The Caja Costarricense del Seguro Social (CCSS) undertakes a complete stage, marked by legislative and judicial investigations that have aimed at various of its senior officials. One of the central actors in this situation is Gilberth Alfaro, the institute's legal director, who recently made statements to the Legislative Assembly's Special Commission investigating alleged irregularities in the administration of the CCSS.
During her confrontation, Alfaro distanced herself from the fact that the suspended executive president, Marta Esquivel, assured her that her presence in the Junta Directiva sessions was not necessary. This decision, according to its functioning, marked a before and after in the dynamics of this collegiate body, and coincided with a series of treatments that were harshly criticized, such as the suspension of the institution's inversion card.
Alfaro reported that the exclusion of the sessions not only affected the rate of decisions regarding reversal, but also raised problems in the smooth functioning of the Board of Directors. According to his testimony, the use of a constant legal criterion led to the use of the figure of the “man's official” to guarantee a quorum in meetings. This mechanism, which had not previously been used by the Board, consists of summoning an official of the institute to temporarily assume the functions of director.
The legal director explained that, although it was not his initial criterion for implementing this figure, the Attorney General of the Republic has established that collegial bodies can convene under this modality in exceptional cases. Furthermore, he cited Article 11 of the Ley General de Administration Pública, which defines a “public administration official” as one who exercises a public charge without a valid investment, but whose implementation is permitted in emergency situations to ensure the continuity of public service.
One of the most challenging moments of the confrontation was when the Frente Amplio deputy, Rocío Alfaro, consulted on the decision to suspend the CCSS reversal card. According to the legal director, this measure took place just after his exclusion from the sessions of the Directive Council, which, for some legislators, raised doubts about transparency and the deliberation process after that decision.
On the other hand, Alfaro also spoke about the auditorium he went to at the head of the Equipos Básicos de Atención Integral en Salud (EBAIS), administered by four cooperatives and an association of doctors. This review was carried out as part of the investigation known as the «Barrenador case», managed by the Fiscalía General de la República. The official recognized that, before judging the management of EBAIS in cooperatives, a basic legal criterion was not issued, which focused on the legality and justification of these decisions.
Throughout the session, other lawmakers raised questions about several issues related to the administration of the CCSS. Paulina Ramírez, deputy of the Partido Liberación Nacional (PLN), expressed her concern about the state of the construction project of the new hospital in Cartago. Alfaro responded that the authorities needed to consider re-awarding the contract to another company, and they also established procedures to determine the responsibilities of the company initially awarded.
Luis Diego Vargas, of the Partido Liberal Progresista (PLP), asked for an exception to the outsourcing rule that regulates the subcontracting of health services. According to Vargas, having clear lines on this issue is essential to ensure good corporate governance practices and improve the transparency of contracts with third parties.
Prior to these concerns, Alfaro reported that it was unclear whether the CCSS had a structured management to address these issues, which are difficult to address with a solid criterion in the decision-making process. In this context, we have underlined the need to strengthen internal supervision and planning mechanisms to prevent similar situations from recurring in the future.
The comparison also highlighted the tensions within the CCSS and the differences in criteria between officials and legislators. While some parliamentarians believe that the measures taken by the institute look after the technical and legal foundations, others suggest that the lack of clarity in the procedures could be linked to deeper structural problems.
In the end, Alfaro walked away from the CCSS Board meeting, made a Saturday in July, addressed structural issues, including the administration of EBAIS and the relationship with medical cooperatives. According to the official, these debates are crucial to ensure the achievement of the institution's objectives, but require greater coordination and transparency to resolve the problems that have given way to their management.
The current situation of the CCSS reflects a complex panorama, in the sense that administrative decisions and legal issues have generated a climate of uncertainty both in the institutions and in public opinion. The ongoing investigations, both legislative and judicial, will be crucial to clarify the facts and define the responsibility of the involucrados. Meanwhile, the CCSS faces the challenge of regaining citizens' trust and ensuring the continuity of health services amid this institutional crisis.
