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Introduction
Some problems of the health sector in the 1980s
Balance of the 1980s and perspectives for the 1990s in the health sector
References
Dr.
Carlos Muñoz Retana and José Manuel Valverde
A systematic intervention of the government of Costa Rica in the health sector began in 1940 through the formation of the Social Security Institute (CCSS) and the strengthening of the Ministry of Health. Beginning in the 1950s, the government increased its participation in the social sector as part of a new development strategy. The health sector was not an exception, and in fact, at this time, government intervention became more intense, culminating in the 1970s, when Costa Rica was considered a model country in the area of health.
At the beginning of the 1980s, the country entered a period of economic crisis that had enormous consequences for the quality of life of the population. Some of the consequences in the health sector were deterioration in some services, economic difficulties in meeting the new demand for services, and government pressure to adopt measures that reduced expenditures.
The problems that were generated by this situation supported the view that the health sector needed to be restructured. This process coincided (at the beginning of the 1980s) with the emergence of neoliberal ideas and the implementation of structural adjustment and stabilization policies that had a strong influence on the evolution of the health sector.
With the
purpose of understanding the events of the 1980s that took place
in the health sector as a result of the crisis and the structural
adjustment, our main objective in this chapter is to analyze the
main problems in the health sector, experiences in institutional
reorganization, and new models in health care. The last section
summarizes the evolution of the health sector in the 1980s and
discusses some issues related to the possible situation in the
1990s.