Running Head: ITALY’S HEALTHCARE SYSTEM: AN OVERVIEW WITH STRENGTHS AND WEAKNESSES
Italy’s Health Care System: An Overview with Strengths and Weaknesses
Kimberly Moriarty
University of Wisconsin-Milwaukee
Italy is a country which practices universal government financed health care. Every legal citizen is provided equal and free access to their health care needs. Although many differences lie between the conditions of hospital and services in the north versus the south (Maio, 2002) all are financially supported by the government. The Servizio Sanitario Nationale (SSN) is the primary governing body of health care delivery. This is the local health authority which is governed by each region of Italy (Maio, 2002). The Italian health care system is financed by taxes; each employee pays 1% while the employer pays the rest (Cowell, 1994). The self employed person is liable to contribute 5% of their earnings (Cowell, 1994). The rest of health care costs lies on the government. Many Italians do take out private health insurance in addition to their public insurance. This private insurance will cover private hospitalization costs, and allows them to be choosier with physicians (italytravelescape).
Italy was voted number two by the World Health Organization in 2000 in regards to health status, fairness in financial contribution and responsiveness to people’s expectation of the health system (Maio, 2002). Italians are limited in their choice of physician, and must use this primary practitioner for any referrals to a specialist that they may need. Italy has a high number of physicians, one for every 163 people (Cowell, 1994). Many physicians work in both public and private hospital. Publically, their salary and billing is capped (Cowell, 1994), while privately physicians can charge upward of $60 an hour. Physicians go through a long training program, similar of that in the United States. Most doctor offices operate on a first come first serve basis (italytravelescape), staying open during normal business hours.
As far as medications and pharmacies, Italy requires a prescription for any medication needed. Those under age 6 and over age 65 as well as the disabled are not charges any fee for medication. The rest of the population is subject to a co pay fee (Healthcare Economist, 2008). The emergency department is available for the citizens’ use, however, if the emergency room does not consider the condition emergent, the citizen will be asked to pay for services on the spot (italytravelescape). Italian citizens are entitled to sick pay but must show written documentation by a physician. The maximum period to be off work is 6 months, and the patient will receive a portion of their wages lost.
Numerous strengths can be seen within the Italian healthcare system. Primarily, all citizens are given equal access to healthcare. This allows every citizen to be cared for regardless of financial status and health status. Citizens may seek the treatment they need anytime they need it. In addition, the Italian system is paid for by the people. The government does help in covering costs, but the working citizens and their employer foot the majority of the health care bill. Medications are available to the young and old, leaving the working class with a reasonable co pay. The system also does not spend healthcare dollars in advertising, billing and other administrative areas, keeping healthcare costs lower. The system prevents misuse of their emergency department by charging on the spot if the condition isn’t considered an emergency. The system is regulated on the national, regional and local level. This multilevel regulation allows for minimal manipulation or abuse of the system. Overall, Italy provides to all its citizens equally in health care needs. By providing national healthcare, Italy ranks high among life expectancy and low amongst infant mortality (Maio, 2002).
However, many weaknesses lie in a universal healthcare system as well. Since doctors operate on a first come first serve basis, patients must arrive very early to their doctor’s office to have a chance to be seen. In addition, there are long waiting lists for common simple procedures and tests. A simple mammogram or endoscopy could take up to 75 days to be done (Healthcare Economist, 2008). This delays diagnosis and treatment of diseases. Similarly, the technology is lacking in Italy. The United States has more MRI and CT scanners (Healthcare Economist, 2008). This lack of diagnostic machines also impedes the ability of diagnosis and treatment. Physicians are also working in both the private and public sectors. They chose to work privately because they can make more money. This could lead to physicians only wanting to work privately. If this push came, they could eliminate public healthcare altogether. They are also able to use their public hospital funds to buy expensive hospital equipment to use in their private practices (Cowell, 1994). The biggest weakness in the system is the fact it is paid for by the working population and its employees. As this population ages and retires, the costs fall back on the next working class. However, with the decrease in live births over the last few years (Maio, 2002), this new generation of working class is too small to support the retiring. The healthcare system in Italy will fall into debt, undoubtedly causing increased costs being pushed onto the citizens. In addition, some Italians take out private health care insurance so they can stay in private hospitals (italytravelescape). This directs attention to the idea that public hospitals aren’t the best places to stay. Poor food, unsanitary conditions and faulty equipment have been the major complaints or people staying in these public hospitals (Cowell, 1994). In summary, Italy’s healthcare system shows many strengths and weaknesses. Above all else it allows every citizen access to affordable healthcare. The United States, looking at country like Italy, could push for some healthcare reform to help decrease costs, and make healthcare accessible to all citizens.
References
Cowell, A. (1994, November 8). Italy’s Public Health-Care System Is Doing Poorly. New York Times. Retrieved September 9, 2008, from http://query.nytimes.com/gst/fullpage.html?res=9C00E6DE103EF93BA35752C1A962958260
Healthcare Economist (2008, April 15). Health Care around the World: Italy. Retrieved September 9, 2008 from http://healthcare-economist.com/2008/04/15/health-care-around-the-world-italy/
Health service/Health insurance in Italy. Retrieved September 9, 2008
www.ess-europe.de/en/italy.htm
www.italytravelescape.com/Health%20system.htm Retrieved September 9, 2008
Maio, V. & Manzoli, L.(2002). The Italian Healthcare System: W.H.O. ranking versus public perception. 306 P&T, 27(6), 301-308.