The amendment was proposed by legislators of the Partido Acción Ciudadana (PAC) and approved unanimously.

The reduction in fines is in addition to amendments that removed the point system and the increase of the maximum amount of intoxication limits of drivers.

With the changes the new Ley de Tránsito does not have the same bite as when it was introduced for drinking and driving and reckless driving in December 2008 and the remainder of the law on March 1, 2010.

Legislators, the same ones who first approved the law in December 2008, have been busy at work in the last 10 days to modify the law, bowing to public pressure of fines and other sanctions being too harsh.

The motion passed on Tuesday does not affect fines and sanctions for drivers going in excess of 120 km/h or are found with more than a 0.75 blood alcohol content.

With the changes the fine, some of the reduced fines include:

- driving over 120kp/h, driving under the influence of alcohol, not buckling in children in a booster of child seat, will cost ¢255.551 from ¢381.420

- driving over 20 kp/h of the limit, talking on a cell phone while driving, not respecting traffic signals, not using a seat belt, crossing a red light or not havein the marchamo (circulation permit) will cost ¢190.710 from ¢2860.65

- not having the Riteve inspection, passing on the right, obstructing intersections, not having a license plate on the vehicle and modifying an engine will cost ¢52.907 instead of ¢190.710

- driving with an expired license, driving in reverse on a highway, not having the right license plates on a vehicles will cost ¢38.142, down from ¢114.426

- not carrying a drivers license while driving (different than driving without a license) will cost ¢26.699 and not ¢76.284

- violating the vehicular restrictions of San José will now cost ¢11.442 instead of ¢38.142

A complete list of all the reduced fines will be available in the coming days as legislators release the full text of the amendments.

Many cheered the changes. saying that the fines are now more reasonable, as the fines contained in the original text were over exaggerated, forcing economic hardship for many for minor infractions.

These changes, as well as the other changes approved in the last 9 nine days will all go into effect once they are published in La Gaceta.

The situation forces customers to connect to the 3G service and the cost of adquiring a 3G cellular phone.

Ofelia Taitelbaum, the ombudswoman, assures that he roffice will be investigating into the practice by ICE and without notifying customers aforehand.

ICE announced that it will be elminating the TDMA service in the coming year and assigning that frequency to the 3G network. Customers will have the choice to switch over to 3G or GSM without changing their number.

The Defensoría says that forcing customers who have lost of phone or have their service suspended is illegal.

Currently some 264.000 ICE customers continue to use the TDMA service, a little over half of TDMA subscribers prior to the introduction o of the 3G.

And although the Dirección General de Tránsito doesn’t have a definitive number, the majority shouldn’t be there, say MOPT officials.

The situation is so bad that in some cases the vehicles are parked on the along the driveways leading into the yards, like the case in Pavas.

The question is, what has happened to their owners?

In the majority of the cases it is a simple case of the common practice of Costa Ricans and foreigners in Costa Rica not to complete the transfer of ownership to avoid paying the tax.

When a vehicle is purchased/sold, a lawyer or notary is used to prepare the appropriate documentation for the transfer of ownership, have the transfer tax and legal fees paid and proceed to submitting the paperwork for registration.

The purchaser has the responsibility to transfer the title of the vehicle and pay the taxes. For the seller, the notarized purchase/sale agreement is all that is required

However, a customary practice is do nothing. The buyer uses the vehicle as his or her own, pays the circulation permit and submits the vehicle to the annual inspection.

However, nothing has changed from a legal point of view. And thus where the problem begins when there is an accident and the vehicle towed to the MOPT yards or the vehicle is confiscated by the traffic police for whatever reason.

Only the registered owner - the owner of record in the Registro Nacional - can retrieve a confiscated vehicle and the required paperwork for the process. In many of the cases, the registered owner is not available or cannot be found and as such the vehicle sits waiting.

In other cases the fines owed on the vehicle are greater than the value of the vehicle.

The concern of transportation officials is that with the new Ley de Tránsito, the number of confiscated vehicles will increase, while MOPT officials work on a regulation to be able to dispose of the vehicle.

