Dear A.M. Costa Rica:
How much are expats paying for Caja? Less than $1,000 per year? What is the value of the treatments received? Often, considerably more. Who is paying for the difference? Costa Ricans.
As an American, I do not appreciate knowing that my tax dollars often go to people who misuse social services. No matter who they are or where they are from. Why would Costa Ricans feel any differently? Many expats move here when they are older and retired. All of us will require more medical care as we age. I do not feel it is responsible to have the expectation that we will utilize a system that we have contributed very little towards. I view Caja as an additional tax of which there are many. It can be avoided by being a perpetual tourist and making a border run every 90 days and staying out of the country for three days, or you can just pay it.
All expats should have private insurance. It’s expensive compared to the Caja, but now the risk is shifted to a company and away from the Ticos. The Caja system is already struggling, so we should not add to the problem. The fact that the quality of healthcare in Costa Rica is relatively high is important. How we access the system is also very important.
Ticos have a very unflattering slang expression, Pinche Gringo. It basically translates to “Cheap Gringo”. It is not specific to healthcare, but a general characterization. I hate it. The Big Mac index was invented by The Economist in 1986 as a lighthearted guide to compare purchasing-power in different countries. The cost of a Big Mac in Costa Rica is very close to that of the United States, which means the cost of living is very close.
I realize I may be offending many people who have a different view. I do not feel I have the right to tell anyone how they should live. All I ask is that people try to see it from the other side and fight against the negative stereotype that exists. I realize generosity can be expressed in many ways and not just financially. It is important to me to be considered a generous expat, and I still have a lot of room to improve.