Dear A.M. Costa Rica:
This is a response to a Letter to the Editor of A.M. Costa Rica about expats gaming the Caja health care system here in Costa Rica.
First I would like to point out that Costa Rica has made it a requirement for expats to join the Caja as a condition of obtaining residency. It is not like we have a choice. Many, many of us expats would have chosen to NOT join, if we had had the option. Additionally, like insurance companies everywhere, it is the Caja who sets the price of belonging, not the beneficiary.
After being forced to join, I and many, many of the expats I know do not use the Caja. Even though we pay every month for the privilege, we either have private insurance or, like myself, pay our own way if medical treatment is needed. We impose no costs on the Caja system. For many of us, belonging to the Caja is only a backup for use in the event of an emergency.
Exactly how you think we are taking advantage of the system and putting a burden on Ticos escapes me. Certainly there are some expats who use the system, but just like Ticos, but not every expat needs expensive medical care, regardless of age.
I find your base assumption that expats who make payments to, and use the Caja, are somehow taking advantage of the system a bit short-sighted and somewhat offensive.
To me, it is being a perpetual tourist that takes advantage of the system. The person lives here and enjoys all the benefits of the country. By leaving and returning every 90 days those persons contribute nothing, yet they have the opportunity to receive emergency medical care from the Caja system if they need it. Who pays for that?