About two weeks ago this letter arrived in the mail. If you read Italian, you can confirm what I am about to tell you, if not, take note.
Socialized medicine is a topic that is terrifying to many Americans and one of the things I always make a point of talking to my tour members about is how the medical system works here in Italy. I am not going to dissect the entire system today, that is too much to bite off in one post but I would like to share a few things.
Before I talk about the letter you should know that I am generally quite happy with our health care system and I have had a fair amount of experience with it, too much in my opinion. Personally I have had: two C-sections, one emergency, one scheduled, one hip replacement and emergency gall bladder surgery, with my husband’s family we have experience with cancer care and as a veteran tour guide a few of my tour members have had accidents along the way as well. I have visited quite a few ER’s in many parts of Italy, some are better than others, newer, more spacious, more staff, etc…none of them have ever been negligent. That is not to say the system is perfect but overall it works fairly well. Another thing you should know is that healthcare is managed on a regional level here even if it is a federal system. A region can be compared to a state and some states are managed better than others and even within the regions, some structures are run better than others.
So what is the letter about…
Where I live, in Piemonte, there is a program that focuses on women’s health…Prevenzione Serena…Serene Prevention. Every three years I get a letter with a scheduled PAP test and after 45 years of age the mammograms begin. Between the ages of 45-50 women have an annual mammogram and between 50-75 years of age it becomes biannual unless of course they find something. After the age of 75 you would simply go to your family doctor if you suspect something is wrong as you would if something suspicious were to come up between the exams. The frequency of the tests it based on what research has shown to be optimal in terms of tumor prevention and we simply get a letter delivered via snail mail. The letter tells me what test I am scheduled for, where and when I need to show up and a phone number to call if that time isn’t convenient. The day my appointment was scheduled I am on tour and will be away for a month. I called the number thinking I would have to reschedule a few months out. I have seen stories on the news about how some regions have wait lists of over a year out for mammograms…they are usually in southern Italy (remember regional management). Much to my surprise I was told they could get me in sooner, at the end of the week, great! It’s actually at the same place my oldest son is scheduled to have a panoramic X-ray of his teeth to take next time we visit the orthodontist.
So then what…
We arrive at the hospital 10 minutes before my son’s appointment at 11:30 and get checked into radiology. Both of our appointments are in the same department today so I check in for my appointment even if it’s not until 12:10. “Perhaps we can slip you in early, ” the receptionist tells me. They are generally on time. The only thing I need to bring is my national healthcare card, la tessera sanitaria. There will be no out of pocket expense for this exam. For other health services we pay a “ticket. If you are under 6 or over 65, if you are unemployed or earn less than 8300/year as an individual or 11,200 with a spouse you don’t pay a thing. There is a formula for dependents…you get the idea. We are not exempt from fees and pay € 27 for the X-rays…of course we pay for all of this with our taxes but that is a whole other can of worms…not today.
After checking in Filippo and I are given numbers that will be called when our turns come…11:32…I am called and tell Fili I will meet him in the waiting room when we are both done…as I enter my exam room I hear his number being called. Ten minutes later we are both done and free to go…che culo! (slang for “what luck!”)
If something is awry with my exam I will receive a phone call within a week or so and told how to proceed…I hope not! If everything is normal, no lumps, I will get a letter in the mail with the results. This can take up to 6 weeks. Regardless of what type of exam I get, be it blood work, X-rays, an MRI, vaccinations, etc… I get the results of the exam and I am responsible for keeping track of them. That way if I need to see a specialist in the future I can take all the necessary information to the visit.
Filippo’s X-rays will be put on a disc and I will pick them up at the hospital next week. His mouth is beautiful after years of orthodontia.
Fingers crossed for my mammogram…