Costa Rica
Costa Rica has been a long sought out retirement destination for older adults due to the lush, tropical landscape, relatively cheap prices, and even more beautiful culture. Known globally for its wildlife tourism, environmental landscapes, vibrant forests, active volcanoes, beautiful beaches, and coffee, Costa Rica has a lot to offer. With records from the U.S. Department of State, it is estimated that currently around 20,000 expatriates live in Costa Rica. With a growing middle class, one of the highest living standards in Central America, low cost of living and high quality of life, it is no wonder why the country’s motto is “Pura Vida” and why so many Americans choose to make Costa Rica their permanent home when retiring to another country.
Being a globally known expat destination, especially for retirees, Costa Rica has a wide range and more or less equally distributed age groups with an average lifespan of up to 81.5 years for women and 76.1 years for men. According to the Costa Rica Demographics Profile, with a total of 4,930,258 people currently living in the country, 7.82% of the population is what we would consider to be older adults. With only an average of less than 3% of the Costa Rican population choosing to live abroad, most of the native Costa Rican population chooses to stay in country and live out their lives there.
Costa Rica spends an average 20% of its national GDP on services such as free education, healthcare, clean water and electricity with 9.3% being spent on healthcare alone since the 1970’s which has helped it make continuous strides towards raising the standard of living for its people. Costa Rica has one of the best universal health care systems in all of Latin America with its infant mortality and life expectancy rates allowing it to be arguably compared to higher income, developed European countries. While the country’s constitution does not have an expressed right to healthcare, legislators have made a number of amendments in order to ensure that its citizens have the access to healthcare as was shown with their Article 21 resolution which guaranteed the right to health under the human rights doctrine. Despite being a middle income country, Costa Rica has high standards when it comes to healthcare and medical practices often being as high of quality of those found in the US and Europe and has long been a tourist destination for medical care as procedures that often cost hundreds of thousands in other countries can be found at a fraction of a price in Costa Rica. The Costa Rican healthcare system is one of the few countries in Latin America to have a completely universal healthcare system and coverage. The state recognizes that not all people can or do contribute to the healthcare system due to various possibilities such as poverty, disability, etc. and has since created a “non-insured” category which still offers residence access to emergency and primary care. With the private healthcare system also alive and well in the country of Costa Rica, it is most often used by expats in the country as they often allow for the use of either cash or health insurance policies from the United States as well as Europe.
Despite the fact that Costa Rica has made tremendous strides in providing universal healthcare, the system is not without its flaws and challenges. One of Costa Rica’s biggest challenges in its healthcare is due to the fact that its system was designed for the working class. While its healthcare system has programs to treat those who are unable to work due to any number of reasons, many who may be eligible to receive those services are unable to access them due to lack of social security ID’s. Costa Rica also has a large flow of migrant workers as well as a growing immigrant population who are ineligible to receive social security until an immigration process is completed and while they still have access to preventative and emergency care, they are unable to create a patient file which makes it near impossible to track their progress and follow up on recovery. While this continues to be a source of problems in terms of healthcare, it also lends itself to becoming a social issue due to the continued demand for migrant workers which leads on to larger issues as a whole.
Despite the high standard of living, universal access to healthcare, clean water, education, and so on, many see the elderly population of Costa Rica as a forgotten generation. The complicated system of Costa Rican social security leaves many of the elderly confused and unable to access programs that could possibly help them. Even if the elderly are able to access programs made to help them, lack of public transportation to certain rural areas negates these benefits as they are often left untreated. Despite a traditional Latin American sense of respect for their elders, many of the elderly feel as though they are seen a nuisance as more and more elderly people are abandoned at hospitals and other elderly care facilities. With an elderly population of 7.82% and continuing to grow as the birth rate has now fallen below the death rate, many are hoping that new legislation imposed that helps those 65 and older living on the street and a simplification of the pension process will allow those who may be unable to help themselves to receive their earned benefits.
Due to their healthcare system, high standard of living, and quality of life, the life expectancy of the average Costa Rican citizen is about 79.59 years beating the United States by nearly two years in a 2015 study giving the country a world ranking number of 30. The top killers of the average Costa Rican is much like the United States with the top three reasons of death being coronary heart disease, stroke, and prostate cancer making it one of the healthiest countries in all of Latin America. Costa Rica also allows for elderly people who still wish to continue to work the opportunity to do so with a variety of different work options. A new form of legislation appeared in 2016 which proposed raising the retirement age in Costa Rica from the traditional 65 to 70 in order to keep the healthcare system and social security benefits intact and affordable. This piece of legislation stated that in order to continue to pay the pensions of retired adults, it would have to use reserve funds, which at the current rate, would be completely depleted by the year 2030. Due to this pension crisis, multiple reform options have been proposed such as raising the retirement age to 70, paying only 40% of the salary as opposed to the current 60%, having the state pay 24.6 percent of the retiree’s salary, or have to the labor management and state contributions rise from the current 9.16% to the proposed 24.6% (Villanueva, 2016). Such increases could put a strain on the economy as with the rising elderly population, the state department would end up having to pay more in pensions and social security than what is currently issued. Due to not having any national employment program, at times the elderly face discrimination due to age which feeds into the issue of the abandoned elderly in the country.
Due to Costa Rica’s universal healthcare system, the health benefits and services for the Costa Rican elderly allow them to get access to their pension programs as well as the state run healthcare system allowing them to have their file with them as well as demand physical care with no chance of denial. The universal healthcare allows the elderly to receive the necessary medication and pre-screenings for possible illnesses or health issues that may be present or could possibly occur. The system also allows for the elderly to receive the care they are in need of regardless of whether they have access to social security or pension through emergency care and free primary screenings. Despite its seeming accessibility, as stated before the pension program in Costa Rica is often seen as long and complicated for the elderly to have to go through and due to its complexity, many elderlies often go for long periods of time before they finally gain access to their pensions due to the the arduous process as well as current state financial issues.
While Costa Rica enjoys a high standard of living and life expectancy, in terms of assisted living and long term care, it ranks below what you would come to expect as the traditional Latin American culture of elderly care is still seen to belong to the family of those in need. Due to primary care culturally falling on the family, certain circumstances may lead to the elderly being abandoned and abused by the family which has raised questions and concerns in terms of future legislation in order to prevent this from happening any further. In spite of these current issues, Costa Rican health care has increased its expenditures and has one of the highest rated care systems in terms of elderly care in all of Latin America and continues to make improvements to care for its rising elderly population.
Costa Rica, along with its fellow Latin American countries has made and continues to make great strides in terms of health care and the well-being of its citizens and immigrants often surpassing or being equal to that of higher income countries. With countless beauty both natural and man-made, Costa Rica is certain to be one of the best places for the elderly or expat community to live in in terms of healthcare and general quality of life.