Currently, there is no clear law that allows the MOPT to dispose of the vehicles - sell them off, donate or junk them. The current regulations only allow MOPT officials to store the vehicles up to and until the time the legal owner shows up with a court order to retrieve it.

This has led many players around the world to be wary of sites licensed and hosted out of the country. Like in all situations, there is no reason to generalize on this level; instead, sites need to be evaluated on an individual basis. More importantly, Costa Rican gambling laws are beginning to tighten, and talks of stricter regulation have been in the works for a while. It will still take the country a while to overcome their reputation for hosting problematic gambling sites.

A case in point is a recent debacle in the US state of Kansas. Over the last few months, several arrests have been made in connection with an underground sports betting operation. So far, six men have pleaded guilty to the US District court. The accused, many of whom have known mob connections, ran an intermediary service taking bets from US players and processing them through an online sports-book in Costa Rica. While most of the guilt falls onto the men who tried to profit from unlicensed bookmaking in the US, the lack of oversight in Costa Rica is also to blame.

The internet gambling websites licensed and hosted out of Costa Rica are not allowed to take bets from local players. Instead, Costa Ricans must gamble at foreign-hosted sites. The local government does little to prevent players from gambling at offshore internet casinos, poker rooms, and other sites.

I was born in Costa Rica at Hospital Clinica Biblica of US parents. I had quite an adventurous childhood growing up between Costa Rica, the United States and Brazil, never quite knowing where home was. After finishing High School in Costa Rica, I moved to Michigan where I not only managed to survive the harsh winters but received my degree from Calvin College. After graduation I was not quite sure where to call home and finally concluded I would be best served avoiding another Michigan winter and returning to Costa Rica where my parents and siblings had settled down.

I spent my first three or four years there running and developing a scuba business with a business partner before finally settling down at Hospital Clinica Biblica. After a few years of business development, I was able to develop my own company within the hospital running all the International Insurance Billing and developing the Medical Tourism Project for the hospital as the Director of the International Department.

Please explain your role at Hospital Clinica Biblica in Costa Rica.

My company runs the International Department for the hospital and our duties include assisting foreign patients, billing all the international insurance claims for the hospital and doctors and coordinating and developing the hospital’s Medical Tourism project.

What kind of growth have you seen in Medical Tourism in the last few years?

We were quite concerned initially that the financial crisis would have a negative impact on the number of patients visiting our hospital and even though there was an initial decrease things quickly returned to normal and are now on the upswing. Overall there seems to be quite a bit of momentum building in regards to medical tourism as we have seen increased interest from insurance companies and employers to research and implement Medical Tourism. I think the financial crisis and health care debate raging in the US have brought heightened awareness to medical tourism and are acting as a catalyst that could catapult the entire industry forward.

What do you see as one of the biggest growth potentials for medical tourism in the future?

Due to the high costs for healthcare in the US I see the biggest potential growth coming from US insurance companies and employers as they look to lower costs by taking advantage of the huge savings and high quality available at top hospitals overseas. Gradually, the barriers to traveling overseas have been coming apart at the seams and I believe it is only a matter of time before large insurance carriers and employers include an international component to their plans. Tell us why there is so much potential growth for medical tourism in Latin America.

The most obvious reason initially is our proximity to the United States and the overall comfort level visitors feel, along with the familiarity with the Latin American culture and its beauty. More important however, is the fact that we truly have some great hospitals and healthcare systems in our region that offer exceptional care at a fraction of what you would pay elsewhere. Add to this the fact that our culture is much more relational which means that doctors, nurses and recovery hotel staffs invest the time and energy necessary to build relationships and trust with patients.

HCB has a reputation of treating patients like Royalty. What does HCB do that is different and sets itself apart?

There is not one thing that sets us apart but a combination of a lot of little things that have a huge overall impact on the patient’s experience.

We definitely pride ourselves on making our patients feel special and the key to this has really been having a process in place so every detail is covered and the patient can arrive, relax and focus on their surgery and recovery. We have put together an exceptional International Patient Program that walks the patient through the entire process from their initial email all the way to the follow up that occurs once they return home. Key in all of this is responding to the prospective patient quickly and with the proper information that allows the patient to make an informed decision.

