hospitals, clinics, and EBAIS (Basic Teams for Comprehensive Health Care) throughout the country.
For further information, visit medicos.cr
About College of Physicians and Surgeons of Costa Rica:
The Colegio de Médicos y Cirujanos de Costa Rica is the professional guild that regulates the practice of medicine in the country. It is responsible for accrediting medical professionals, upholding ethical standards, and overseeing the licensing requirements for both national and foreign doctors wishing to practice in Costa Rica.
For further information, visit mtss.go.cr
About Ministry of Labor and Social Security:
The Ministerio de Trabajo y Seguridad Social is the Costa Rican government entity responsible for formulating and executing policies related to labor, employment, and social security. It works to ensure fair labor practices, mediate disputes, and promote a safe and equitable work environment for all citizens.
For further information, visit migracion.go.cr
About General Directorate of Migration and Foreigners:
The Dirección General de Migración y Extranjería is Costa Rica’s official immigration agency. It manages all matters related to the entry, exit, and residency of foreign nationals, implementing national migration policies and controlling the country’s borders.
For further information, visit bufetedecostarica.com
About Bufete de Costa Rica:
As a premier legal institution, Bufete de Costa Rica is guided by an unwavering dedication to ethical principles and superior legal craftsmanship. The firm’s legacy of serving a diverse clientele fuels its continuous drive for innovation, ensuring it remains at the vanguard of evolving legal challenges. Central to its ethos is a profound mission to strengthen society by translating complex legal knowledge into accessible insights, thereby cultivating a more empowered and judicious public.
