Cost of Living

Why We Moved to Italy | Healthcare Costs

A look at American Healthcare vs Italian Healthcare and the effects both have on health, stress and household budget.

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.

What are your experiences with healthcare?

Please weight in! Add your story in the comments section at bottom of the post.

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:

  • cardiovascular
  • diabetes
  • obesity
  • oncology screenings
  • vaccinations
  • 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.

Health promotion is a determining factor for the well-being of the person, for the quality of life but also for the sustainability of the health system. A framework that combines lifestyles, early diagnosis, vaccines and accident prevention at home, at work, on the street and in leisure time, the safety of what we eat and drink, the protection of children from games and dangerous products.

Italian Ministry of Health

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.

14 comments

  1. Dear Brandy,
    Just found your blog tonight while attempting to take a break from the political insanity on television. (2nd night of the 2020 Republican Convention, arghhh!)
    I’ve been to Italy about 8 times over the years, several of those for 1-1/2 mos. at a stretch, so I can identify with much of what you write about beginning to learn the language and other newbie cultural experiences there. I found this post about healthcare especially interesting. To begin with, you exactly describe the dilemma I currently face in America with regards to paying premiums for ‘healthcare’ you then can’t afford to use. Then, just the prohibitive out of pocket expense for the self-employed, even if you are ‘covered’. I won’t go into a whole long, drawn-out thing, but suffice it to say that after one supposedly-covered first attempt at getting my increasingly useless legs ‘seen to’, I just bought a cane with a little pull-down seat attached, a large bottle of extra-strength acetomenaphine, and have decided to just hobble it out til I qualify for Medicare in a few more years. Besides the high drama of your recent move, mid-Covid, I think you were fortunate to make the move just when you did, age/health-wise!
    Thanks for the entertaining and informative reading material and much needed distraction. I plan to follow your blog now, and will be desperately need it in the coming months til we see if the world over here will calm down a bit after the election in November. Thanks sgsin, and continued Good Luck in your move!

    Liked by 1 person

    1. Hi Debra. Welcome to ALOR! I’m honored to be able to bring a smile and some distraction during a difficult time in America. I’m also frustrated for and with you at the current state of health care in America. For me it’s a very personal issue. Not just for my own health but for that of my family. My Father retired three years early to care for his wife who has advanced MS. During that time, he went without health insurance depending on the VA center. Unfortunately, during that time he also developed prostate cancer that went undetected. By the time he qualified for Medicare he had late-state prostate cancer. He has been through surgery and treatment since but had he had proper access to medical care earlier, he might not have suffered nearly the way he has. All of this to say, here on my blog, you have a place of understanding and empathy. I hope I can bring some measure of enjoyment, fingers crossed some laughter and a bit of harmless escapism to Italy for you. 8 visits to Italy is impressive! Do you have a favorite region or city?

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    1. Hi Sam! There is a Facebook group by Loval.it called Living in Italy. I’ve met a lot of expats on the group and a few are now Doctors practicing in Italy. I’d look the group up (or friend my Facebook account and I’ll connect you) Speak any Italian?

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  2. 1 noticed you did not discuss the Corona Virus impact in Italy’s health care system. Please elaborate on the current Italian answer here. How well are the aged faring now?

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    1. A good question but one that’s difficult to answer because it falls under too soon to tell and not enough information. That said as of two days ago the EU reached an agreement on an $859 Billion dollar recovery package of which Italy will receive $240 Billion dollars.
      As for my personal experience with how the elderly are faring. Currently my Papà is undergoing treatment for cancer which was delayed due to COVID but is now fully back on track. He is 81 and has been fighting cancer since 2006. He’s doing well and had multiple tests and doctors appointments in the last few weeks.

      It is very true that Europe and Italy in particular were slow to reach to COVID. Italy’s death toll says it was far to slow. However when they did react it was collective and effective.

      Italy is a country that respects its elders. If anything COVID has made the country more vigilant and determined.

      As you saw on my other posts I moved to Italy in part for my own health reasons. I might not be in the elder bracket (fingers crossed I get there) but I have already found the healthcare system to be vigilant in preventative healthcare myself in several doctors appointments and a hospital visit myself.

      Here’s an article about the relief package the EU reached.

      https://www.washingtonpost.com/world/europe/italy-and-the-eu-have-fought-through-the-pandemic-now-eu-aid-may-help-ease-tensions/2020/07/21/93d0121a-cb58-11ea-99b0-8426e26d203b_story.html

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  3. Thank you for sharing! I’m glad the Italian healthcare system is working out for you and you don’t have to worry about the US healthcare system anymore! Btw, do you find that drs have a different way of treating you in Italy vs the US? I noticed that when I grew up in England and I have known Canadian chiropractors and they just have different attitudes to treatment than Americans

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    1. So far I haven’t noticed a difference in treatment because I’m American. The language barrier is real but my Husband is helping me bridge the gap. The only surprising part was my poor husband having to translate the phrase “you have to lose weight.” In Italy I’m a little plump in America I’m thin. Cultural fun!

      Liked by 1 person

      1. Good luck on the language barrier! I know going to the dr requires more advanced knowledge of a language. I know that from living overseas drs would say that they weren’t going to do a certain treatment because it was the American thing to do. I’ve also seen how government healthcare systems can be successful, but also unsuccessful. France was excellent but England was disappointing. I’m glad Italy has a good one!

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          1. That’s good to know about Canada. I have friends there who work in healthcare and they’ll show me the ropes of the system. I know what you mean about the US. Even getting appendicitis was risky financially, but I was lucky… for now

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