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Older Single Woman Puglia

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tex62
9/29/2019 19:04 EST

Hello. I'm trying to obtain information from retired single women that have relocated to Italy and their experiences. The positive, negative and maybe things that you hadn't considered. I really appreciate your input on this topic so that I can consider and try to make the best and safest decision for myself.

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codybrandy
9/30/2019 11:49 EST

Just to help clarify: Why Puglia? We on this forum hear from so many who just pick a place on the map and go...not the best idea. If you vacation in a spot and return often you will get a feel for the area, make friends, find out prices of rentals, be prepared for the type of roads (some are very hilly and a bit scary), and decide whether or not you will need/want a car. City living can be as isolating as being in the out-back. Each area of Italy is different not only climate-wise but also service-wise. Do you want to be near quality medical centers, do you want to be walkable to shopping, will you be happy with taking a train to the Dr. or Questura (when you need to re-apply for Permesso di Soggiorno.) or when you need to yearly re-apply for the health insurance? We are in Liguria and love it...the climate is mild, services are readily available and yes we need a car. Are you prepared for getting a driver's license within 1 yr of becoming a resident...if we can you can but it's not easy. Are you fluent...there are many areas where ex-pats are more prominent (say Lucca for instance) and it's easier to do all the day to day stuff. I know this has nothing to do with "older single person" but just some ideas I thought might be helpful. Best of Luck to you...Ex-pats is a terrific site and a big help for all of us.

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tex62
9/30/2019 13:50 EST

Thank you CodyBrandy for the different areas/aspects to think through. I do want a mild climate with walkability and public transportation and per someone else's suggestion I am looking into whether there are the medical specialists that I need. I am having difficulty finding what specific specialists are in what areas. Any suggestions would be appreciated. Thanks again.

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codybrandy
10/1/2019 06:20 EST

Good Morning, We have had a bit of experience with not only the emergency services but also hospital stays for surgery. We seem to be blessed with wonderful services here in middle Liguria. My husband had surgery earlier this year and with pre-op exams and post-op we saw 1. the emergency hospital in Lavagna, 2. the Chiavari big hospital for post-op and 3. the big brand new very impressive (and we are from Boston!) Rapallo hospital for the actual surgery. All were impressive as was the treatment and care. As for the emergency services this area has on call 24 hr ambulance service and a friend just used the helicopter service for med-flight to Genoa for head trauma. An ambulance rushed him to the heliopad only 2 blocks away and the helicopter landed and took off with-in minutes. Very impressive. Price: 0=free with the health care system...for which we pay c. 1600E/yr. (not each, for both of us) So, yes if you have health concerns this is worth looking in to. There have been some horror stories of health care in the south. Before you choose an area and the next time you visit your favored area...find out (from the local pharmacy or doctor) where the Regionale dei Servizi Sanitaria or Sevizio Sanitaria Nazionale is...they may call it different things in different areas...basically you are asking Where do I get the Carta Sanitaria?/Health Card. Ours for instance is in an old ex-hospital in Chiavari. They know the specialists for each field of medicine. Also keep searching on the ex-pats site. Well good luck and have a good day. By the way the Health Card is for residents...so you will need Travel health coverage for at least 6 + months until your Permesso di Soggiorno is approved and arrives...as soon as you have it in hand you can apply for the Italian Health Care... it runs Jan-Dec and you re-apply and pay every Jan. (I know it sounds over-powering...just go step by step and don't expect to get anything done timely...that's just not the Italian way)

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Shellyclark2002
10/1/2019 08:58 EST

Hi Tex 62. Have you traveled much to Italy? It is very different than the US. Do you wish to live alone.? I would be interested in several retired single women teaming up and renting a nice place together. For me it’s a matter of companionship more so than finances. I don’t drive there and walkability and public transportation is a must. Of course compatibility is important but I truly believe co-housing to be a great opportunity for social, intellectual and spiritual enhancement for all involved. Any interest out there? Shelly

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maradel
10/1/2019 09:32 EST

I'm going to add some info here about health care, because I'm living in Abruzzo, which is southern Italy. I'm in a small comune, Atri, in Teramo province. I am completely unimpressed with health care here, to the point where I will probably have to move somewhere else. I will give specifics so you can judge for yourself.

First I will make the disclaimer that I am a retired veterinarian, ie, a medical doctor, and have a Ph D in neuroscience. I practiced clinical medicine for years and also worked in research. I expect my own doctors to practice medicine with the same standards I did and to be and to knowledgeable. There were plenty in the US that didn't meet that standard, I must say. So far, I have met only one doctor here (a private pay specialist) who comes close to meeting my standard.

Now, I have multiple and complicated medical issues. I managed them fine in the US with some help from doctors, and I assumed that I could do the same here. It has been a constant battle, and I'm struggling because the system is so inefficient just to get simple things done: plain radiographs, ordinary bloodwork, visits to specialists.

There are limited doctors to choose from for primary care here. My primary care doctor has only 10 office hours/WEEK. She does not practice medicine; she doesn't even pretend. Her office consists of a room in an old building, with a desk, computer, printer, and a few chairs. All she does is enter information in her computer and print out forms for medications or referrals. By the way, like most doctors around here, she doesn't speak any english and my spoken Italian is at best B1 level; my comprehension of Abruzzo Italian is about A1 level.

In general I don't need much more than prescriptions and referrals; however, when my doc writes an order for me to see a specialist, she doesn't recommend anyone. I have no idea who to go to, where or how. I needed to see an orthopedic surgeon. She said don't go to the local guy, apparently he's a hack. So I did some research and decided to go to someone in Milan and pay out of pocket, like I've been doing for most of my healthcare.

So, I made the 7 hr drive to Milan to see this experienced surgeon. Here's what happened:
1. Appointment with the surgeon in Milan; he does nothing except write an order for radiographs to be taken. That trip cost me 700 - 800 E (fuel, tolls, B&B, doctor fee).
2. A week after my appointment with the surgeon, I take his order to my local doctor in Atri, who writes the “real” prescription that I have to take to the hospital to make an appointment to have radiographs taken
3. Two days later, at the hospital I waited about 30 minutes to get to the desk where I made the appointment for radiographs
4. I waited a month to have 5 min worth of plain radiographs taken of my spine and hips
5. I arrived an hour before my appointment to find the waiting room full of people. I took a number and waited about a half hour to bring to the desk the paperwork that showed I had an appointment. I was given another number and told to wait until I was called. I paid 70E for the privilege.
6. I waited another 2 hours, ie, 1 ½ hr after my supposed appointment time, for my number to come up on the board
7. I waited another 15 min outside the room where the radiograph machine is before someone told me to come in.
8. 5 min later I was done
9. Then I had to wait ANOTHER week before I could return and pick up the disk with the radiographs

The really stupid part is that I probably could have gotten radiographs done privately without all this drama for about 300E. If I had known how much stupid I was going to have to deal with, the extra 200+ E would have been worth it.

Every orthopedic surgeon I’ve been to in the US since the car accident that destroyed my body worked in a clinic or hospital where radiographs were taken the day of the appointment with the surgeon so that he would have them before and during the actual appointment. The radiographs were taken by technicians trained to use the best procedures to visualize what that particular surgeon wanted to see. Then if I needed specialized imaging, the surgeon would know at that appointment and his staff would make the appointment at the facility that would do the MRI or CT scan, and they would also make the follow up appointment with the surgeon while I was there.

The radiology technician in Atri had no special training; it was obvious. He slapped me up against a board, took AP and lateral films. They will probably be useless because of the metal in my hips and spine and all the surgical pathology and repeated dislocations of my hips.

