Costa Rica tiene un sistema nacional de salud, cuyas prestaciones corresponden universalmente a una institución pública: la Caja Costarricense de Seguro Social. La CCSS legalmente cubre al 100% de la población (en la realidad, al 90%). Costa Rica tiene un sistema centralizado de justicia constitucional que conoce cerca de 17.000 casos anuales (más del 95% corresponden a Amparos). Los amparos de salud vienen creciendo año con año. La gran mayoría de los recurrentes reclaman contra los tiempos o listas de espera para cirugía, procedimientos de diagnóstico y citas con especialistas en los Hospitales y Centros de Salud de la CCSS. Los reclamos por medicamentos (fuera la Lista Oficial de la CCSS –numerus apertus-), representan cerca del 5% del total de amparos de salud. Analizaremos el impacto de la judicialización de la salud (básicamente amparos de salud) en los servicios, en el acceso y en la equidad.

Proteccion Judicial del Derecho a la Salud en Costa Rica

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The objective of this podcast series is to scale up the knowledge exchange and coalescing activities on right to health in Latin America. It is intended for policy-makers, health economists, health planners, health policy analysts and researchers, and other involved in health system reform.

Health

Alternative Health

Self-Help

Sexuality

Fitness & Nutrition

Government & Organizations

Non-Profit

National

Regional

Local

The presentation will review existing approaches and available policy options to improve access to health care services and financial protection against health shocks for informal-sector workers (ISWs). Findings from some country cases based on published and unpublished reports and on structured interviews of expert informants will be discussed. The ISWs are typically left behind and have been referred to as “the missing middle.” They find themselves financially unprotected against health shocks and with limited access to quality and timely health care. ISWs are generally reluctant to enroll in insurance schemes, including social health insurance (SHI), community insurance, and other arrangements. Further, initiatives to enroll them in self-financed contributory schemes have generally resulted in adverse selection, as those with high anticipated health needs are more willing to pay and enroll than others, thus threatening the schemes’ financial viability. Successful initiatives to cover this population group are the ones where government has abandoned its expectations to derive relatively substantial revenue from it. Offering this group a benefits package that is relatively smaller than that of formal workers and charging them a premium that is only a fraction of that charged to formal workers is a strategy used by some countries to limit the need for public subsidies. Switching from SHI to a tax -financed system is an alternative strategy adopted by others. While there is evidence that greater insurance coverage has improved access to health services for ISWs and their dependents, in several countries it has not yet improved financial protection for this target group. A broad set of reforms will be required to strengthen the supply side to ensure that additional public financing translates into improved coverage for ISWs. Finally, large and sustained economic growth is indispensable to achieve UHC, as it creates the public resources to subsidize coverage for the poor and ISWs.

Universal Health Coverage and the Challenge of Informal Employment: Lessons from Developing Countries

La Base de Datos de Salud Global y Derechos Humanos ("Global Health and Human Rights Database" en inglés) es una base de datos de leyes de alrededor del mundo en materia de salud y derechos humanos. Con la colaboración de una red mundial de socios--incluyendo a ONGs, académicos e investigadores particulares--la base de datos ofrece un sitio web interactivo, investigable y completamente indexado de jurisprudencia, constituciones e instrumentos internacionales. El Instituto O'Neill para el Derecho de Salud Nacional y Global de la Universidad de Georgetown ("O'Neill Institute for National and Global Health Law at Georgetown University" en inglés) y Lawyers Collective te invitan a participar en un webinar que presentará la base de datos a los participantes y resaltará sus principales características.

La Base de Datos de Salud Global y Derechos Humanos

The Global Health and Human Rights Database is a free online database of law from around the world relating to health and human rights. With the collaboration of a worldwide network of partners—including NGOs, academics and private researchers—the database offers an interactive, searchable, and fully indexed website of case law, national constitutions and international instruments. The Lawyers Collective and the O’Neill Institute for National and Global Health Law at Georgetown University invite you to participate in a webinar that will introduce participants to the database and highlight its main features.

Global Health and Human Rights Database

Esta ação é uma iniciativa que visa reduzir a judicialização da saúde através de diálogo entre os diversos atores dos Sistemas de Justiça e de Saúde, com a instituição de comitês locais. A aplicação desta experiência resultou uma redução expressiva no ingresso de novas demandas judiciais de medicamentos ou internações.

Ação de planejamento e gestão sistêmicos com foco na saude

The healthcare sector faces major challenges resulting in inefficiencies and ineffective delivery of quality healthcare. . This is manifested in the dissatisfaction of many stakeholders, especially patients. Dissatisfaction among stakeholders in hospital performance signals the need for change. One step at reforming healthcare service delivery is to create autonomous, accountable and well-governed hospitals capable of taking evidenced-based decisions to deliver patient-centered and quality care, while also positively interacting with their complex stakeholder environment. Corporate governance frameworks propose structural reform principles leading to autonomy and accountability. The adoption of such principles within the hospital setting has the potential to increase the level of efficiency by which hospitals deliver health care, make decisions, and competitively enhance their overall performance. The Healthcare Governance and Transparency Association (HeGTA) supported by Center for International Private Enterprise (CIPE) developed a Guide: Principles and Guidelines of Governance in Hospitals, with the aim of introducing practitioners to a framework for addressing governance challenges in Egypt’s hospitals. Launched in Egypt in March 2014, the guide sets a milestone towards well-governed hospitals by bridging the gap between theory and practice whilst refraining from quick fixes. The Guide interlinks five different domains: corporate governance and clinical governance; board excellence; control, audit and risk frameworks; sustainability and inclusiveness; and transparency and disclosure, under one umbrella.

Dr. Mostafa Hunter, Lead Founder and Chairman of HeGTA and Lead Author of the Guide will share his insights on key principles for improving governance in hospitals to achieve effective and efficient delivery of healthcare services.

Proteccion Judicial del Derecho a la Salud en Costa Rica

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