Reducing some upper government incomes and pensions will probably be necessary, but many government employees barely get by. Some benefits, such as the high number of holidays given to government employees, the aguinaldos, and the system of mandatory raises (the latter two for all employees), should probably be re-thought. Any reduction of salary or benefits should be accompanied by strong anti-corruption measures, as lower salaries will increase temptation. I strongly support polygraphing public employees in positions susceptible to corruption and independent fiscal audits on all departments and government contracts.

One money pit in desperate need of repair is the Caja. Everything they do is unnecessarily inefficient and burdensome to their patients. When one is referred to a specialist, he/she has to take the referral sheet on only certain specified times and days to one place, go back later to retrieve a slip of paper that tells when to pick up an appointment, go on a different specified date and time to pick up the appointment, then finally go back and see the specialist on the designated time and date if the specialist shows up that day. Of course, in a private practice, this is a one-step process. There is no reason why this could not be the case with the caja, with the patient making the appointment in person or on the phone, or receiving the appointment via e-mail. This would save the patients a tremendous hassle, cut down on traffic in the hospitals and demand on parking (which is seldom available), and save staff time due to multiple handling. The public hospitals have long waiting lists for procedures because they lack bed space, but they lack bed space because patients are admitted to wait (sometimes weeks) until their procedures are scheduled. If these hospitals operated like private ones and admitted patients only for emergencies or when procedures are scheduled, the backlog would soon be cleared and fewer people would die or have their conditions worsen while waiting for procedures. The Caja is probably the most broken institution here and would benefit immensely from these two simple changes in procedures. When the Caja started, these procedures probably made sense, but today, everyone has at least one telephone and an email account, so there is no reason not to use these technologies to schedule appointments and hospital admissions. What is best is that these changes would not require legislative action or increased funding and could be implemented immediately in an administrative directive.

Of course there are many other “penny-wise, pound-foolish” practices that hamper efficiency in not only governmental but other office operations. The one that comes most to mind is the absence of printers/copiers/ scanners in office settings, requiring employees to leave their desks and walk across a room to retrieve documents at least once per customer, or even to send customers to another building to have something copied. Since a printer/copier/scanner can be purchased for under $100 USD (even in CR!), this is an extremely inefficient use of employee time (unless it is part of some type of unwritten employee fitness program) and yet another inconvenience to the customer.