Another example: In spite of the fact that I'm on the thin side, my blood glucose levels have been heading up into the pre-diabetic range for the last couple of years. I had to go to an endocrinologist (again, private pay) here for other things, but she failed to follow up on that, and so did my primary care doctor at my first visit. So I had to go back to her, and specifically ask her to write an order for some blood work. That was a 3 hour wait to see her that day.

I finally got my nerve up today to get my blood drawn, not because I'm afraid of needles, but because I dreaded the wait in the hospital. For good reason. It took another 3 hours of waiting in an uncomfortable room packed with other people waiting to get their blood drawn. There were TWO phlebotomists for at least 100 people in the waiting room and spilling out into the hallways this morning. I was #49 and came about 45 min before the lab opened.

For another lab test I need to get done, a couple week ago I went to the lab, waited about an hour just to bring my paperwork to the desk, and then was told "we don't do that here". I asked where I should go and the girl said "non lo so". I left. I still have to get that one done. Apparently I have to go to a private lab and pay out of pocket.

I have a friend in Atri who has been here 12 years, is bilingual and knows lots of people and how to get things done. I wouldn't have lasted a week here without her help! She has been incredibly generous. And yet, I also need to learn to do things on my own, so I try first by myself and then if/when I fail, I ask her for help. So I will give you some advice that another person on this forum (and others) gave me months ago. Unless you are fluent in Italian and already have family and/or friends where you plan to move, you cannot just move to a place and expect to go on with your life. You will have to find someone who speaks some english and knows how to get things done where you move to. EVERY area will be different. Good luck with the dialects. Italy seems utterly chaotic to the uninitiated, because so much is done through social connections, and those are strictly local.

I'm a dual citizen, so if you are not, you will have other challenges. Plan to have at least 6 months of good travel medical insurance coverage when you come. That's assuming you can get it. I think it's difficult to find if you're over 65. I was just under 65 when I moved to Italy last January, so I was able to purchase affordable, very good travel insurance. I used it. I got very sick the second day I was in Italy and was sick for 5 months with recurring bronchitis and pneumonia before I diagnosed what was causing it. Expect the unexpected!

The health care system here is very different from the US. Everything you do through the system (ie, not private pay) has to go through your primary care doctor. There are no appointments; you just show up and wait. Even if you do have an appointment, you show up and wait. If you have complicated medical conditions and/or need to see multiple specialists, expect to waste hours, days, weeks of your time waiting and waiting.

Doctors do not keep your medical records, which I find to be completely unacceptable according to good medical care standards. However, by Italian standards, it probably makes sense. Italians tend to stay in the same place for generations. The local doctors know people in the community. They've probably been seeing the same families for years. New people in a practice are RARE, other than newborn infants. I think that's especially true in parts of Italy with few expats, like all of southern Italy. So, doctors may not need records. They know everyone and their extended families. It used to be that way in the US, but isn't now.

However, be aware that you will have to cart your medical records around to your appointments (and then your doc probably won't even look at anything!), and you will have to be knowledgeable and a strong advocate for your health. You won't have much choice in doctors unless you go to private pay doctors, especially if you move to a southern area, and most especially, a small town.

I wish someone had told me some of this before I decided to move to Abruzzo. On the other hand, because of other chaotic aspects of my move, it took a long time for me to get to a place where I could establish residency. Things finally got to the point where I had to just pick a spot and establish residency so I could get my carta d'identita (you can't do anything here without that) and my tessera sanitaria.

One of the reasons I moved to southern Italy and a small town is because at least this year, new residents in Italy are offered a tax break to move to southern Italy. It hasn't been worth it, for me. I've spent a lot of money out of pocket for private health care, and there are many other problems associated with living in a small town in southern Italy. I'm speaking as a single retired woman with no family connections here. In the US I was very independent and did many things without help. Here, the simplest things are confusing, frustrating and exhausting.

Like Sergios on this forum, I moved to Italy so I could travel through Europe and stay for extended periods of time in different areas. That is a huge benefit of having dual citizenship. But first, I need to get certain aspects of my health taken care of, and that has proved daunting, to say the least. Nevertheless, I plan to start traveling this month. Besides, I need a vacation from Italy!

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Shtinky
10/1/2019 10:11 EST

I’m not single but I know plenty of single women who’ve retired here. They are doing fine and loving it. I have a blog about our move to Italy and it seems most people interested are single women.
But really I’m commenting on the health care as well. I happen to be in the hospital in Perugia in Umbria right now (knee replacement) and am blogging about the experience, which is not anything like the US experience. I just posted a blog about being here and about my lovely roommate, an octogenarian from Bari in Puglia. Here is the excerpt about her and a comment about why she’s here in Umbria being treated and not in Puglia.
“ I have a room mate. She’s a small rotund Italian woman who had a fall which got her here. I’m guessing she’s 80. Her name is Francesca. She’s sweet and we’ve become friends. She’s been here over two weeks and I just heard she leaves Thursday. Happy for her. And, get this, she came with at least three family members from Puglia! 550km away. Her doctor said she wouldn’t get the good care she could get here. So I guess he got her set up here. I had heard the health care is much worse in the south, a definite consideration if a person is planning to move here. Just goes to show the huge difference people talk about may be true.”
Tex62 I hope this helps in your considerations for your move.

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rsetzer99
10/1/2019 11:26 EST

There is a large, modern teaching hospital in Chieti

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Shellyclark2002
10/1/2019 11:38 EST

Maradale. Wow. Other than travel why would you stay in Italy given all of That?

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dave2018
10/1/2019 12:37 EST

I have heard other Italian health care stories similar to that of maradel.

Where health care is concerned, one can be lucky and have a good experience or unlucky and have a bad one. That is true anywhere, even in the USA where we pay through the nose for health care, about 2 to 3 times what Europeans pay.

You should understand an important characteristic of Italy: that unlike in the USA, things are not at all consistent over the whole country, and this is also often, but not always, true of health care. Each region is different in a number of ways from the other regions, and the differences between the northern and southern halves of Italy are even more stark. I know because I have lived in both Puglia and Friuli Venezia Giulia.

We had a very good experience with a local general practice doctor at the Guardia Medica in Puglia, but a disappointing experience at the hospital. A friend of my brother in law in northern Italy told me he had to wait 4 months for an MRI, and he was very negative about Italian health care in general. My mother in law always went to a private pay doctor in northern Italy and got much better service than those using the "mutua", i.e. the national health service that everyone gets for "free" (you pay for it through sky high taxation).

The vast majority of Italian health care horror stories that I've heard over the years happened in southern Italy, although to be fair there have been some in the north as well.

It's pretty much hit and miss, really, but be aware that southern Italy is generally more haphazard, laid back (they'll take care of it domani, domani), and less clean. When we lived there almost everyone we knew had their houses broken into or their cars stolen all within a couple of years. It reminded me a lot of Mexico. The people are generally friendlier than northern Italians though, at least that was our experience.

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foxwhite1
10/1/2019 14:36 EST

In response to Maradel's ongoing saga allow me to add my thoughts. I feel for her! However, her story of medical care in Italy does not vary too much from medical care in a lot of the US. Hurry up and wait, make an appointment for 8 am then sit there for hours, need to see a specialist- OK, the next available appointment is not for four months, did the doctor even hear what I had to say? I live in a prosperous coastal community in Florida where even our doctors and nursing friends drive out of the area to go to specialists since those here are generally hacks. My suggestions are if one has ongoing medical issues that require constant attention, then you should locate near a major metropolitan area AND search out specialists before needing one. Now, no one knows what unexpected medical issue may arise tomorrow and if your locale hospital/doctors can effectively treat you. This is not to say that bureaucracy and incompetence are excusable, but we find that everywhere, unfortunately, and we have to minimize the risks as much as possible. Saving a few tax dollars may not be worth the aggravation Maradel had by relocating to Abruzzo...just saying.

