I’ve dealt with chronic pain since the age of 16. This is part of why we decided to move to Italy. I need health care and in America it’s too damn expensive. I was sick and tired of being afraid to get sick.
Italian Healthcare vs American Healthcare
The year that Paolo’s father turned 80 he underwent radiation treatments for Cancer. That same year, his Mother also had surgery and physical therapy. With all the doctors appointments, surgeries, treatments and medications that come with age, Paolo’s parents paid less than half of what we did that same year for healthcare premiums alone. No doctors appointments, no medications, no treatments. Just premiums. Here’s what that looked like for us.
Healthcare Costs in America for the Self-Employed
As a self-employed couple, Paolo and I were paying $9,600 a year in premiums for the absolute cheapest healthcare plan on the marketplace. Our plan covered one annual doctor’s appointment a year. Everything else fell under our deductibles.
Several times over the last few years when the pain got to be too much I would go to the doctor. Yet when every test, exam, or physical therapy appointment came with a $300 bill (on top of the almost $800 a month premium) I’d give up and live with the pain. Who can afford to go to physical therapy two times a week at $300 a pop I would think?
Heaven forbid we as a married couple were to have a car accident together. With $6,500 out-of-pocket deductibles per person, one accident could set us back $22,600 a year in medical bills. In America, I lived in fear of illness and accidents, my anxiety level rising with each birthday.
Healthcare premiums were our second largest household expense right behind rent and yet, we got nothing for it. No doctors appointments, no medications, no treatments. Pre-existing conditions, out-of-pocket deductibles, out of network charges, explanation of benefits, denied treatment, denied claims. I was sick of it.
Paolo and I both avoided doctors and all medications for years and that’s just not healthy. As a dual American Italian and Italian American citizens we had an option and we took it. We moved to Italy in April of 2020 taking a COVID-19 repatriation flight.
Italian Healthcare is a National Health Service
Although it is regionally based, the healthcare system in Italy is a national health service known as Servizio Sanitario Nazionale (SSN). SSN provides universal coverage to citizens and residents, with public healthcare largely free of charge. Some treatments covered by the public system do come with small co-payments but they include tests, medications, surgeries during hospitalization, out-patient treatments, medications, pediatric, family doctor, and specialist visits.
This year, I’ll turn 45 in November. At which point I am eligible for the National Prevention Plan due to my medical and my family medical history. I’ll be sharing more details about the prevention plan as I get them but, from what I understand, all preventative health care is covered including:
- oncology screenings
- road accidents
- accidents in the workplace and home
Under the American health care system, pre-existing conditions are used to justify higher premiums and insurance denials. In Italy, the same “red flags” raise prevention measures.
American Healthcare vs Italian Healthcare
The American healthcare system is among the best in the world for the wealthy. For the rest of us, it has become so costly it prevents citizens from seeking care. It’s preventative insurance not preventative care. Italian healthcare focuses on prevention.
The way I see it, insurance is a risk. Insurance companies are taking a risk on the citizens they insure. When they are legally given right to deny treatment prescribed by a doctor, they mitigate risk. When insurance companies deny coverage based on pre-existing condition, they control the risk. When out-of-pocket deductibles reach thousands of dollars preventing people from using the very healthcare they pay thousands of dollars to have, insurance companies cheat the game. My health is no game. I took my chips off the table when we moved to Italy.
Moving to Italy has already proven to be the best decision I’ve ever made when it comes to my health. Since moving to Italy I’ve been assigned and met my regional doctor, had follow up blood tests and x-rays. To get my health back on track, there will be more to come and yet for the first time in years, I’m not afraid of what comes next.
The lack of national healthcare and the political division that will make healthcare more expensive before it gets better is a big part of the reason I left America. I’m at an age where I can’t afford for things to get worse before they get better. So when asked “why did you move to Italy?” healthcare is one of my top five reasons.