07 February 2010

LIFE: The Italian Health Care System

There was a postcard from my local hospital in the mail yesterday with the scheduled date for my next mammogram. They ask only that I call and cancel the appointment if I can’t make it so they can put someone else in that time slot. Regular mammogram screening is part of the Italian government’s preventive care system.

When I became a legal resident, I was issued a National Health Card but never thought much about it. In my mind nationalized health was the nightmare my daughter experienced when she lived in London. Long waits, bad doctors, third world care. So I just continued to make private appointments just as I had always had in the States. But then my rheumatologist asked me why I didn’t use the National Health System (Mutua) instead of paying to see her privately.

“It’s the same,” she said. “When they ask you if you want a private or a Mutua appointment, just tell them Mutua. It will save you money.”

And it has. Because I have a chronic disease, (rheumatoid arthritis), anything and everything related to that disease is covered by the insurance program and costs me nothing. Even if I didn't have arthritis, all medical visits would be free because we don't pay for medical appointments.

I have had CAT scans and MRI’s and all sorts of specialized exams over the years and have paid for none of them. I've spent a week in the hospital, have had physical therapy, eye exams, visits to the dermatologist and the list goes on, all covered with no out-of-pocket costs for me. My only expense is for one non-arthritis related medication. That prescriptions now costs me €2 ($2.50) a month instead of $28 which is what I was paying for it back home.

And if you think the drugs are cheaper because they are churned out in some dank subterranean grotto, they are from the same high profile, multi-national drug companies I learned to love and depend on when I lived in the U.S.A.

One of the things I like the best about the Italian health system is that you keep your own records and X-rays, and pick the doctors and the care facility, be it public or private, you want to go to.

I recently had to make a couple of appointments at my local hospital. What I found was that for one exam I could get an appointment faster through the National system and for the other, it was faster to go private. So that is what I did. I used the National system for one and paid for the other. It’s that flexibility, and the fact that the choices are always mine, that, in my opinion, makes this system so good.

Another thing I like is that the doctors take their time. They talk to you. They want to know how you are. There is no hurry because appointments are scheduled a half an hour apart. And do I dare tell you that if you can’t get to the doctor the doctor will come to you? It’s true. Italian doctors make house calls. Have an emergency? Your doctor out of town? The Guardia Medica is on-call 24 hours a day, and they will come to you as well.

In the world wide ranking of health care systems, Italy is rated No. 2, after France, but personally I think the Italian system is better. Basically they are the same. The difference is with the French system you have to pay for your services first and then the government reimburses you, while in Italy we don’t pay. Both systems are similar in that anyone who lives in France or Italy legally is covered.

So who pays? The people who use the system. Taxpayers. A percentage of income tax revenue is allocated to health care. And for all the grousing Italians like to do, I have yet to hear anyone complain about the health care system, or having to pay for it because everyone uses it, and everyone benefits by it. Especially me.

Photos courtesy of the Rivista di Informazione Sanitaria della Regione Lombardia, a monthly consumer Health magazine published by the Region of Lombardy.


  1. Your blogs are always wonderful! The one about health care is VERY interesting. As you know, the US is having a real political battle about nationalized health care. Yours sounds ideal. However, to get from where we are now to where Italy is, I'm afraid it's a mission impossible. Our politicians will undoubtedly create a nightmare. Wish us luck!

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