I think a lot of the decisions on where people move in Italy need to be centered around our fundamental needs - the quality of medical resources, type of transportation required, language/dialect proficiency. To me, these should come first. Using Maradel's experience as an example, I think it would be safe to say she may have chosen a different locale if she knew the obstacles that faced her, given her needs.

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maradel
10/1/2019 14:37 EST

As I've said elsewhere, Italy is not one country. Those who have been here a lot longer than I can speak to that with more authority. My experience in Abruzzo, and more specifically in Atri, is not indicative of Italy as a whole. It's not even indicative of Abruzzo as a whole. I wrote in detail of my experiences because often, certainly when I was asking questions (not here but on several Facebook sites and in private messages to expats), I usually got only the rosy pictures, and nothing in detail.

Whether Italy is right for any one person is a highly individual decision. I would never try to tell someone to come or not come based on my experience alone. For that matter, my overall experience has been quite varied. I've lived in Rome, Todi (Umbria), Lucca (Toscana), Pretoro (Abruzzo) and Atri (Abruzzo). They are very different places. They have different "personalities", the people are different.

When people talk about how good or bad hospitals are, you have to keep in mind that for most people, the amount of time you spend in a hospital is minor compared to how much time you spend in more average encounters with the health care system. Having said that, though, what happens in hospitals is much more critical. I would not have surgery in the hospital in Atri. Not by choice, anyway. For the reasons Dave2018 mentioned regarding the southern italian "personality", if I can use that word, I would probably not choose any hospital in southern Italy. I've been here long enough to see how much effort goes into not-getting-things-done. Why be helpful to a patient when you can spend time gossiping with your coworker, instead??

Those are my general observations, not true for every individual Italian, and based on a limited data set. I'd hate to try to do some kind of statistical analysis using those data. However, when I have to make a choice about my health and my life, I will choose what I think is best for me and not worry about being politically correct.

Will I leave Italy? Who knows? Everywhere in Italy is not like Atri, as others point out. I'm not going back to the US. Germany is a possibility. But mainly I want to travel, and while I'm doing that, Italy will remain my legal residence. In fact, it's likely that Atri will remain my legal residence for a while. My EHIC will cover my medical needs while I'm traveling.

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tex62
10/1/2019 14:40 EST

Great points to consider. I really appreciate your input.

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tex62
10/1/2019 15:09 EST

Maradel, thank you for your input and an over view of your experiences. I'm sorry for your health issues but that is also some of the exact information that I'm looking to obtain. Just as you stated we're accustomed to certain steps in our medical care and it sounds as if at least this aspect of ExPat life in Italy is challenging. I really appreciate your honesty and learning curves.

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tex62
10/1/2019 15:16 EST

Shtinky, what is your blog site? I would like to check it out? Thanks

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tex62
10/1/2019 15:18 EST

rsetzer99, Do you know any details regarding the teaching hospital in Chieti?

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maradel
10/1/2019 15:21 EST

"Saving a few tax dollars may not be worth the aggravation Maradel had by relocating to Abruzzo...just saying."

Absolutely! In fact, I did say that!

Atri happened because I needed an apartment with a registered lease so I could establish residency. I was in a time crunch and needed to get the bureaucracy done. It's not a terminal decision. I can move whenever and wherever I want, within some limits. The point is that you do have to establish residency somewhere to get some things done. And if you're in Italy more than 180 something days, you're considered a resident for tax purposes anyway, so you might as well grab a place and do the paperwork so you get your carta d'identita. Also, I really didn't understand how the health care system worked until I was in it.

Now that I know more, I can make more informed choices. The point of describing my experiences was to provide more details about how the system works. Although Italy has a "national" health care system, it is actually funded and managed on a regional basis, not a national basis. Wealthier regions will have more money for their health care system. However, you still have to go to your primary care doctor who will give you a piece of paper that you then take to the hospital to get testing done or take to a specialist so you can make an appointment.

One reason it's so inefficient is that Italy has been grindingly slow to implement computerized systems for bill payment, scheduling and record keeping. Doctors should be able to send orders digitally to radiology or clinical lab or wherever the testing is to be done. Patients should be able to log onto their accounts and pay their bills and schedule the appointments they need.

Please correct me if I'm wrong, but I think all of Italy is that backward when it comes to implementing computerized medical management systems.

Also, I am not a fan to the US health care system. If you're wealthy, live in a major metropolitan area, and have good health insurance, you can get good medical care. A large number of people don't have that. Moreover, the system is so corrupted by profit over care, the quality of care can be dangerously poor. I know first hand how bad US health care can be.

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tex62
10/1/2019 15:25 EST

Thank you for your input

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tex62
10/1/2019 15:33 EST

foxwhite1, that's why I posed the questions bc as a retired medical person I definitely understand the hoops that a person may need to go through in the US and I am trying to get an understanding of the medical system in Italy to determine IF it's an option, if so what should I even look for (when you don't know you don't even know what to look for) and perhaps as you suggested maybe looking into different areas based on medical care/treatment available in those areas. Thank you for your prespective.

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Shtinky
10/2/2019 02:46 EST

Hi Tex62. My blog is Nancygoestoitaly.com
I’ve been here 5 years and documented all of the move before and after, then life here. And there’s a link at the top “so you’ve decided to move to Italy” in which I tried to compile everything I’ve learned about life here. Maradel is right, it’s imperative to know people where you decide to go. You can’t do it on you’re own.

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almare2
10/2/2019 03:58 EST

I agree about knowing people. I bought a house in Abruzzo to renovate. I have not even started yet due to many factors. Were it not for the fact that the local friend I bought it from has been helping all the way, it would be impossible for me to do anything. My Italian is quite good, but understanding technical terms when people are talking in fast Abruzzese is very difficult, even when it comes to simple things such as getting utilities hooked up.

As far as the health care is concerned, a couple of years ago I was in an auto accident (I was a passenger in a car and another driver ran a stop sign and ran into us) and went to the ER in Avezzano to be checked on. Waited for hours to be seen, partly as a number of hospitals in the province have been closed and the Avezzano catchment area has become quite large. The X-ray machine looked like something from a 1950s sci-fi movie, with big glass plates that the technician shoved in and out. The people were willing, but the equipment is really substandard. Also, as has been discussed in another thread, if you need to stay in hospital, it is assumed that your family will do certain things that we take for granted the hospital personnel will do. And good luck getting your own bathroom. In Avezzano, even women who have had a cesarean have to use the bathroom down the hall. Again, every region is different. It's essential to go to a place where you might want to live, rent an Airbnb for a month or so, and check into these things yourself.

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whidden39
10/2/2019 06:39 EST

Can’t go along with the north vs south generalizations, Maradel. I have written extensively in this forum about my unexpected and serious medical needs since moving to Puglia. Won’t expound here’s again. However, my hospital experiences have been both positive and successful. And I am from an area of the US where we have several hospitals that are internationally renowned. You have to do your research and learn the ropes in a new culture to get connected to good care. It’s possible I would forego treatment anywhere in Italy and elect to return to the US for a particular serious situation. That decision hasn’t presented itself to me thus far here in Puglia. Aside: I met a mother from a northern region of Italy who was at a hospital in Puglia (Conversano) with her son who needed surgery. She related that this hospital was the best one for her son’s surgery. I don’t know what other factors prompted her decision, but it’s clear a north vs south bias wasn’t one of them.