Our team includes a phenomenal group of physicians that speak English fluently and are committed to lavishing extra attention on our patients to ensure that they are truly comfortable with the entire experience. On top of this, our patient coordinators support the patient with rapid responses to their emails and phone calls and by ensuring they are available for questions through the entire process. They often become like extended family for the patient during their medical visit.

We also have an association of recovery retreats and inns in Costa Rica that provide amazing options and amenities for the patient to recuperate in after their surgery. It is also encouraging to international patients that most of our staff are from the United States or have at the very least resided there at some point in their life, so they not only speak the language but are familiar with the North American culture and the high expectations of American patients.

There seems to be a disconnect, where some hospitals are doing really well attracting foreign patients, while other hospitals or clinics are not having the same success. Where are these other hospitals going wrong?

Obviously there are many internal and external factors that influence whether or not your hospital is successful at attracting foreign patients.

As the head of an International Program, you can work to change the perception of your country as an attractive or safe destination; however, you cannot change your location on the map.

The greatest disconnect I see occurs when hospitals claim they are committed to attracting foreign patients but then do not follow through and put the necessary internal elements in place to build and sustain a successful program.

Often, we hear patients and facilitators comment that they chose our hospital simply because we were able to respond to them quickly and effectively in their native language providing the kind of relevant information they were seeking.

This entire process demands time and consistency and requires a considerable amount of commitment on behalf of the hospital. It is vital for any top hospital who wants to be a serious player in medical tourism to have a fully-functioning international patient program or department that understands the market they are trying to attract. In essence the International Department is the face of the hospital when it comes to promoting its medical tourism services. In concert with the International Department the hospital must have several other essential elements in place such as a dynamic team of physicians who are truly committed to the program, a website that can easily be translated into other languages for accessibility to international patients, along with information on your hospital, doctors, procedures and packages. The International Department must also be able to coordinate a variety of concierge type services such as transportation, recovery facilities and interesting, local tours for patients and companions.

In a nutshell you must deliver the total package to your prospective patients because they become your greatest marketing ally once they return home; word spreads quickly in this industry.

Altough Axl Rose made the statement last week on facebook that GUNS N’ ROSES would not appear in Costa Rica, Todoticket has begun selling tickets for the April 9 appearance.Edwin León, general manager of Tod0ticket, told La Nación that the band would in fact visit Costa Rica and that ticket sales have been selling well.

The Play store in Zapote has to limit the number of people to 10 at a time entering the store to buy tickets.

28 Producciones has confirmed that the band will be performing at the Ricardo Saprissa stadium, even though the information is not listed on www.gunsnroses.com the band’s official website.

The website lists the last performance by the band on April 1 in Quito.

The ticket prices range from ¢15.750 in the nose bleeds to ¢63.000 for floor in front of the stage.

Tickets can be purchased online at www.todoticket.com or at the Play stores in Escazú, Zapote and Heredia and Importadora Monge stores in Escazú, Multiplaza del Este, Avenida Cental and Desamparados.

Gerlarmo “Jerry” Cammisano, 56, of Kansas City was among those indicted by a federal grand jury as part of the scheme. He’s the brother of William “Willie” Cammisano Jr., who pleaded guilty to his involvement in the operation in February.

The others charged in a 23-count indictment returned under seal by a federal grand jury on Tuesday included James J. Moretina, 60, and Michael J. Lombardo, 54, both of Kansas City, and James L. Dicapo, 57, of Parkville, Mo. They join two businesses: Phoenix International Teleport Satellite Services Inc. of Chandler, Ariz., and Elite Sports of San Jose, Costa Rica. The indictment was unsealed on Wednesday, after the four men were arrested.

Gerlarmo “Jerry” Cammisano allegedly was the master agent, under which the three others and other bookmaking agents allegedly operated from March 1, 2006, to April 1, 2009. Bettors, mostly from Kansas City, allegedly wagered about $3.58 million during that period, with bookmakers getting a cut of the winnings at the end of each sports season, the indictment said.

