The ''key purchaser'' in Costa Rica is the Costa Rican Social Security FUnd (CCSS). Both 28.b and 28.c don‰Ûªt apply to Costa Rica because the provision of public health care services is done through public hospitals that belong to the Costa Rican Social Security Fund. This institution can buy services from private institutions on given occasions, but have to be paid with the CCSS budget. Patients may also go to private hospitals, which work with their own budget; in these cases, the patient has to pay for the services in a private manner.