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rsetzer99
10/2/2019 08:57 EST

Other than it is modern, large, and where they transfer cases needing critical care

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foxwhite1
10/2/2019 09:25 EST

Since we are on the subject of healthcare services in Italy I thought the following data from the European Commission's Directorate-General for Health and Consumers department worth sharing. In brief, Italy ranked #20 ranks just below Spain at #19 and England at #16 and above Ireland #22.

https://en.wikipedia.org/w/index.php?title=Healthcare_in_Europe&action=edit§ion=3

And in this study:Countries With The Best Health Care Systems, 2019- the Sweden is ranked #28, the US #30 and Italy #37!

https://ceoworld.biz/2019/08/05/revealed-countries-with-the-best-health-care-systems-2019/

So I guess the take-away is that one has to be their own best advocate to insure they find the best healthcare not only in Italy but in the US. The sobering news is that in 2000 Italy was ranked #2 with the best healthcare in the world. So why the continuing decline? Sorry to go off topic!

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miki184
10/2/2019 11:44 EST

Hi Fox,

I agree with you 100%! So much depends on where you live even though I have no doubts that you will find valid doctors here and there in the south. I had a minor accident in Catania years ago and instead of giving me a shot of whatever, the person who was giving it to me have it to themself by mistake ??! I think you can imagine the amount of incompetence.
My advice would be stick to a middle size city/town with a decent size center preferably in the north where there is a university. It will probably be more 'walkable' and there is a chance it will attract more foreigners who can act as a support group.

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miki184
10/2/2019 12:17 EST

Oh the trials and errors of writing on a 'smart'phone!

Should be: the person giving it to me GAVE it to themself.

And all those question marks, etc were actually emojis. Sorry, I won't do them again.

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maradel
10/3/2019 05:56 EST

Widden39, I didn't mean to sound as though I was making a sweeping generalization. However, the north vs south issue is also not something I made up. Many have expressed the same sentiment, including native Italians, including Italians who live in southern Italy.

It's good to know that there is at least one good hospital in southern Italy, although I probably wouldn't move to Puglia just for that reason. Also, I would be curious to know if you go to the hospital just for ordinary testing (radiographs, blood work, etc), what is that scene like? What is the procedure and how long is the wait?

For me, it's the daily grind of stupid that wears me down. By the way, none of the other people waiting to have their blood drawn in the Atri hospital earlier this week were very happy about the situation. They kept getting up to look at the board with the number on it (like a deli counter), rolling their eyes, shaking their heads, looking at their watches. I asked some older guy next to me if it was like this all the time, and he said yes.

When my turn finally came, I realized what was causing at least some of the slowness. The phlebotomists were gossiping with their neighbors and friends as they came through!! OMG even getting blood work done becomes a social event!!

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maradel
10/3/2019 06:23 EST

Almare2,

Your experience in the pronto soccorso is one of the things that really worries me. Presumably, there is some sort of triage that occurs when someone comes into the ER, but if you don't speak Italian well, how can you communicate the seriousness of your condition? And believe me, when you're stressed, unless you're fluent in Italian, your communication skill is the first thing to go.

Before I moved to Italy, I really did not realize how few medical personnel spoke anything other than Italian. In addition, in most (all?) Italian hospitals, there is not a translator on staff. Like with most things in Italy, you are expected to have family and friends do those things for you.

I wear an emergency medical bracelet that allows medical personnel to access my information online or to speak to a person who works for the service to obtain my information. I painstakingly translated a summary of my medical information into Italian and uploaded that and other critical translated documents.

No doctor I have spoken to knew anything about such a service!! They said no one would probably even know to pay attention to the bracelet!!

So many of my efforts towards being proactive about my health care have been a waste of time because Italy is so far behind the digital age. In my opinion there are shocking deficiencies in the Italian health care system. People who come here without a strong support system in place should take note.

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rsetzer99
10/3/2019 06:35 EST

Un-digitize your health summary and have it on a few folded sheets of paper and keep it with you. Put it in a little plastic folder in your car if you have one. Hand then a non digital summary and they will say. Oooh, now I see!

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almare2
10/3/2019 07:34 EST

Fortunately I was not injured, but my friend who had been driving had a broken nose, and after our hours of waiting, she was sent in one direction and I was sent in another for a routine X-ray. I was told to sit in a hallway and wait, all alone. I felt very lonely! After the X-ray I was sent to another empty hallway to sit and wait for the doctor who would analyze the X-rays. Occasionally somebody would pass by, but no one could tell me what was happening. All my interactions were in Italian (nobody spoke English), and though my Italian is quite good, I couldn't help but wonder how I would be feeling if I couldn't even communicate. Fortunately, as it was an emergency, I didn't have to pay for anything except the cervical collar I was prescribed "just in case."

Another story: My friend's father-in-law, who was very old, was admitted to the emergency room for some sort of illness, I don't remember what. He was taken into a holding room alone, while my friend and her husband waited outside. He was parked in a corner with an oxygen mask on. He sat there for hours without even a drink of water. Once or twice a nurse asked him if he was okay, but with the mask on, what could he say? And in this case the whole family was Italian!

After those experiences, I decided it was OK that I couldn't meet the Italian elective residence requirements. I moved instead to Wisconsin, where I'm very happy, and just visit Italy (and other countries). I'm healthy now, but who knows what the future will bring? :-)

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maradel
10/3/2019 07:45 EST

Foxwhite1,

WOW! This information certainly reflects what many people are finding in Italy.

The full European Health Commission Report is worth reading. Here is an extremely important paragraph:
"It is inherently cheaper to run a healthcare system without waiting lists than having waiting lists! Contrary to popular belief, not least among healthcare politicians, waiting
lists do not save money – they cost money!"

I wonder if Italian politicians will take note??

Here's the direct link to the pdf report:
https://healthpowerhouse.com/media/EHCI-2018/EHCI-2018-report.pdf

Your post is not at all off topic. For someone of retirement age planning to make a permanent move to Italy, health care has to be at or near the top of the list of important considerations.

Having said that, given where the US ranks on the overall list, how should an American use that information?

Many people don't like to think about what might happen as you get old. For those who are single, without family nearby or at all, and without a strong social network, aging can be a frightening prospect. In Italy, there is no nursing home care included in the health insurance. In the US, there are "nursing homes" and medicare covers a certain amount of time, but the reality of those places is truly grim. What happens in Italy or in the US if one develops dementia or parkinson's disease, has a stroke, or has other severe mobility issues?

These are the kinds of considerations one has to keep in mind as one ages, no matter where you live.

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maradel
10/3/2019 08:14 EST

Rsetzer99,
I have already done that! But, ya know, how ridiculous does it have to get? I have a copy when I'm biking, I have a copy in the car. Will someone actually look in the glove box if I'm in an accident?? Will they look in my backpack if I'm hit by a car while biking? etc, etc.

I bring my translated medical summary to every doctor I go to. Most have never given it more than a glance. My primary care doc has never looked at it. For her I have to make a one page bulleted list of important information (in Italian), and she still misses stuff!

