The main actors on Costa Rica’s health care market, at least concerning the provision of
personal health services, are the CCSS, the National Insurance Institute (Instituto
Nacional de Seguros, INS) and a large variety of private health care providers. Since the
reforms of the 1990s, the Health Ministry is nearly fully dedicated to its role as health
system steward. Figure 4 represents the organization of the market structured around the
health financing functions. Subsequently, a short description of each of the main actors
and their mutual relationship is provided.