At the risk of baiting anybody.. I had put together some answers for MKLD and anyone else who is curious:
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The system in Italy is far from perfect. A good basic overview of the structure is here:
http://www.ess-europe.de/en/italy.htm
I was struck by MKLD's inclusion of plastic surgery and Lasik..!! How bizarre.. of course the government would not pay for that, nor would any private insurer that I know of... perhaps you know differently?
Just as someone can pay out of pocket and go to Mayo.. an Italian could travel less distance and still go to Switzerland or any other European country for private care if they didn't like the public or private options in Italy. My defense of the Italian system, even with all its faults, is that everyone -- upper- middle- and low-income people are covered for basic health care and emergencies. That is not available in the US except to the destitute. Since I have money, of course in the US I was able to "choose" a $9000/year HMO for two healthy 35 y.o. adults.. What if I didn't have that $9000/year? If I'm insured through my employer, the company "chooses" for me.. so what "choice" is that?
A definitive tax rate is just as difficult to establish here as in the US; it depends on your income, property tax, consumption, deductions, etc. There's a 20% VAT on everything you buy (some food items are less, at 10% and 4%). I think I have gone into this before.. Income tax rates can be found here:
http://www.worldwide-tax.com/italy/italy_tax.asp
This I got by typing "italy tax rates" into Google.
Taxes are of course higher than the US, but difficult to compare across the board, since there is a level of std. deduction and their deduction schemes beyond that are a bit different. I don't file in Italy since I only have US income; I file in the US. The average salaries here are roughly 1/2 or even less for equivalent jobs, so income tax still yields less $ per capita than would an equivalent, or even lower, US tax rate.
Again, I think I've gone into this elsewhere.. be aware that it would be false to assume that the increased taxes Italians bear go solely to cover health expenses. They obviously have other huge public subsidies that are higher than in the US.. let's say public transportation for one. They also choose to maintain a very big overall bureaucracy on the backs of the taxpayers. There are a lot of problems in Italy, but health care (problematic as it is) is one of the least among them.
Also, just curious....if someone had to have a cornea transplant, cataract surgery, spinal surgery, brain surgery, plastic surgery, or hip replacement in Italy, is there any kind of waiting time?
My MIL had cataract surgery with a wait time of a month or two, I think. Obviously not life-threatening, but she was hot to get her driver's license renewal at 81! Wait times depend on the region and on the hospital you choose. MIL also had two separate knee-replacement surgeries with wait-time maybe a couple months each once she put her name on the list. Again not life-threatening... Same thing with a friend who had a hip replacement in the South of Italy. I don't think the wait time was any longer than a month or two.. but he wanted to put it off as long as possible, so.. hard to tell. I'm more curious what the wait times would be in the US for knee replacement.. do they just do it at the drop of a hat?
My husband is waiting on lithotripsy and it is taking months.. but that's his choice to wait because he wants to go to a heavily-used center in Rome, when he could go to a private clinic in Perugia that is "convenzionata" (i.e., they have a deal with the government to take public patients as well as private). The Rome center is undergoing renovations that won't be done until the fall, and they have a new machine sitting under wraps waiting for the new space to be ready; he wants to wait for the new machine and the trusted technician that treated him several years ago. Years back, for the same procedure he waited a long time (like more than a year) at another hospital that never got back to him; he contacted a second hospital and got in in a couple months. Again, it's not perfect.. you have to put this in the context of a country where it is not out of the question to go to the Post Office and find they have no stamps, or to ask the clerk how much it costs to send a letter to the US and they say "how should I know?".
America can do better.
Fortunately among our family and close associates we haven't come across the need for any urgent procedures.
One interesting thing I noticed is that the Italian health service will pick up the tab for services abroad (like an organ transplant) if the doctor presents documentation that either the waiting list is too long, or that the patient needs a special procedure.
Totalip (prescribed for DH) is Atorvastatin, the same as Lipitor, and he got it "free". The others I don't know.. Looking up Advair.. it is of course available in Italy under the name "Seretide" (we're not a third-world country); whether this is free or with a co-payment depends on the doctor's dx, and your income level or something like that.. I don't have time right now to research the others.
Life-saving or essential medicines are labeled "Class A" and are always "free". Class "B" are things like hormone treatments, antacids and certain painkillers, (Advair would prob. fall into this group too) and for these some people pay some kind of "ticket" (co-payment). Class "C" for which everyone pays full price are things like cough drops, aspirin (unless with an Rx), dermatological creams.. This is just a brief idea and not an exhaustive list.
Now that Italy has "de-volved" many health care decisions onto the 20-22 regions (fans of federalism rejoice).. some regions have established co-payments on prescriptions.. You can be exempt from the co-payment, though, if you show you have a low income. Hence it's not the same for very region or every patient. However, the "ticket" ranges from €1 to €4 per prescription.. hardly prohibitive.
As far as private ins. rates go, I'm not sure.. there is some info here indicating it's €1300-2000/year for a family of four.
http://www.justlanded.com/english/italy/tools/just_landed_guide/health/private_health_insurance
In closing.. I don't see how it could hurt to try a single-payer universal care scenario, with the option to purchase extra insurance if one wanted. It doesn't have to mean the government runs everything.
Look at it this way:
In Italy, all the major highways are toll roads, whereas in the US the interstates are "free" (meaning everyone pays for them through taxes). But in Italy basic health care for everyone is "free" (paid for via taxes), while in the US there is a hodgepodge of incomprehensible health care "tolls", many out of reach of a sigificant number of people.
It's just a different political choice. In the US we want free roads but take a "I've got mine/screw everybody else" approach to health care. In Italy, it's the reverse. There's nothing that says roads or hospitals or insurance or pension schemes have to be "bad" just because they are public. We can do better if there is the will to change.
This is an interesting report:
http://www.rand.org/pubs/corporate_pubs/2005/RAND_CP484.1.pdf
Go to page 16 to see an informative chart.
The second paragraph below the chart:
The United States is spending more on health care per capita than any other country, but its use
of medical services—measured by, for example, hospital days and physician visits per capita—is
below the Organisation for Economic Co-operation and Development (OECD) median.
Pay more.. get less.. sounds good to me!