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foxwhite1
10/3/2019 08:18 EST

Ok, I know this post is going to get slammed by some, but perhaps I will be expressing the views of others, if not, so be it. I find political correctness offensive! After reading these 'horror' stories about Italian healthcare experiences, I have to say, enough already! My son lives in Denmark, speaks Danish, and he and his Danish wife have had horrible to excellent experiences. My wife fell off her bike in Denmark and was in a lot of pain and we suspected she may have fractured a bone in her hand. When we went to the closest Danish hospital, the nurse brusquely told us they were not seeing any more patients for the evening as they were getting ready to go home, it was 7 pm and this WAS a hospital. She told us that we needed to go to another hospital. She did not even glance at my wife, standing next to me in obvious pain. Her co-worker walked by an looked and kept on going while talking on her phone. Speak to anyone in the states, and they or their friends have stories about incompetent medical staff, incorrect diagnosis, lousy hospital stays, etc. I imagine we can go on indefinitely with everyone relaying their medical 'horror' story. Bottom line, no matter where you are in the world, there is no guarantee that your healthcare at any given moment is in the hands of capable, caring people. As for the recurring criticism that has been repeated, that 'no one speaks English' I have to ask, why did you move to Italy if you seem to be shocked that staff at a hospital or government office do not speak English? And the surprise at the Italian healthcare system not be digitized is ludicrous. As stated in another post, my primary residence is in a very upscale community in Florida, and the Cleveland Clinic now owns our hospital, ranked as one of the top 3 hospitals in the US, yet they have JUST in the last 90 days gone digital. However, sadly, the new doctors they are hiring are mostly Osteopaths rather than MDs and many from dubious schools. One can only ponder the quality of some of these OD will provide, many who struggle with English. Not a good sign! Moving to a foreign land is an adventure, and like all adventures, one needs to be prepared and fit enough to endure the obstacles. The choices one makes as to where to settle needs to be balanced by their own health needs, tolerance for setbacks, adaptability, and willingness to make lemonade out of lemons, as they say. Personally, nothing grates on me more than Americans or English expecting things to be nearly the same as it was back home, and when it is not, they are surprised. I find these are the worse expats and quite frankly probably have a tough time assimilating with the locals because of that attitude. Just saying......

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foxwhite1
10/3/2019 08:30 EST

Maradel, you are spot-on about the fear of being incapacitated by some illness, particularly in a foreign land. Those of us expats/seniors who are fortunate to have a spouse may feel a bit more 'secure' for the time being. But that security can be fleeting. And the word 'grim' is exactly the correct word to describe US nursing homes. I guess the best we can do is locate to an area with a good level of healthcare, make friends fast, take care of our health and hope for the best! Here is hoping your future in Europe will be less stressful than the past. You have certainly had a steep learning curve and appear to be one tough women. Many may have thrown in the towel by now!

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whidden39
10/3/2019 09:03 EST

Maradel: There are several good hospitals in the south. I’ve actually used four of them. It seems you’re caught up in the cultural aspects of the delivery system. The national system is virtually free. Any government operated system probably won’t fully satisfy an American. It’s just different. Veterans Hospitals in the US further document the inefficiencies of governments running health care. Private hospitals are available in Italy with better and more efficient service. And, there are local private diagnostic and imaging clinics that offer quick professional service at a reasonable price. I’ve been using these to avoid multiple visits and long waiting lines. Perhaps your particular area was not well chosen for health care. Same can happen in the US. Once you’ve been here a bit longer you'll know better how to work the system to your satisfaction. And I know firsthand how that process is not always easy. Salute!

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whidden39
10/3/2019 09:11 EST

Foxwhite1: I agree with the sentiments you expressed so well.

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almare2
10/3/2019 09:17 EST

Hi, foxwhite,

I have actually lived in Denmark (I speak fluent Danish and always thought it was terrible the number of English-speaking residents who didn't bother to learn), France (I speak French moderately well), and England, and no, I don't expect people in other countries to speak English. I do speak Italian quite well. I was just reflecting on what somebody who doesn't might have felt in my situation. I guess I'm fortunate to be healthy and not to have had a lot of doctor/hospital contact anywhere in the world, so I don't have much to compare with. But as a single woman with no children, I feel more comfortable being in Wisconsin as I get older. The senior services are quite good in Sheboygan, where I live, and if I need familial help, I have cousins who aren't close by but within about 50 miles, which is drivable.

I did think it was terrible what happened to my friend's father-in-law, a little old man suffering and in pain. And Italian!

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miki184
10/3/2019 09:58 EST

Foxwhite doesn't think it should be expected that medical staff speak English, but they should and must if they are to be good in their field. Good ones considered an absolute must! I've worked in Italian hospitals and know what the environment is like. All the research papers are in...English. All international (and some national) conferences are in...English. Back in the 90s I was working for a doctor and he asked me to go to the library and photocopy a list of medical articles. Notwithstanding the fact that they came from various countries around the world, they were all in English.
If doctors want to continue learning and advancing in their career, they need to understand and speak English independent of where they come from.

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foxwhite1
10/3/2019 10:04 EST

I expect American doctors to speak English well enough to understand them, which is becoming rarer in places like Florida. Sorry we disagree. I would not be so presumptuous to suggest that if an Italian doctor does not speak English then he/she is less than competent. That attitude strikes me as American arrogance personified.

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foxwhite1
10/3/2019 10:04 EST

I expect American doctors to speak English well enough to understand them, which is becoming rarer in places like Florida. Sorry we disagree. I would not be so presumptuous to suggest that if an Italian doctor does not speak English then he/she is less than competent. That attitude strikes me as American arrogance personified.

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Napol01
10/3/2019 10:50 EST

Maradel  my husband and I live in Lecce we have been living here off and on for the last 15 months, 7 of the months we lived in Valencia, Spain. For ten years we have been planning this move, during the planning stages  we heard more horror stories about the Italian health care system, but that did not deter us from moving.  Thankfully, my husband and I are both very healthy and my husband took an early retirement to move to Italy.  When we got into the national health care system there were things that we were not prepared for as you said non- digital systems, waiting forever to get an appointment, but we worked around it. As the saying goes "there are no problems only solutions" and in many cases for us it has worked. I would like to make something very clear  you can't compare the Italian health system to US health care it is like comparing apples to oranges, however living in Valencia for 7 months I found the system there is much more efficient and pro-forward, they are in the 21st century or at least the end of the last century.   YES  Italy is even further behind than other European Countries .We have used the national health system along with private doctors both have worked efficiently without a lot of pain and much gain.   We are very lucky that we found a wonderful  GP who does not speak English, but really why does she need  to speak English we are her first English speaking patients in her 30 years of practice.  You asked the question about ordinary lab work like blood test.  We have had blood work done twice within the system and it has never taken more than 15 minutes including paying to be seen. I have seen a dermatologist  twice within the system getting an appointment within a month with the added bonus that my doctor speaks English Grazie Dio!  Our rule of thumb, if we need to be seen by a doctor immediately we go private. Since moving here 15 months ago I have seen 6 private doctors in both Spain & Italy and the total cost has been equivalent to what I was  paying for one month of insurance in the US before the co-pays.  I have been extremely happy with all my health care thus far both public & private.  I am happy to say that as of October 1 I am now on medicare.  Would I return to the US if I were gravely ill probably, because  as you said the system here is not perfect but at least I have the choice to make the decision. 
Yesterday I went to the best hospital in Lecce saw a  private cardiologist who spent over an hour with me. Included in the exam was an EKG, Echocardiogram with a consultation, he did not speak one word of English but took the time  to use google translate and the entire cost was 122 euro. It took me one week to get the appointment.  By the way you can book  some appointments on line without having  to go to a pharmacy or a hospital. I feel you don't have to rely or test the entire health care system solely on  public service there really are other options at a fraction of the cost you would pay in America.

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maradel
10/3/2019 11:01 EST

FoxWhite1,

OK, I'll respond.

(1) No one here is providing "horror stories". We're sharing our own experiences of the health care system, which many of us find problematic. That does not mean that we have not had bad experiences elsewhere. I have had far worse experiences in the US. My main motivation for moving here had nothing to do with the health care system. However, given the fact that the OP wanted information about ITALY, I think it's useful for all of us to provide information based on our own experiences. Why is it necessary for everyone to only provide happy experiences??

