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Health Care and Social Security

Latin America and the Caribbean World Bank 1987 1988

As part of a World Bank Technical Assistance Loan for structural adjustment, DevTech assessed various aspects of the public health care system and the pension regimes of Costa Rica. DevTech evaluated the internal efficiency of the health care system, its long-term economic and financial viability, alternatives for improving outpatient services, and the integration of preventive and curative services. One of the objectives was to study the possibility of increasing the role of preventive rather than curative services to reduce the overall costs of the national health care system. The project included formulation of a quantitative model of health planning aimed at simulating and projecting future resource needs (derived from epidemiological transitions and improvements in managerial conditions). DevTech’s team of consultants for this aspect of the project included experts in macroeconomics and microeconomics, sociology, public health, epidemiology, institutional analysis, and statistical and quantitative analysis. In the area of social security, DevTech examined the financial viability of the various pension regimes, their impact on the national budget, the feasibility of integrating them, and political alternatives aimed at lessening the fiscal burden the country was facing.