The betting ring operated through a toll-free number, two Web sites and Internet servers based in Costa Rica. Cash was paid out or collected in person, typically on a weekly basis, the indictment said.

Elite Sports processed and tracked bettors’ activities on a server in Costa Rica, charging a price-per-head fee for managing the accounts, the indictment said. Phoenix International provided the toll-free numbers, the indictment said.

The indictment charged each defendant with one count of aiding and abetting one another to operate an illegal gambling business. Cammisano is charged with six counts of using the Internet to transmit information to help place bets about sporting events.

Moretina is charged with six counts of using a telephone to help with such bets; the other two are charged with five counts each.

The indictment includes a forfeiture provision, which means the defendants would have to give the government any proceeds they gained from the alleged illegal acts, including the more than $3.58 million in gross wagers.

Cammisano would have to give the government $196,677, two laptops seized from his home on March 31, three pieces of real estate and two businesses — Sun Auto Sales Inc. and Cam & Vig LLC. Dicapo would have to forfeit his residential property, Moretina would give up his interest in Be Amused Vending & Amusement Co. and Lombardo would give the government his interest in Advanced Mudjacking LLC.

Phoenix International would give up all equipment used to transmit calls or Internet traffic to Costa Rica, including computers, servers, satellite dishes and other equipment.

That is the prediction from Manpower Costa Rica, which conducted a survey on the topic with employers. Some 28 percent of the employers contacted expect a strong increase in the labor force while 5 percent expect a decline, the company said.

The Mint Costa Rica plant was inaugurated on Tuesday by government authorities, Banco Central and Catholic church officials.

Located in Ipis de Goicoechea, the plant is expected to produce up to 100 million coins a year.

The company, Amera International AG, says it will be investing another us$6 million dollars in the near future.

Amera also provides services of storing and the destruction of coins, in effect completing a life cycle of each coin.

The plant in Costa Rica will allow the Banco Central to have an “immediate” availability of coins and at lower cost.

Human papillomaviruses consist of more than 100 different viruses. Some types of HPV cause warts on the hands or feet; others cause genital warts; and some have been linked with cancer, most notably cervical cancer. The types of HPV most commonly linked with cervical cancer are HPV16 and HPV18, but several other high-risk types contribute to cancer as well.

The types of HPV that cause cervical cancer or genital warts are transmitted sexually. HPV infection is extremely common and generally occurs soon after an individual becomes sexually active. Although most infections resolve on their own, some persist and can lead to precancerous or cancerous changes to the cervix, vulva, vagina, penis, and anus. HPV infection has also been linked to certain cancers of the head and neck.

Recognition of the link between HPV and cervical cancer led to the development of vaccines designed to prevent infection with certain high-risk types of HPV.

Currently, there are two vaccines approved for the prevention of HPV 16 and 18: Gardasil® and Cervarix®. Gardasil also protects against HPV 6 and 11, which are associated with most types of genital warts. The vaccines are recommended for girls as young as age 9 and up to age 26. It is generally agreed that vaccination of older women would be of little benefit. A previous study conducted by the Researchers from the Harvard School of Public Health reported that HPV vaccination for prevention of cervical cancer is not cost-effective in women between the ages of 35 and 45 years.

A study of more than 9,000 Costa Rican women ages 19 to 97 evaluated the patterns of HPV infection as women age. These researchers found that the rate of newly detected infections declined with age—from 35% in women ages 18-25 to 13.5% in women over the age of 42. In both younger and older women, new infections typically cleared up without treatment within two years. They found that new infections typically did not progress to worse disease in older women.

Based on their findings, the researchers concluded that HPV vaccination was not likely to be beneficial for older women. The vaccinations are used to prevent new infections, and older women are not getting many new infections.

Reference:

1 Rodriguez AC, Schiffman M, Herrero R, et al. Longitudinal study of human papillomavirus persistence and cervical intraepithelial neoplasia grade 2/3: Critical role of duration of infection. Journal of the National Cancer Institute. 2010; 102: 1-10.