Caja needs to reinvent itself

Dear A.M. Costa Rica:

Here is a plan to help the Caja. First implement a moderate office visit fee, not so much to raise revenues rather to discourage mothers and older folks from running to the clinics for every little thing, as its natural to many to abuse what is perceived as free.

Stop over medicating. As a matter of routine, often drugs are dispensed when unnecessary, especially blood pressure medicine. Many Ticos have a mini pharmacy of Caja drugs at home that they are willing to share with you and your ills. Most of these drugs go unused and expire. Doctors must not be quick to hand out drugs to justify their job.

Next is a change of image and purpose by offering preventative care and health education. Health education enabled me to normalize my blood pressure without drugs by eliminating most oils, large portions of meat and most dairy products and salt from my diet, then adding salads and physical activity.

Each clinic could be a health facility offering exercise classes: a community meeting place focused on preventative care, a place to socialize and get healthy where completion of health classes and participation in exercise classes result in lower individual health care fees. This could be as simple and entertaining as watching popular health programs such as “Doctor Oz,” and then discussing how to apply the information and bringing in local health enthusiasts, such as yoga teachers, etc.

The Caja should be recognized as a resource for emergency care and major medical problems, with more resources focused on serious illnesses and injury, rather than a resource used for colds, aches and pains.

In short, just as many producers are offering products with reduced quantity, so, too, the Caja needs to do so by instating an office visit fee to discourage minor care, and stop over medicating. Then reinvent itself as a preventative medicine and health education center locally, and a resource for major health care regionally. Let the consumer pick up the tab for comfort drugs and hand holding.

Out of control Caja fees are leading to exorbitant pay for administrators and doctors, as the pool of faceless money from high health care fees increase, so, too, do doctor and administrator pay. Without an adjustment to the reality of the times we will see more increases in fees and continued misdirected resources.

Phil Baker
Costa Rica
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