Italian Health Care

I have been trying to decide which of the emotional issues regarding my hospitalization I wanted to write about first, or wanted the reader to view first. Of course there is a lot of interpersonal stuff, but I have decided for that to wait until after I deal with some bureaucratic issues, that are highly emotionally charged to me right now, as my country of birth, the country I first and still loved, prepares for an election.

This is how it seemed to work. I needed a specific kind of surgery. Instead of going into a general sort of hospital, where the surgery could have been done, I was sent to a hospital that included in its menu of services a specialized unit dealing with problems like mine. It is one of four such hospitals in Palermo, and one of ten in Sicily.

The thoracic surgery department is staffed by six doctors, a caposalla (head nurse - administrator) twelve nurses, and four auxiliary personnel. There were also some students from the University of Palermo, studying for thoracic specialization. Each of them had specialized training to be a part of the team, and a team they indeed were. They all felt that by working together they could take the technical aspects of medicine to the next step, and together they could work to be healers.

I was not there for any staff interviews, but I will tell you that in the interview process, somehow they were able to determine the ability to be a part of the team, along (of course) with technical expertise, and along with caring about patients. The staff as a whole reminded me of teaching at its very best, when I was with a team of teachers who shared a common vision, and for whom the consumers were most important.

Beyond that, the chief surgeon, Dr. Regeo, networked his team with the other teams in the hosptial. In one case, he wanted another doctor to look at something he was concerned about with me, and called consult. The other Dr. was there to consult within an hour. They did this not because they needed the businesss, and not because they would get payed more, but because they wanted what was best for the patient. When a room mate needed a special consult, and the best person for that consult was in Rome, they did not settle for second best, but made an appointment and got their patient a plane ticket to go see the man in Rome.

Because my case was unusual, Dr. Regio, who was the only one who had ever seen a case like it, did the surgery himself. The other surgeons watched, except the one who was making the video to be used in teaching at the University of Palermo. The whole team used it as a training experience.

Of course the hospital was clean and orderly. The needs of patients were met, always. One might take issue that the bathroom did not have soap or toilet paper, but that is the norm in Italy. Hospital bathrooms are not supposed to have toilet paper or soap, that is something the patient is supposed to bring. They also bring their own TVs to watch, and their own books to read. I knew this going in, so I brought in a lot of books, and more than enough toilet paper and soap, although I knew that I could ask a room mate to help out if I was caught short. I have heard complaints about Italian rest rooms not having toilet paper from Americans, I used to complain, and now I just realize that it is simply the norm here.

I will say that the ceiling could have been in better repair, but as I lay in bed looking at it, I decided that is was really paintings showing what was wrong with the patients. Neat graphic displays.

So, I think I got good care. I was in hospital for twelve days. The reason it was so long is that I live alone, and they would not send me home until I could take care of myself. True, I could hire someone to take care of me, but as long as I lived alone, hiring someone or not, they would not send me home unless I could take care of myself.

I was in reanimation, which is sort of like an intensive care unit, for two nights. I always had at least one nurse or doctor by my side when I was in reanimation, as did anyone else who was there.

The billing office, which operates out of an office smaller than the one I had in the Fulton School District, helped me get my health care card, so they would not have to bill my US insurance. Besides, they said, I would probably have to pay something if I used my US insurance. Because I am a resident of Italy, I was covered by the Italian Health Care System.

The total cost of my stay, including meals and medication, but not including toilet paper, ended up being zero out of pocket. No insurance claims, no billing office at the end, no disputes about what care I got and did not get. Nothing. No cost. It is simply a part of living in Italy.

But was it quality care. Would someone who knew the system use it? Well, the person in the bed next to mine was a noted cardiologist in Sicily, and it is the system he chooses to use. It probably has something to do with the fact that Italy is ranked number two in health care in the world by the World Health Organization of the UN.

Some of my friends in America, and some of my friends at the Sigonella Naval Air Station here, indeed a friend of mine in Germany, all wondered if I should have gone to the states to get the operation. I will admit that I myself had some misgivings. But no more. I am glad I stayed, and I am glad that now I no longer need to have second thoughts about staying here for the long term because of health care.

All the reasons the US gives for not providing universal, free health care for all of its residents is baloney. There is no reason it should not be done. I am embarrassed almost to tears as I think about how poorly my birth country treats its own citizens. It is a shame, a terrible, life costing, depressing shame.

Italy certainly has fewer resources per resident than the US. It is a matter of how the resources are spent. Well done, Italy. BRAVO.

BRAVO