While America has been embroiled in the great health care debate, I have been settling in as a customer of Italy’s National Health Service. The Italian constitution lists health care as a basic right, so once I had applied for residency, I was eligible to join the service. It’s been an illuminating experience.
I was able to choose a primary care physician, and I based my choice on a friend’s recommendation. I can change physicians at any time. The doctor practices with her sister, also a doctor, and I can see either of them whenever I need to by dropping by during office hours. Yes, I often have to wait for a while, but since I always have a book to read, I don’t mind. I pay nothing for these visits.
The two doctors are the only staff. No receptionist means that patients keep track of who’s next to see the doctor. No nurse means the doctors give injections or take temperatures or bandage wounds. No technicians means the doctor writes an order for lab work. The patient goes to a lab (either one within the NHS or a private one). If the order requires a urine analysis, the patient buys a little sterile cup at the pharmacy and prepares the sample at home.
At my neighborhood lab, we all stand outside waiting for the doors to open early in the morning, most patients carrying a telltale green and white pharmacy bag with our personal liquid. Inside the lab, the receptionist records the doctor’s orders on the computer, accepts urine sample, takes the fee (I usually have to pay about $75 for a general work-up), gives me a number, and tells me when the results will be ready.
When my number comes up, the technician has printed out labels for the various tests I need. She draws blood, applies the appropriate labels to the vials, and bids me good day. When the results are ready, I pick them up and take them to the doctor who analyzes them and makes appropriate recommendations. I take the results home for safe-keeping and to bundle with the results next time.
I am quite healthy, so I’ve needed no serious care, just the usual winter sniffles and summer allergies. I get an annual flu shot (no charge) and get the usual mammogram, PAP smear exam, bone density tests for diagnostic purposes.
Friends who have been here longer than I have and who have more serious health problems or have had babies praise the system, too. It’s worth noting in Italy life expectancy is higher and infant mortality rate is lower than the U.S.