(2) The OP asked about Italy, not Florida or Denmark, so people here, including myself, have responded with experiences in Italy. I could tell you horror stories about medical care in Colorado, but the OP didn't ask about Colorado.

(3) Everyone I asked prior to coming to Italy assured me that most doctors in Italy speak at least a little English. It's proven to be untrue, so I have adapted by making sure I have basic information in documents translated to Italian. It would be nice if doctors actually looked at those. However, as someone on another forum pointed out, it's one thing to have the ability to speak Italian and something very different to be able to communicate complicated medical information in Italian. Even my friend who has been here 12 years and is fluent in everyday Italian had some trouble when she came with me to one of my appointments to help translate.

(3) Digitalization. Again, the topic is Italy, not Florida. Good medical care depends on communicating information. Digitalization is one advance that has improved medical care wherever it is instituted. When computers within the same hospital can't communicate with one another, there is a problem. I don't know how many hospitals are like that, but the hospital in Atri is, and it's considered to be one of the better "rural" hospitals in Abruzzo. It takes both money and motivation to implement changes. Italy has been short on both.

The OP asked for relevant information. Providing relevant information has nothing to do with political correctness. Nothing grates on me more than when someone basically says if you can't hack it here, go home, after I've related my own valid experiences. Telling the truth about your own experience is not whining. It is simply telling the truth. Just saying...

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maradel
10/3/2019 12:10 EST

Napol01,
I agree. I have mostly used the private pay system, so far. One reason is that it took me so long to establish residency and get my tessera sanitaria. Even in the US, I had to go to some doctors outside of my insurance plan and pay out of pocket.

I will probably continue to figure out how to manage things here to suit my own needs. I don't know how much it would have cost if I had gone to a private lab for the blood work I had done earlier this week, but I will find out! I suspect it will be worth avoiding the 3 hour wait next time.

Paying for the radiographs out of pocket would definitely have been worth avoiding all the hassle. In fact, the surgeon's instructions had been transcribed so many times through the whole process that the radiographs that were done were not what he ordered!! So I paid 70E for something that's useless.

I just spent 435 E for compounded prescriptions (several months worth) ordered from another private pay doctor. It does add up, but not as fast as in the US.

These are things I am learning now, but knew very little about before I got here. I don't know why people don't talk more about these things on forums. It's like people are afraid to tell the truth about life in Italy. It's tough, very tough, to live here, especially as a single person with no real connections here (I do have parenti in Compagna, but haven't gotten around to meeting them yet). I still would have come, no matter what, but I would have tried to be better prepared, both mentally and "materially" before coming. And there are some things you simply cannot prepare for. However, I think it is important for people who have made the transition to Italy to talk about what they had to do to adapt to life here.

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dave2018
10/3/2019 12:17 EST

I find it a bit amusing when some folks tout the fact that they "only" paid 122 Euro for a doctor visit and exams while at the same time not only having to pay into the system(unless you're a citizen or married to an Italian), but also paying sky high taxes. The whole point of the national health service is that it's supposed to be "free". However, as many have discovered and as I and my wife already know, Italy's national health service leaves a lot to be desired, which is why those who can afford it go private when they can. I went to the doctor here in the USA a few months ago, had the visit, an EKG, and heart stress test - my total bill was $250. Yes, a bit more expensive than Italy, but I will still pay thousands less in overall taxes and insurance than I would just in taxes in Italy in a single year. Plus, I didn't have to wait several weeks for an appointment. Many who've read my comments may believe that I don't like Italy, but it's quite the contrary. I actually have somewhat of a love/hate relationship with Italy. I love the food, culture, geography, history, architecture, etc., but I hate the awful government and its frustrating bureaucracy, the high taxes and nickel and diming you to death, and the political philosophy of most Italians which is screw everyone else and get what you can while you can from the govt. Tax evasion is a national pastime, which I don't condone but can understand as they're so high. Anyhow, I am very critical of Italy, but I am also critical of the USA.

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maradel
10/3/2019 12:32 EST

Foxwhite1,

Actually, I DO expect Italian doctors to speak English, specifically for the reasons that Miki184 gave. Doctors who do not know English are not able to read the relevant medical literature. I've had this discussion several times with others, and it is something I do know a lot about, having published extensively myself.

NO ONE who wants to publish important research findings will submit manuscripts to an Italian language journal, including Italians!! One of the main driving forces for choosing a journal to publish your work in is the audience you will reach and how many researchers will then refer back to your paper in their subsequent papers.

So the point is that the most up-to-date and important research is published in english language journals, so Italian doctors who don't speak english will not be up to date in their practice of medicine. And to me, that is very worrisome. In fact, the endocrinologist I went to in Atri, who spoke no english, was at least 10 years behind in her understanding of thyroid physiology. I know that because I do keep up with the literature that deals with my own medical problems. But that is the reason I searched for and found a doctor here who does keep up with the endocrinology literature, and he speaks English. He is the one who wrote me prescriptions that cost me 430+ E today. The reason they had to be made in a compounding pharmacy is that Italian endocrinology as a whole is way behind endocrinology in SOME other countries, including the US. The medications that end up in the Italian Health Care System Formulary, and therefore are available in all pharmacies here, are the ones that are "officially" recognized. They have some catching up to do!

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foxwhite1
10/3/2019 15:09 EST

dave2018 I assume you are on Medicare since your US based medical treatment was only $250. The actual bill, I would speculate was in the 4 if not 5 digit range. Those not on Medicare and with high deductible insurance plans, [which are the norm today] would have seen a much higher bill no doubt.

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miki184
10/3/2019 16:40 EST

Sorry, but absolutely not. I speak Italian without any problems so I never have the need to speak to them in English. But if they do want to be top in their fields they must speak English. Sorry if you don't agree, but that's the way it is.

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dave2018
10/3/2019 16:55 EST

No, I am on a high deductible health insurance plan. The discount saved me about $300, so the actual bill was about $550.

Now, should I or my wife have a major medical problem this year we will have to pay up to $6,000 out of pocket and then the insurance covers the rest. In Italy we wouldn't have to worry about a large expense like that. Of course, I'm saving about $5-6K a year living here instead of Italy so the cost of living would come out about the same should that happen. I also have my own house with a yard here so I don't have to live in a condominium and share walls with other apartments and have to hear other people's noise, and believe me Italy is a noisy place. Even though the walls are concrete, you can still hear noise, and good luck to you if you have very noisy neighbors who don't respect your peace and quiet - the police in Italy will not help you.

Despite my criticisms, my wife and I would both like to move back to Italy (I lived there for 8 years in the 90s and my wife is Italian), but with the high taxes and the way a number of things have gotten worse over there in the past 20 years we're just not convinced we'd be happier there. We'll be visiting next year so we'll see what's what, although to really know what a place is like you have to live there for a year or so. We'll be able to quickly compare what it's like now compared to 20+ years ago.

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miki184
10/3/2019 16:57 EST

Maradel, I don't know if anyone told you, but if you go to a private doctor and he gives you a prescription and if it is covered by the NHS, you can ask your family doctor to re-write the prescription for you. That way it could be free or greatly discounted - depending on the drug, especially if it is considered a life saving drug and sometimes on your income. You also have the option of asking for a generic drug.

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maradel
10/4/2019 05:18 EST

Miki184, No, no one told me that, including the doctor who wrote the prescriptions. Thanks!

This being Italy, though, I half suspect that this doc gets some "kick back" from the compounding pharmacies he uses, But I will ask him the next time I go.

