If conservative radio host Rush Limbaugh is a man of his word, he may be visiting Costa Rica as a medical tourist in the future. In 2010, Mr. Limbaugh stated that if the Affordable Care Act legislation passed in the United States, he would come to Costa Rica. A major ruling by the U.S. Supreme Court on Thursday gave the green light to the legislation some people refer to as “Obamacare”, the most comprehensive health care reform in the U.S. in many decades.
When Mr. Limbaugh made the reference to Costa Rica a couple of years ago, some people thought he would actually pack his bags and move here as the ultimate expression of his opposition to President Obama’s health care initiative. He debunked this conjecture directly on the air:
“I was asked yesterday where will I go for health care if Obama’s health care passes, and I said if doctors here are not permitted to form private practice little clinics with individuals paying a fee, a retainer, and for services, then I’ll go to Costa Rica to get major medical health care.”
In the past, Mr. Limbaugh has mentioned New Zealand as a place he would consider retiring in, but not Costa Rica. It does not seem as if Mr. Limbaugh made reference to seeking treatment in the public health care system of La Caja, either. He more than likely meant that he would consider medical tourism, an activity that is on the rise.
While the Affordable Care Act will not completely transform the U.S. into a nation that guarantees government-provided socialized health care for the citizenry, it could be argued that it is a step in that direction. If that is the case, then the U.S. is moving opposite to a trend observed in both Costa Rica and the United Kingdom: the dismantling and privatization of public health systems.
Socialized Medicine Faces a Corporate Invasion
Supporters of the Affordable Care Act in the U.S. claimed that the lobbyists who opposed it were driven by pure greed. Health care is a lucrative industry, and not just in the U.S. The respective public health care systems of Costa Rica and the U.K. -La Caja and the National Health Service (NHS)- are their most treasured public institutions, but they are also the most expensive to sustain.
Both La Caja and the NHS have experienced serious financial difficulties in recent decades, even before the advent of the global economic crisis. In the case of the NHS, a recent article on the Guardian describes the financial health of three public hospitals that serve the populous South London region:
“The trust running three south London hospitals has crashed into bankruptcy, unleashing an avalanche of blame.
Queen Elizabeth hospital in Woolwich is one of three hospitals run by the South London Healthcare Trust, which has a £150m deficit.
Half of NHS managers expect care to deteriorate next year.”
As for the state of La Caja, readers of The Costa Rica Star are probably familiar with the various articles published on this matter. Here’s an excerpt of an article published back in March:
“careless spending and mismanagement [are] the reasons why La Caja is in the precarious positions it finds itself in today. [...]the alarm [went off] back in July of 2009, when La Caja noticed an $18 million shortfall in monthly contributions. Two years later, an ominous report from the Pan American Health Organization indicated that La Caja would not be able to sustain itself financially past the year 2015.”
Dire financial difficulties aren’t the only problems that La Caja in Costa Rica and the NHS in the U.K. have in common: They are both currently sustaining what an article on Media Lens describes as a corporate assault:
“Few political acts (the NHS bill) have exposed the sham of British ‘democracy’ like the decision to dismantle the National Health Service.
Private companies will be able to move in and take over NHS infrastructure such as hospitals. The new law also allows hospitals to earn up to 49% of their revenue from private patients; previously the limit was 2%. Doctors and nurses say this will create a two-tier system, with one queue for the rich and one for the poor, with the rich having priority regardless of the seriousness of their condition. So that’s goodbye to one of the founding principles of the NHS: to supply care based on need, not the ability to pay.”
Compare the paragraph above from Media Lens to this 2011 opinion piece on the state of La Caja in Costa Rica, published by Arturo Herrera in Puntarenas.com:
“Over the last few years, the private health care mafia has been seeking to dismantle La Caja piece by piece to get a greater share of the market.
We see how the private facilities are now hospitals of great capacity for our small country, and the proliferation of private practices -often run by the same doctors that work for La Caja- in the vicinity of the public hospitals. For this reason, what we face today is a plot to eliminate La Caja…”
Supporters of the Affordable Care Act in the U.S. today scored a significant victory, but they still have to face some of the same corporate interests that are laying siege to Costa Rica and the U.K. The formal commitment from a government to provide health care for its citizenry is magnanimous, but there’s only so much that can be done to keep the opportunistic forces of greed at bay.