Italy
The healthcare system in Italy includes both a public and a private sector. Under the federal government, the Ministry of Health administers healthcare by region in the public sector through the National Health Service (SSN). The SSN pays family doctors’ salaries. Family doctors are not allowed to have more than 1,500 patients; however, they must offer visiting hours five days per week. Prescription drugs, when prescribed by a family doctor, are subsidized by this service. Costs depend on the income of the individual and the drug required. Visits to specialists or diagnostic tests such as MRIs and CAT scans are offered at public hospitals and require a referral from a family doctor in order to qualify for subsidies. These tests are free for those who live in poverty; however, wait times are generally long. Those who can afford it may choose to obtain these medical services through the private sector, where wait times are shorter and costs are paid out-of-pocket. Surgeries and hospital stays are free of cost for everyone, irrespective of income. However, once again, wait times are long.
Healthcare Spending
Italy’s healthcare spending is on par with other European nations. In 2012, 9.2% of the GDP was spent on health care costs, which amounted to an average of $3,040 USD per person. Italy ranks 33rd in the world with respect to the percentage of the national GDP that is spent on health care costs. The average amount spent per capita is higher than the average across the European region, which is just above $2,000 USD per person.
Availability of Care
Italy boasts a high number of physicians, compared to both the European region and the rest of the world. The World Health Organization (WHO) reports that there are 4.09 physicians per one thousand people, a ratio of 1:244. This statistic is significantly higher than the regional average of 3.31 physicians per one thousand persons within Europe.
Life Expectancy & Mortality
Life expectancy is very high in Italy; in 2014, it was reported as 82.03 years, which ranks Italy as 11th overall in the world. There are, however, discrepancies between males and females. Men can expect to live 79.4 years, on average, and women can expect to live 84.82 years, on average. Very few large European countries rank above Italy on this measure, only Switzerland has a higher life expectancy at 82.39 years.
Other Issues
WHO ranked the Italian health system second worldwide, after France, in their 2000 report. However, the Italian economic crisis significantly affected healthcare spending across the country. In a survey conducted by Europ Assistance in 2012, 27% of Italians reported having canceled or postponed medical services due to insufficient funds. The SSN has also reported financial problems since its inception in 1978. Difficulty coordinating healthcare at the national level was also a major flaw in the system, since regional units are responsible for delivery. The 1990’s saw reforms to this system in order to stabilize ever-increasing healthcare expenditures. However, with the current economic situation, spending is still too high for it to remain sustainable for the country.