Mission Statement

So there is no misunderstanding, this blog isn't just another ex-pat site full of information and miscellaneous advice (unless you consider learning through my mistakes and observations a type of advice). My vision for this blog is to let people in on the truth of what it means to live in this crazy and lovable country. If you want to continue glorifying and romanticizing Italy, then some of what I have to say may be hard for you to hear. Consider yourself warned.

Saturday, May 21, 2011

Dr. Who's Paying For This?



     On May 3rd, at roughly 11:30pm, my husband and I were involved in a rather serious car accident with a Lamborghini. My husband's 1981 Alfa Romeo 33, which he had been meticulously restoring for the past few years, did not survive the crash. We, on the other hand, somehow emerged with only five stitches in the back of the head (him) and pretty bad whip lash (me). We were very lucky, but that is all I will say about the accident itself.

      About fifteen minutes after the accident, which admittedly felt like an eternity at the time, an ambulance showed up and took us to the nearest emergency room where my husband got stitched, CAT scanned, and sonogrammed for internal injuries while I had the scrape on my forehead disinfected and my neurological responses tested. The next day we went to our own doctor for an antibiotic prescription to prevent an infection of my husband's head wound and he was given two weeks of paid sick leave from work. In the meantime my neck had started hurting and so back to the emergency room we went, where I was x-rayed and subsequently informed that my cervical curve was temporarily straightened and that I should wear a neck brace for at least a week. Ten days later my husband went back to our doctor to have his stitches removed. At no time during any of this ordeal did anyone ask about insurance coverage or payment of any kind. Only the antibiotic cost €2.50, and only because we chose the name brand. The generic brand would have been free.

      Now, I don't honestly know how this all would have gone in the US, but I'm willing to bet not like this. At best there would have been the hassle of co-pays and deductibles and at worst there would have been the knowledge of paying the very arm and leg that we hadn't lost in the accident. In fact, I believe that the reality of medical care in a country with socialized medicine is so far from the reality of medical care in the US, that most American citizens truly can't comprehend what it means. I know that I initially couldn't.

      The first time I went to the doctor in Italy was a surreal experience. I probably didn't even really need to go, but I admit that I was curious. I called ahead, thinking I needed to make an appointment, but was told to just show up. After visiting with the doctor, it felt too strange to simply walk right out of the office so I went to the reception desk to see if there was something I needed to do, sign, pay... The receptionist just smiled and shook her head. But I still couldn't bring myself to leave.

      “You're really really sure? That's it?”

      “Yes.”

      “So I can just go?”

      “Yes.”

      Her eyes indicated that she was possibly entertained by my troubled expression. Finally, with an embarrassed and apologetic laugh I explained, “I'm sorry. This is new to me. I'm American.” The receptionist responded with another smile and an understanding nod. And I left.

      It's been a little over four years since that initial visit and though I'm able to preach about the beauty of socialized medicine, I find that it rarely occurs to me to take full advantage of it. Living in the US, uninsured for years, I would never think of going to the doctor for something as minor as a sore throat and a cough. This “habit”, for lack of a better term, turns out to be exceedingly difficult to rid myself of and leaves my husband at a loss for words. In the midst of a recent episode of bronchitis, I had to be nearly dragged to see the doctor. In the end I grudgingly went and was prescribed antibiotics...again free.

      As much as Americans don't truly know how different it all could be, the same goes for Italians, who generally (and I think obviously) take for granted the only system that they have ever known. My husband is one of these, and even after countess discussions on the topic I think he still harbors a profound shock that a country as civilized and revered as the US could be so backwards and barbaric when it comes to the health of its citizens. As for me, I didn't realize just how far removed Italians truly are from us until I overheard a neighbor complaining that her chemo-therapy drugs (whose market value is thousands of euro) would be costing her €9.... Take a moment with that.... To further understand her situation, know that this woman is middle-aged, unemployed, far from financially stable, and nonetheless going through chemo-therapy for breast cancer at no cost to herself other than this €9 prescription. People in similar situations in the US have been known to go bankrupt, die, or both when confronted with such an illness. Of course illnesses and circumstances such as these are an extreme and are therefore something that relatively few of us actually have to deal with. For that reason it's easy to fall into complacency, coming to regard the doctor as a luxury to be taken advantage of rarely and learning to ignore and/or live with our various aches and pains.

      So when a friend of mine from NY came to visit a couple of months ago I immediately jumped at the chance to have her experience the other side. She suffers from migraines and we had gotten to talking about how her insurance stopped covering one of her prescriptions, having arbitrarily decided that a cheaper (and ultimately ineffective) medication should suit her just fine. I took her to my doctor, he wrote her a prescription for the proper drug, we went to the pharmacy, and IT WAS FREE.* Needless to say, she too returned home preaching about the wonders of socialized medicine.

      I'm not saying that there are no flaws. Sometimes hospitals look a bit run down and sometimes you're tenth in line at the doctor's office. Those who can afford it may choose to go to a costly private clinic instead of roughing it with the rest of us. But that is an individual choice. No one will ever die because they couldn't afford a treatment, or worse, because their insurance company wouldn't pay for it. Maybe the most fundamental and life-changing thing that Americans can't imagine in all of this is the peace of mind; that in the midst of life's unexpected catastrophes one will be taken care of, no questions asked and no co-pays paid.

*Only medications that are considered “life-savers” or “quality-of-life-savers” are free. Others will cost several euro.