Costa Rica has a government health care system, for which I pay only about $20 per month, which covers everything, doctor's visits, labs, meds, etc. ; and a private health care system that is a whole lot cheaper than in the USA. The gov. system or "Caja" is excellent for life-threatening situations, but for non-life-threatening situations there are long waits. For a hip replacement, for example, you'd probably have to wait 5 years. Many people use both gov. and private health care, for faster service such as doctor's visit or an X-ray, if they can afford it. The gov. system is under threat of privatization, unfortunately. I tell Ticos to protect the "Caja".