Indeed, the Government of Costa Rica took the decision to deregulate the health insurance market in 2009 to allow private medical insurance companies (Balabanova et al., This was a consequence of signing the Free Trade Agreement with the United States, and it meant that the INS lost the monopoly within the insurance marked that it have had since 1924 (Muiser, 2012). Fearing this would open up for foreign corporations to dominate the insurance market and risking to loose equity in the system, this deregulation w'as allegedly put in place in order to enhance the financial sustainability of the health care system.