On April 7, Dr. Roman Macaya, PhD, MBA, an instructor in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health, joined YSPH Dean Megan L. Ranney, MD, MPH, for an hour-long conversation about Macaya’s “zigzagging” career journey that ultimately led to him becoming executive president and chairman of the board of the Caja Costarricense de Seguro Social (CAJA), the institution that provides all public health care services in Costa Rica. The event was part of the Yale School of Public Health Leaders in Public Health speaker series.
After receiving his PhD in biochemistry from UCLA and an MBA in health care management from the Wharton School of Business at the University of Pennsylvania, Macaya returned to Costa Rica, where he’d spent much of his childhood. He went on to hold leadership roles in the fields of biomedical and clinical research, private equity, health care, and agribusiness.
In 2014, then-president Luis Guillermo Solis asked Macaya to serve as Costa Rica's ambassador to the United States. “I did not see that coming,” Macaya said. “I was not a diplomat, I was a scientist. When I got to Washington D.C., I thought, ‘Well, I'm a scientist, and I'm now in diplomacy. I think I'll promote science diplomacy.’ It ended up being a very productive avenue. We made a name for ourselves in science and in health diplomacy as well.”
Ultimately, the experience led to Macaya taking the helm of CAJA in 2018. CAJA owns and operates all public hospitals, clinics, physician networks, and procurement procedures, creating a unified institution behind the nation's commitment to universal health care coverage. Through CAJA, the country’s citizens and permanent residents have 100 percent coverage for all medical procedures, appointments, hospital visits, and prescription drugs.
Macaya explained that universal health care coverage has been enshrined in the country’s constitution since 1941. “It [essentially] says that if you have a right to life, you must have a right to health, and if you have a right to health, you must have a right to health care.”
Macaya also drew a connection between Costa Rica’s robust public health care system and the country’s steady economic growth. “One could argue that if you hadn't had CAJA in place, you may not have had the economic success that you did, because it is a healthy population that allows folks to feel that they can take risks in terms of what they do,” he said. “They have both the physical and the mental well-being to allow them to innovate.”
Dean Ranney singled out Dr. Macaya’s willingness to say ‘yes’ to things and his propensity to lean into his knowledge of science [during his appointment as a diplomat]. “I mean, what a gorgeous takeaway for our students and faculty and staff,” she said.
A complete recording of the Leaders in Public Health discussion with Dr. Macaya is available on the YSPH YouTube website.