The Medical System... From A Gringa's Viewpoint

When I first came down to CR, I bought traveler´s medical insurance. I went to a private clinic for the couple times I was sick enough to go. I paid for my health care costs, and then the US insurance company reimbursed me for my expenses. It was somewhat costly to invest in this plan, but it had some nice benefits... like if I were in critical condition, the insurance company would reimburse me for a plane ticket back to the States. Or I had 15 days of medical coverage every US visit. Or a small life insurance package.

But now :). Through our school, we are finally part of what is called ''The Caja'', which in short is CR's medical system. Socialist in theory, all persons pay a percentage of their income to the Caja and in turn receive free medical care. ''Free.'' I mean, we are paying for it from our paychecks. I now have my Caja insurance card and my monthly paper saying I still work at the Insitute, and the medical doors are wide open.

Lol. Wide open means that you have to follow the system. The closest Caja clinic near me opens at 7am; however, the line starts forming around 6am. There is a sign on the clinic door that says "Line forms here," and all the people line up down the street, around the corner, as far as necessary. In order to get an appointment, you must stand in this line. You cannot call to schedule an appointment. You also must take your passport (for a US citizen), your insurance card, and your monthly insurance paper.

At about 7:05am (7am tico time), a doctor comes out and hands out numbers. The senior citizens and pregnant women get the first numbers, and then the rest of us get numbers. You are lucky if your number is less than 40. That means you probably will be able to see a doctor that day.

So then wait #2 begins as you wait for your number to be called. This could take anywhere from 5 minutes to 30 minutes, depending on the needs of the people before you. When your number is finally called, the receptionist asks what time you would like your appointment. I always say after 3pm because that is when I am out of school, but it is not always available because they close at 4pm. They print another paper saying what time your appointment.

So you come back for your appointment later in the day, bringing all 4 things with you again (passport, insurance card, insurance paper, appointment paper). If any are missing, they may turn you down for the appointment. (This is where I try not to be a nervous worrywart that I forgot something but it doesn't work very often... especially since everything is in my second language!) You do not "check-in" like you do in the States, instead, you simply walk down the hall and place your appointment paper in a box outside the door that says "Enfermeria." (But seriously, how are you supposed to know this?) You shouldn't be scared by the next door that says "Cirugia Menor" (Minor Surgery). LOL. Then you go back down the hall to the waiting area, and sit down until they call your name. My name sounds something like "kot-reen sees-ko" so I have to listen really close because they never quite get it right. So finally, you talk to someone about your current ailment, and they take your temperature, weigh you, measure how tall you are (The last time the girl couldn't reach above my head so I had to measure myself, lol), and take your blood pressure. OH, and (if you are a woman) you might be asked when the last time you had a pap smear was and if you would like to have one today. (awkward) THEN you are sent out into the hallway again to wait outside the doctor's door.

The doctor calls you in (again "kot-reen sees-ko" has to be ready to listen), and you again explain your current ailment. She (or he) checks your ears and throat, listens to your lungs and heart, ask you questions using words like "hinchada" "apretado" "fiebre" (swollen, tight, fever) so you better be having a good Spanish day. Then she sits at her computer and types away, prints yet ANOTHER paper(s) that tell you what drugs you will be prescribed.

Then you are back out in the hallway, walking toward the reception desk again. Wait in line at the prescription counter, and give them your paper(s) again. If you are lucky, they will send you back to the enfermeria room for your injection(s), usually in the tush. When I have asked why the tico system relies so much on shots to the tush, I have been told that it quickens the circulation of the drug throughout your body. Makes sense, I guess. If you are unlucky, they tell you to come back the next day to pick up your medicine.

Yup, you got it right, then the next day you come back with your passport, insurance card, and insurance paper to wait in that same line to be called "kot-reen sees-ko" again, and then to pick up your drugs.

All this for "free." Spanish medical terms practice. Medicine. Pap Smear. The confusion of which line to be in. Experiencing cultural cues first-hand.

"Kot-reen Sees-ko, venga para la Enfermeria." Oh, that's me they're calling! Gotta go!!!