Italian Health Care System
Italy’s spending on health is only around 6 per cent of GDP, and expenditure per head is among the lowest in the EU. The quality of health care and of health care facilities varies from poor to excellent according to the region you live in and whether you use private facilities. Italian doctors and other medical staff are dedicated and well trained, the best Italian doctors being among the finest in the world (many pioneering operations are performed in Italy). The best private hospitals in Italy are also the equal of those in any country. However, state hospitals, particularly in the south of the country, are notoriously bad, a situation made worse by Mafia-inspired corruption and doctors fleeing to find work in better equipped (and run) hospitals in the north. Throughout Italy, nursing care and post-hospital assistance are also well below what most northern Europeans and Americans take for granted.
Italy has a national health service, which provides free or low-cost health care to all residents who contribute to social security and their families, plus university students and retirees, including those from other EU countries. It also provides emergency care to all visitors, irrespective of nationality. In addition to the state health service, Italy has many private doctors, specialists and clinics. Many Italians use these in addition to the national health service, e.g. to avoid long delays for operations, to obtain better hospital accommodation or simply to obtain treatment from a preferred specialist. Many Italians and most foreigners have private health insurance, which ensures that you receive the medical treatment you need, when you need it. Whether you opt for state or private health care, it’s important to have some form of health insurance, without which health care costs in Italy can be prohibitively expensive.
Non-EU citizens taking up residence in Italy should note that immigration officials may ask you for proof of health cover before issuing a permit to stay.
Despite the shortcomings of the health service, Italians are generally healthy and have one of the highest life expectancies in Europe – around 82 for women and 76 for men – which is attributed in large part to their healthy Mediterranean diet of fresh fruit, vegetables, olive oil and red wine (in moderation). Infant mortality is around average for Europe, at six deaths per 1,000 live births. The generally mild Italian climate (at least in central and southern Italy) is therapeutic, particularly for sufferers from rheumatism and arthritis, and those who are susceptible to bronchitis, colds and pneumonia. The slower pace of life – outside the major cities, at least – is also beneficial to those susceptible to stress. However, the country has a high incidence of diseases of the circulatory system, as well as of cancer (often smoking-related) and liver-related illnesses (due to excess alcohol intake). Common health problems among expatriates include sunburn and sunstroke, stomach and bowel problems (due to the change of diet and, more often, water), and alcoholism. Italians’ love of the motor car also gives rise to excessive air pollution in Italy’s major cities, which is blamed for the increasing number of asthma and hay fever sufferers.
Consumption of alcohol per head is high (up to 90 per cent of Italian adults are reckoned to drink alcohol with every meal) and alcohol is responsible for a number of alcohol-related illnesses, e.g. cirrhosis of the liver and some forms of cancer. There’s no official age for the legal consumption of alcohol (children tend to drink moderate amounts of wine from a young age), although young people under the age of 16 aren’t permitted to buy alcohol. In common with other European countries, Italy has an increasing illegal drugs problem, particularly among young people (ecstasy and amphetamines have flourished in recent years). Drugs are comparatively cheap in Italy, but the law is strict on prohibition and the penalty for drug dealers can be life imprisonment.
Otherwise, there are no special health risks in Italy and no vaccinations are required before visiting. Pollution levels in the sea are tested regularly (particularly during the tourist season) and swimming is generally safe unless there’s a sign to the contrary, e.g. divieto di balneazione (bathing prohibited). On trains and other places where water isn’t fit for drinking, you often see the sign acqua non potabile. However, you can safely drink most tap water in Italy, although many people prefer bottled water, and the wine tastes much better.
If you’re planning to take up residence in Italy, even for part of the year, it’s wise to have a health check before your arrival, particularly if you have a record of poor health or are elderly. If applicable, you should also bring a spare pair of spectacles, and contact lenses and spare dentures and a hearing aid with you.
This excerpt has been republished with permission from Survival Books. Some of the information may apply to EU citizens only. If you would like to get the inside track on moving to Italy, pick up your copy of this great book by clicking here.