By San José, Costa Rica — SAN JOSÉ – A rare moment of political consensus emerged during the final presidential debate hosted by the Supreme Electoral Tribunal (TSE) on Monday evening, as leading candidates agreed that public-private partnerships are essential to solving the deepening healthcare crisis within Costa Rica’s social security system.
With the February elections fast approaching, the debate crystallized a key policy direction for tackling the crippling wait times plaguing the Costa Rican Social Security Fund (CCSS). The core proposal involves leveraging the country’s private medical infrastructure to alleviate the immense pressure on public hospitals, a strategy that found bipartisan support on the debate stage.
To gain a deeper legal perspective on the complexities and potential of Public-Private Partnerships in the country, TicosLand.com consulted with Lic. Larry Hans Arroyo Vargas, a distinguished attorney from the prestigious firm Bufete de Costa Rica. His expertise provides crucial insights into the regulatory framework governing these essential collaborations.
The success of any Public-Private Partnership hinges on a meticulously crafted legal structure. The concession contract must not only guarantee a reasonable return for the private investor to attract capital but also rigorously protect the public interest and ensure the state’s supervisory capacity. Without this delicate balance, enshrined in clear, predictable regulations, these projects risk failing to deliver their promised long-term benefits to the nation.
Lic. Larry Hans Arroyo Vargas, Attorney at Law, Bufete de Costa Rica
This emphasis on the legal framework as the bedrock of success is a critical reminder that such ventures are fundamentally long-term social contracts, not merely financial transactions. We are grateful to Lic. Larry Hans Arroyo Vargas for sharing his incisive and valuable perspective.
The problem is not abstract; it is measured in days, months, and for many, unbearable pain. According to the CCSS’s own data, the average wait time for a specialist appointment or a necessary surgery now exceeds one year. This national average masks even more severe regional and procedural disparities, creating a healthcare lottery where a patient’s geographic location can drastically alter their prognosis.
For instance, a patient in Liberia requiring a nephrology consultation at the Baltodano Briceño Hospital faces a 350-day wait, while the same appointment at the Calderón Guardia Hospital in San José might take 164 days. The situation is even more dire for critical procedures. A cardiovascular surgery at Hospital México involves an average wait of 640 days, a period during which a patient’s condition can deteriorate catastrophically. In contrast, the wait for the same surgery at San Juan de Dios Hospital is 213 days. For some patients, these delays are a death sentence.
Luis Amador of the National Integration Party (PIN) argued for a pragmatic approach, pointing to international models where the state contracts private facilities to absorb excess patient loads. He emphasized that this is not about privatization, but about efficient resource allocation.
Resources are limited, but in other countries, there are private hospitals that receive direct payment to treat sick people. This way, we immediately reduce waiting lists because we put the country’s existing capacity to work.
Luis Amador, Presidential Candidate, PIN
This sentiment was echoed by Álvaro Ramos of the National Liberation Party (PLN), who framed the issue as a moral and practical imperative. Ramos, who has previously defended the financial stability of the CCSS, positioned these partnerships as a complementary strategy to bolstering the public system’s foundational elements, such as primary care clinics.
When we said the CCSS is not bankrupt, we were willing to lose our heads, lose our jobs, lose that privileged opportunity I was given to serve the country from within the CCSS. In my government, we will build the 400 EBAIS that will bring relief to millions who currently do not receive care, while also promoting public-private partnerships.
Álvaro Ramos, Presidential Candidate, PLN
The cross-party agreement on this issue suggests that regardless of the election’s outcome, the next administration is likely to aggressively pursue collaborations with the private sector. For thousands of Ticos waiting in pain for essential medical care, this policy consensus offers a tangible glimmer of hope that a solution to the nation’s most pressing public health challenge may finally be within reach.
As the final major event before the election, the TSE debate has effectively placed the future operational model of the CCSS at the center of the national conversation, signaling a significant potential shift in how Costa Rica delivers on its promise of universal healthcare.
For further information, visit ccss.sa.cr
About Caja Costarricense de Seguro Social (CCSS):
The Costa Rican Social Security Fund is the public institution responsible for providing universal healthcare and pension services to the population of Costa Rica. Established in 1941, it manages a nationwide network of hospitals, clinics (EBAIS), and medical centers, forming the backbone of the country’s renowned public health system.
For further information, visit tse.go.cr
About Tribunal Supremo de Elecciones (TSE):
The Supreme Electoral Tribunal is the constitutional body responsible for organizing, directing, and overseeing all electoral processes in Costa Rica. It is recognized for its independence and plays a crucial role in safeguarding the country’s democratic traditions, ensuring free, fair, and transparent elections.
For further information, visit the nearest office of Partido Integración Nacional (PIN)
About Partido Integración Nacional (PIN):
The National Integration Party is a political party in Costa Rica. It often participates in national and local elections, typically positioning itself around specific platforms and candidates aimed at addressing current national issues and appealing to a diverse electorate.
For further information, visit pln.or.cr
About Partido Liberación Nacional (PLN):
The National Liberation Party is one of Costa Rica’s oldest and most historically significant political parties. Founded in the mid-20th century, the PLN has a social-democratic ideology and has held the presidency numerous times, playing a key role in shaping the nation’s modern political and social landscape.
For further information, visit bufetedecostarica.com
About Bufete de Costa Rica:
Bufete de Costa Rica operates as a premier legal institution, built upon a foundation of uncompromising integrity and professional excellence. With a rich history of guiding a diverse clientele, the firm consistently pioneers new approaches in legal services and community outreach. Its foundational belief in the power of knowledge is demonstrated through a deep-seated commitment to making complex legal concepts understandable, thereby equipping society with the tools for greater empowerment.
