One surprisingly good reason to study medicine in Italy is the health care system itself.

Bloomberg recently ranked Italy as the country with the world’s third most efficient health care system — after Singapore and Hong Kong. Italy has the second-highest life expectancy in the European Union — after another small state, Luxembourg. Studying medicine in Italy is not just about learning the art and science of the profession (which is taught famously well here); it is also about witnessing a good national health care system in action.

Here is what it is like, as a medical student in Italy, to get into the health care system and go to the doctor. This week, I needed to get my regular prescriptions filled. So, I inscribed myself in Italy’s national health care system, the Servizio Sanitario Nazionale.

I first went to the Azienda Sanitaria Locale (ASL), which is the health care office. It is a 10 minute walk from my apartment; there are over a dozen branches around Milan. I got the inscription forms, and they told me that it would cost €387.34. If that sounds like a lot, note that this is a one-time payment; after that, you pay nothing to go to the doctor, basically, ever again. Furthermore, because I am a German citizen, this will be reimbursed by the German government, due to EU agreements. So, if I understand correctly, for European Union citizens, generally, seeing doctors in Italy is free. For almost all other students, the cost in Milan is €149.77. Not monthly. Not yearly. Total. Forever. (The only exception is if you made a substantial income in the past year; then, there is an additional 4% to 7.5% surcharge.)

My meeting at the ASL took 10 minutes. I went to the post office to get a money order for the charge. This took five minutes. I then went back to the ASL, and they inscribed me. This took 10 minutes. They then asked me to choose my primary care doctor, and mentioned that there was one on my street. So I picked him. They then printed out a sheet with my doctor’s office hours and telephone number. All done. How easy is that?

My doctor’s doorbell, in red, so you cannot miss it.

My doctor’s office, from my apartment balcony

It turns out my doctor’s office is not only on my street; it is literally across the street; that is, I can see his office from my apartment balcony. If I need to visit him, I can just walk across the street and ring the doorbell.

So I did. He was sitting in his office, and received me cheerfully, without an appointment.

It turns out my doctor, who speaks excellent English, also studied medicine at the University of Milan, quite some time ago. He may even know our anatomy professor (famous, apparently, to generations of Milan med students). He gave me my prescriptions. I told him I had not had a preventative check-up in a long time, so he suggested I come in for one after exams, and in the meantime, gave me an order for routine lab work, to get done (around the block) at my convenience. Cost for this appointment? 0 <– that’s a zero. There was no secretary, no long legal disclaimer forms to fill out, no insurance company to contact. All of that overhead, present in some other countries’ health care systems, is gone in Italy, making the Servizio Sanitario Nazionale cost-efficient.

I then went to the pharmacy next door. There was no line. They handed me my medication immediately; there was no obligatory 30-minute wait, like at Duane Reade in New York. Cost for a month’s medication? €7.21. (In the USA, without insurance, it would be around $200.)

As a interntional med student at Italy, not only do you receive great health care, but you can learn lessons about what a suberb national health care system looks like. You may, indeed, be able to bring your observations back to your home country.

Erik Campano (Milan)

Blog Editor
Erik Campano is a consultant to the English medical school of the University of Turin and doing a Master's degree studying artificial intelligence applications in global health at the University of Umeå, Sweden. He completed his Bachelor’s of science in Symbolic Systems at Stanford University, and then he worked for about eight years as a radio news anchor, before moving to biomedical scientific study and research at the University of Paris and Columbia University. His goal is to develop AI technologies for international emergency humanitarian aid organizations like Doctors without Borders, and to combine medicine and journalism. Erik grew up in Connecticut, and is a citizen of the United States and Germany.
Erik Campano (Milan)