My Experience With Italian Healthcare Has Been Eye-opening

My experience with Italian healthcare is very different from the US. It is ranked among the best in the world and this article will guide you understand more.

Countries With The Best Healthcare

In 2000, the World Health Organization (WHO) had carried out the first ever analysis of the world’s health systems. Using five performance indicators to measure health systems in 191 member states, it found Italy was second, behind France, providing the best overall health care. The indicators are:

• Overall level of population health

• Health inequalities (or disparities) within the population

• Overall level of health system responsiveness (a combination of patient satisfaction and how well the system acts)

• Distribution of responsiveness within the population (how well people of varying economic status find that they are served by the health system)

• The distribution of the health system’s financial burden within the population (who pays the costs).

It compared each country’s system to what the experts estimate to be the upper limit of what can be done with the level of resources available in that country. So in other words, poorer countries aren’t penalized because they are poor. It also measured what each country’s system has accomplished in comparison with those of other countries.

Another, more current ranking by the Legatum Prosperity Index puts Italy 17th and the US 68th. This index is a framework that assesses countries on the promotion of their residents’ flourishing, reflecting both economic and social wellbeing. One of the 12 pillars of prosperity is health: the Health pillar measures the extent to which people are healthy and have access to the necessary services to maintain good health, including health outcomes, health systems, illness and risk factors, and mortality rates.

Those are very different measures, so you should be suspicious when anyone claims their country’s healthcare system is the best. This isn’t a black or white issue and because of its importance it deserves more thought when you evaluate what you want out of your healthcare system.

Misconceptions About Healthcare In Italy

Growing up in the United States, you hear a lot of horror stories about European or Universal Healthcare. At this point, I’ve been engaged with the system for about a year and I wanted to dispel some misconceptions that are spread when talking about healthcare in the US. For context, we are Italian citizens and this is only my experience, so I will try to point out if there might be a different process for non-citizens.

Healthcare In Italy Is Free

This is wrong on two fronts. Of course Healthcare is never free and this is something that is called out whenever there is a discussion about Universal Healthcare in US political circles. The system is supported by taxes, so when you pay any tax (VAT/IVA) when you come to Italy, those taxes are supporting the healthcare system.

Second, when and what you pay is dependent on a number of factors. Generally, your appointments with your Primary Care Physician (medico di base) is free. Tests, for example blood tests or scans, have a small fee equivalent to a copay in the US. Different tests I’ve had generally range from 35€ for a scan to 55€ for CBC blood test. If this seems like a lot to you, keep in mind there isn’t a monthly insurance premium to go along with it. These fees can be exempted for a number of reasons, like being on public assistance or having a pre-existing condition.

Similarly, medication isn’t free either, but the cost is analogous to a copay. Only a few euros, but enough that you don’t abuse the system.

You Can’t Choose Your Doctor

Over the years I have heard this as being a reason that Universal Healthcare is bad for the United States, but it simply isn’t true. In fact, my first responsibility once I had my health card (Tessera Sanitaria) was to choose my own doctor. This was more of a challenge than I was expecting since I didn’t know anyone and the information available was simply name, address and hours of service. I’m currently on my third doctor and it has been simple to select a new doctor as I’ve learned more about the people and the system.

You Have To Wait Forever For Healthcare Services

For your Primary Care Physician (medico di base), there is almost no wait and there is no cost for the appointment. In fact, when I’ve tried to make an appointment I’ve found availability within a couple days every time. I’ve also gotten nearly immediate appointments for blood tests and you get the results in a day or two.

For specialists and for tests there can be a wait for lower criticality appointments, but you can call the Healthcare Reservations number (ReCUP) and check for available appointments that are more convenient or sooner. The wait is really dependent on how critical the tests are. I can’t speak to how quickly you can schedule surgery because I haven’t gone through that, but I don’t believe it is anything unusual either.

The Quality Of Healthcare Service Is Lower

There are noticeable differences when I’ve gone to hospitals or outpatient clinics. I would argue, however, that these are mostly cosmetic. The buildings I’ve gone to are in the historic center in Rome, so it might not be fair to compare them to a new office space or private hospital in the US, but they are not as new and shiny as they are in the US. I would equate this to spending your resources on the things that matter most. I want clean needles and new equipment more than I care about a water stain or peeling paint on the walls.

US Healthcare System Equipment

The equipment, on the other hand, was basically the same as that which is used in the US. They use sanitary paper on the seats, the needles are all new and the equipment might not be by GE, but the German company Siemens instead. 

Also, one other part I found interesting was that the doctors themselves do the tests, instead of a tech who then turns it over to the doctor for review. The doctor performs the test, writes up the report and you leave your appointment with all the results in your hand without much of a delay.

People Will Overuse Limited Resources Of The Healthcare Systems

While it is possible that people will overuse the system, it doesn’t seem to be a problem in Italy. There are a couple of reasons that I think limit this possibility. Your family doctor (medico di base) seems to be a kind of a gatekeeper for services, so they would have to send you to too many tests and services and why would they? Also, even though the copays are fairly small, it does act as a deterrent to some degree. Lastly, is this even a thing? Certainly there are hypochondriacs in the US and I would assume in Italy as well, but who really wants to hang out in a hospital, a doctor’s office or getting a blood test. It’s possible that healthcare usage would increase when it is made available to all, but I don’t believe that it is necessarily a bad thing because people hold off going to the doctor when they can’t afford it and don’t we want them to have access to healthcare?

Learning From My Experience With The Italian Healthcare System

My experience with the Italian healthcare system has been a learning opportunity and one for which I’m glad I’ve had the chance to do. I try to approach this objectively, but that probably isn’t really possible so I try to be obvious with my biases when writing about it. When you read this, I hope you keep in mind that I am at a point in my life where my healthcare needs would be different from those of a younger, older, richer or poorer person, so my needs might be different from yours but I hope we can all agree that healthcare should be available to everyone and be of the highest quality possible.