Actually, I need to move somewhere else and get a better primary care doctor. My current one is extremely unresponsive and disinterested.

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miki184
10/4/2019 13:56 EST

Yes definitely ask because if is considered a life saving drug you should be able to get it either free or at a very low cost. Of course, this may also be regional but I know 95% of the 'drugs'/creams (I have eczema) I use pass, including those prescribed by private pay doctors. And that goes for the dentist as well.

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HenryGiovanni
10/4/2019 15:28 EST

Hi Maradel,
Glad to hear you are still alive, at least! Who would take care of the Pekes if you weren't? You know, they have Animal Trusts in CA so you know where your pets will go after you die, because you certainly will, one day. Not sure if they have those Trusts here in Italia, though. Also not sure who will outlive whom.

This post has gotten down to the level of nit-picking individual health histories. As such, I believe it requires a reset back to the original idea of moving to Italia, and why one chooses to do so. Sometimes it's good to return to sit on the couch so one can see the whole picture, instead of looking at details up-close.

From what I see on this post, Italian health care is either better (or worse) than some other country's better (or worse) health care. Hardly worth comparing A vs B on those specs. It becomes, as it has, an endless cycle of "he says, she says".

When I was doing Wills and Trusts in CA, every single client started out with "If I die, . . . .". I always cut them short to remind them that it was not an "if" but a "when". Plain fact: folks tend to shy away from thinking about their own impending death. Just human nature, I suppose. Loose language covers sloppy thinking.

I remember a story from the news, maybe 20 yrs ago, about a woman in Cool, CA (can't forget THAT city name). She was about 30 yrs old, and did everything "right". She ate the right foods, did her exercise and yoga or whatever, watched her calories, didn't smoke, didn't drink, early to bed and early to rise, and etc.. She was, to my thinking, the very epitome of health. Well, she was out jogging on a local trail one day when a cougar jumped her and killed her (and probably ate, at least some of her. Cougars (or Mountain Lions, if you will) tend to jump from above and behind, attacking the back of the neck, so no warning at all until it was way too late. Also, an 80-lb cougar can easily take me down, at double his weight. I would be like a rag doll in his teeth. A 60-lb cougar is hardly "better" in the odds department. The deceased woman did everything "right", health-wise, and still died at 30.

And here I am, smoking and drinking, riding motorcycles without a helmet (back when it was allowed; I would still do it if I could because I believe helmets, in themselves, are dangerous because they limit the rider's sight and hearing), doing dangerous things, burning the candle at both ends, and all that stuff. And I'm twice as old as that young lady who died, plus throw on a few extra years.

Life comes with no guarantees, not for medical care or even for life itself. There is nothing that says you get to live until [pick an age sometime in the future; the past doesn't count anymore because you've already lived to those ages]. We've each been given a job to do in our life here on earth. When your job here is done, then you die. If your job remains unfinished, then you live. But we go through life never knowing what job we have been given to accomplish before we die. Hence, we never know when our time is up.

So. My point? Accept that your health may (or may not) be as good (or as bad) as the health of other people. The trials are not against one's health, but against one's character and the job one has been given to do that is determined by the character one has. Live with what you have, and be grateful, because (and I say this all the time), "Life could be worse, but it's not". Because life can always be worse. And there's just no sense in wishing for someone else's better life or better health or better "luck" or whatever. Life doesn't work that way. The cards have been dealt; now you must do what you can with what you have. The other guy has all the aces; you have lots of threes.

Don't know if this makes any sense to anyone but me, but I'll throw it out there anyway. Probably some folks will blast me for it. No matter. Doesn't change anything, It's just my opinion. Fact is, we don't get to choose our character any more than we chose our birth parents. One plays the hand one is dealt.

And by the way, Padova has good hospitals (I'm told, because I use them as little as possible). There's a University here that has just opened up a new medical [class? section? Didn't pay as much attention as I maybe should have; the news was in Italian and I'm still practicing}. It had far more applicants than seats. But almost nobody speaks English well, if at all. My wife comes with me and translates. Sometimes I, the subject of the conversation, feel left out of the conversation. Fine. Not gonna sweat the small stuff. I live, and one day, probably not a day of my choosing, I'll die. How life works.

Hope this helps to get the post back on track. The bad is always newsworthy. The good? Hardly ever.

Cheers, John.

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maradel
10/5/2019 01:50 EST

Hi John,
Yup, I'm still alive! But I've only lost a couple of my lives (not sure how many I have in reserve!), so apparently I'm pretty hard to get rid of! In fact, I did have trusts for my dogs in the US. What happens to them if they're still alive after I die is the biggest concern I have.

I would be shocked if anything like animal trusts exist in Italy. But now that you've mentioned it, I will ask the veterinarian I take my dogs to. By the way, he speaks perfect English and is always interested in improving his English, asking me many questions every time I come.

For anyone in Abruzzo who needs an excellent veterinarian, I highly recommend his clinic, Clinica Veterinaria Salina, right off the Pescara Nord Citta S Angelo exit on E55. It's a large, modern, well equipped clinic, multiple well-trained vets (2 speak english), specialists who rotate through the clinic, 24h emergency care. Tommaso Ruggieri is the vet. My dogs get better health care than I do...

Which brings me back to the topic. I agree, John, that the big picture is important, but so are some details. For some reason, the details were noticeably absent in all my attempts to get information about health care prior to arriving in Italy. Do any single person's details generalize to the world of health care in Italy? Of course not! But a balanced view is important. And I think that some of the discussion that has happened here indicates that more people than just myself have experienced some of the less desirable aspects of the Italian health care system.

Hospitals are undoubtedly important in health care; however, as I said previously, most people will spend a minimum of time overall being hospitalized. The ordinary interaction with the health care system is what will consume most people's time and attention. I think it's important to explain how some of that works, or at least how some people have experienced that. Someone who only needs a prescription for high blood pressure medication will have a very different experience than I will. Not having any information of the OP's health care needs, the only thing we can do is describe our own experiences.

Most people in the US who knew me were somewhat shocked that I would consider moving to Italy, given my medical history. But I have a similar attitude towards life that you seem to: everybody eventually dies, so why not do as much as you can while you're alive! I've ploughed through life like that. Real adventures are never easy and predictable like they seem to be on TV. To me, the point of an adventure is personal growth, not fun and happiness. It's nice when there's fun and happiness, but that's not what I search for. When I look back over my life, I realize that fun and happiness happen every day in small, seemingly unnoticeable ways, and I cherish those. The big "fun and happiness" things are usually disappointing, so I gave up looking for those.

Now, back to what's going on here...Defining a problem is the first step in solving it. Part of defining a problem is pointing out what doesn't work. No one here is going to change the Italian health care system, but many people here have found ways around the problems and are sharing them. That is the power of this kind of forum. But until people talk about what is causing them problems, they're not going to get any help, and pointing out the problems is not a weakness. When someone on this forum wails about something stupid in Italy, no one should take that as a repudiation of their own experience and reasons for being here. It's just a normal expression of misery. No one should have to suck up all the stupid and suffer in private!

The take home message for the OP is, I hope, that there are problems. Expect them. Plan for them, as much as possible. There is also help available in figuring out ways around some problems. The most important thing anyone can do, though, is to know your own capacity for dealing with problems and living with imperfection.

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Sergios
10/6/2019 03:45 EST

John, as always, interesting and sage advice. But I do have one quibble with one thing you said. Nobody, cosmologically speaking, has given us a job to do. We all are in search of that thing that either gives us meaning or at least keeps us interested. When we tire of doing that or when some outside force, or internal force, decides we have had enough time, then it's over. Keep searching.

