My Personal Experience with Italian Healthcare:

Most people’s fun fact is that they have a sibling or they’ve traveled somewhere cool.

Mine? I got an emergency appendectomy in Rome, Italy in 2018.

Fast forward to March of 2020 and outside of China, Italy has been hit the hardest by the CoronaVirus pandemic. On March 20th, they reported nearly 800 deaths in one night from the virus. With Italy being an advanced Western European nation, Americans and many others can’t seem to understand why they’re getting hit this hard by COVID-19.

Many friends and family have reached out to me asking “why is Italy suffering so badly”. Although I do not have the answer to that question, I would like to give you my first hand experience of the Italian healthcare system, some facts, and some insight into the life of an Italian.

April 10th, 2018 “The calm before the storm”

After just getting back from a 10 day trip to France and Spain with my roommate, I was getting back into the groove of class and being in Rome. I felt fine the entire day, and had been studying for my exam on the 11th. For dinner my roommates and I decided to go to Pico’s for our usual Taco Tuesday. During dinner I remember barely being able to eat, feeling extremely bloated and overall just kind of crappy. One of my friends even commented on how I barely ate anything.

After I got home, I took a shower and laid down to study in my bed. I remember feeling a pretty sharp, constant pain on my lower right side but I just popped a few Tylenol and fell asleep for the night.

April 11th, 2018 “The Storm”

8:30 AM

I woke up that morning and felt like trash. I was in the kitchen making breakfast and I remember telling some of my roommates I didn’t feel great. I still had that pain in my side and I was feeling extremely nauseous.

Unfortunately I had an exam at 8:30 that I couldn’t miss. The walk to class was around 20 minutes and I felt like an absolute zombie walking there. I skipped breakfast, rushed through my test, and somehow found my way home. Honestly, I don’t even remember the walk back to my apartment.

10 AM

I got home and immediately called my friend who was also studying abroad. It was around 3 am at home, so I felt bad calling my parents. At this point, I already had an idea in my head that this was an issue with my appendix. The call with her confirmed that this could be a serious issue, so I called the doctor associated with my study abroad program. I told him my symptoms and he didn’t seem so concerned, so he told me he’d be there in a few hours.

1 PM

In Italy, they have a lot of on call doctors that come to your home. Dr. Andrea was one of those, so he showed up and did a 2 min exam in my living room. Immediately after pressing on my right side, he looked at me and very calmly said “it’s your appendix, you need to go to the hospital”.

2 PM

I arrived at the Salvator Mundi International Hospital in Rome via taxi. I got a blood test and then immediately got a pelvic ultrasound. During the ultrasound, the doctor only spoke broken english. At this point it was just my friend Dana and I alone at the hospital. He looked at me, and in broken english said “I will call the surgeon now” and then brought me back to the waiting room.

2:30 PM

I was escorted into the surgeon’s office and they told me that I would need to have my appendix removed before it bursts.

Now in Italy, it is a “healthcare for all” system, so they do not normally need to associate with insurance companies, all medical services are free. But…. there’s a catch. They’re only free in public hospitals. Salvator Mundi was NOT a public hospital, it was private.

That probably doesn’t mean much to you, but it really does matter. There’s a huge difference in cost and quality of healthcare. I was told by the doctors that I had two options:

  1. Go to a public hospital. There would be no cost, but I could wait for 24+ hours and risk my appendix bursting before it was my turn to get surgery.
  2. Stay at the private hospital, get surgery in less than an hour, and pay nearly $35,000 USD out of pocket for the whole thing.

Many normal people don’t have $35K laying around, especially in Italy where the average yearly salary is 30-50 euro. Therefore, for most people this would completely turn them away from getting surgery in a private hospital.

Luckily, my study abroad program had a plan where the costs would be reimbursed. I also just didn’t feel like sitting in a crowded hospital and risking my appendix bursting so I decided to choose option 2.

4 PM End of Day

I was put in a private room and I was already going into surgery. Barely anyone spoke english, so it was extremely hard to communicate. The nurses and doctors had little to no bedside manner, unlike the US. However, I was able to get in and out of surgery very quickly with no complications. The rest of the night I was not in any pain, and the nurses were extremely attentive and quick when I called them.

April 12th – April 17th

Throughout my recovery in the hospital, I had a private room and attentive nurses and doctors. I was never waiting for anything or anyone. That’s one of the up sides of being at a private hospital.

However, there were some downsides as well. Being a private hospital, they were constantly discussing payment options and plans. They wanted their money and they made it clear.

The day I was supposed to get my stitches out, the doctor that was doing it asked when the wire transfer of funds would go through. I responded saying it was sent but it would probably arrive tomorrow. After that, he conveniently said I now needed to wait a few more days to get my stitches out.

Another fun fact about private hospitals: the doctors get paid directly for any procedures they do, which is why he was so pushy about getting his money before I left the country.

I can say I definitely maxed out a credit card or two during this whole fiasco.

My Reflection + Personal Opinions

This unfortunate emergency surgery taught me a lot about the Italian healthcare system- more than I ever wanted to know. So I’ll break it down for you.

The everyday Italian earns around 30-50,000 euro a year and only 30% of Italians have some sort of secondary insurance. This means that most people (unless you’re rich) are going to go to the public hospitals in Italy. Why go to a hospital that you have to pay for when you can go to one that’s free? This is great, except for the fact that it causes these public hospitals to be understaffed, under-equipped, and overcrowded during “business as usual”.

Now imagine this in a growing pandemic. Everything is heightened. The understaffing, the lack of supplies, and the absolute overcrowding.

I have no knowledge of whether private hospitals are now converting to semi-public hospitals during this crisis. However, please understand that overall there is a lack of doctors, beds, and medical equipment throughout the country.

Between 2000 and 2017, the number of hospitals in Italy dropped by nearly 200, thats an average of 12 hospitals closing its doors per year, most of them public. The number of beds have also dropped by 70,000 over the past 17 years.

With these facts, I hope you are able to see why Italy is having a tough time during the crisis. Not only are people sick with this virus, but people also need to go to the hospital for other things. In the end, there is just simply not enough resources to go around.

Other factors

When thinking about this entire situation, please realize that Italians have some very different cultural traits than Americans:

  • The majority utilize public transportation daily.
  • They value being with others and they enjoy going out to restaurants bars, and cafes, which is incorporated into their daily routines.
  • They are very “touchy” for lack of better words. They love hugs, kisses, and handshakes and incorporate that into their everyday greetings.
  • Hand sanitizer and hand washing did not seem to be emphasized in the country when I was there.

Overall…..

Overall, please realize that I am simply trying to show you the realities of Italy’s healthcare system through my own personal experiences. Please form your own opinion about Italy and their handling of the pandemic, but keep these facts in mind when reading any future news!

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