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HenryGiovanni
10/6/2019 09:11 EST

Hi Sergios,
Thanks. It's always good to hear from you, and we are glad to have you back here in Italia.

However, I will stick to my point. I suspect it gets rather farther into a religious discussion that others are more qualified to address than I, but it is my belief. Some years back, a series of events occurred that no law of probability could have allowed. As a result, I no longer believe in "coincidences"; things happen for a reason. The fact that I remain unaware of the reason does not permit me to dismiss or deny the existence of that reason.

The movie (from a book, I presume) titled "A Winter['s] Tale" takes this idea one step farther, crediting Life itself to the performance of just one miracle. In the movie, the miracle to be performed is mistaken, and life continues (for the protagonist) until that miracle is finally performed. This may be a rather casual way of showing the reason for life, but I believe it is not so far off the mark to make that much of a difference.

I don't mean to start a thread about religion, so I'll stop here. At any rate, I am the last person who could speak with any authority on the subject.

I am willing to agree to disagree, without fuss or rancor. There is nothing that says I'm right, and I have enough trouble trying to guide my own life without inserting myself as a guiding light for others. That bit is above my pay grade.

Cheers, John.

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HenryGiovanni
10/6/2019 09:25 EST

Hi maradel,
Fair enough. It just seemed to me that the conversation had turned to all negative health stories, and away from the OPs question. I do note, on looking back, that she did ask for positives AND negatives. I just prefer to look at the positives. I'm not sure what a life of negatives would make of me, but it wouldn't be pretty.

Cheers, John.

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almare2
10/6/2019 09:35 EST

Hi, John, I agree with you about being positive. However, where medical care is concerned, as you mentioned, your Italian-speaing wife can go along with you to help you navigate the system. Some of us others have been writing specifically about the situation of single women, as is the original poster. It's a little different, and anyone who moves to Italy as a single should be aware that (1) it's important to be able to speak Italian with a high level of fluency and (2) having Italian-speaking family or close friends close by to assist is very important. Many English speakers think that nowadays "everybody in the world speaks English," which as we know is not the case and needs to be pointed out. (And as I mentioned, in my own case, even though my Italian is quite good, it is 100% helpful to have a local friend helping me with the house I bought. I don't know what I would do without her.) But always happy to read your cheerful input! :-)

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HenryGiovanni
10/6/2019 10:09 EST

Hi almare2,
Yes, I agree. I have been fortunate to have an Italian wife, and to have her family here, even if they don't speak English (except for my wife, my nephew speaks "some English", but not the other family members). And it is important to have some sort of social life.

And I further agree about the medical system here. It remains doubtful whether I could have navigated that system on my own. One day I should write down how that system works so others can get an idea of the process.

People call me a lot of things, but "extrovert" isn't one of them. My Italian skills, or lack thereof, sometimes lead to a sense of isolation. I have tried to remedy that by volunteering at a local WWI museum, where only a few of the military personnel speak English. Again, I have the benefit of a translator when things get beyond my Italian skills. But I get some interaction by giving the guided tours to folks who speak English but not Italian. These visitors come from all countries, and their English ability is the only common denominator, language-wise.

Other than that, I just try to expand my Italian. One day I'll get there.

I think it must be very hard for someone on their own to just come here and live. That is outside of my experience, and anything I might say would be of questionable value. Under other circumstances I might never have come to live here. It is not easy, and those who come under those circs have more guts than me.

Cheers, John.

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maradel
10/6/2019 13:05 EST

John, I don't mean to pick on you specifically, but I want to make sure people here understand the difference between the personal choice of focusing on the positive and the need to present a balanced picture to those considering moving to Italy.

I got nothing but rosy or neutral pictures when I asked. repeatedly and on multiple forums and from individuals. It was not helpful in any way. It did not allow me to plan more realistically about many aspects of my move.

For example, I asked detailed questions about whether I could get my prescriptions filled in Italy, and what I should do about medications I have made by compounding pharmacies. The information and descriptions I received were not lies, but were so far from the reality of the effort it has taken me to get my prescriptions filled, that it's mind blowing! The stress involved in all of this is exhausting, but it didn't have to be. I could have been better prepared if I'd had more realistic information. The information I needed wasn't even specific for me, but I needed some idea of how the system works here. And there is not just one way that it works, because sometimes you can go to a pharmacy with your old prescription and say "I need a refill", and you'll get one. Other times you won't. You'll be told that you need a piece of paper from a doctor. It varies from pharmacy to pharmacy.

Also, just because a medication is included in the Italian formulary, it doesn't necessarily mean that you can go to a pharmacy and get it, even when you have the right piece of paper. Some things can only be filled by a hospital pharmacy. Some doses of ordinary medications are available from regular pharmacies while others can only be provided by hospital pharmacies. There seems to be no rational reason for all the variations that exist. It's Italy!

Providing a variety of what's being called "negative" (they're not) views can be very helpful. The examples I gave of hours of waiting, of wasted time, effort and money might be called "negative", but they are not in any way out of the ordinary for experiences in the health care system.

We need to give real information, not just rosy pictures.

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maradel
10/6/2019 13:05 EST

John, I don't mean to pick on you specifically, but I want to make sure people here understand the difference between the personal choice of focusing on the positive and the need to present a balanced picture to those considering moving to Italy.

I got nothing but rosy or neutral pictures when I asked. repeatedly and on multiple forums and from individuals. It was not helpful in any way. It did not allow me to plan more realistically about many aspects of my move.

For example, I asked detailed questions about whether I could get my prescriptions filled in Italy, and what I should do about medications I have made by compounding pharmacies. The information and descriptions I received were not lies, but were so far from the reality of the effort it has taken me to get my prescriptions filled, that it's mind blowing! The stress involved in all of this is exhausting, but it didn't have to be. I could have been better prepared if I'd had more realistic information. The information I needed wasn't even specific for me, but I needed some idea of how the system works here. And there is not just one way that it works, because sometimes you can go to a pharmacy with your old prescription and say "I need a refill", and you'll get one. Other times you won't. You'll be told that you need a piece of paper from a doctor. It varies from pharmacy to pharmacy.

Also, just because a medication is included in the Italian formulary, it doesn't necessarily mean that you can go to a pharmacy and get it, even when you have the right piece of paper. Some things can only be filled by a hospital pharmacy. Some doses of ordinary medications are available from regular pharmacies while others can only be provided by hospital pharmacies. There seems to be no rational reason for all the variations that exist. It's Italy!

Providing a variety of what's being called "negative" (they're not) views can be very helpful. The examples I gave of hours of waiting, of wasted time, effort and money might be called "negative", but they are not in any way out of the ordinary for experiences in the health care system.

We need to give real information, not just rosy pictures.

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HenryGiovanni
10/6/2019 14:11 EST

Hi Maradel,
No offense taken, and none intended. But I already knew before I moved here that I'd be out of my comfort zone in dealing with everyday things. Folks here on this forum advised patience, which I try, not always successfully, to follow. I do not overlook my good fortune in moving here; things have been easier for me than I see in the posts of others. That is no credit to me, just fact. But it is still hard, even for me, and patience pays dividends, regardless of the particular bureaucracy one must deal with at the moment. I am still out of my comfort zone, but there is some small comfort in being there, in an odd sort of way. Life was getting too predictable.

It is my opinion, and that's all it is, that more is achieved with optimism than with pessimism. I find that most of the people I come into contact with are friendly and truly want to help me with whatever problem I bring. Some rare exceptions apply, of course, but I find that the vast majority of the bureaucrats (of all stripes) here in Italy are far more professional in their interactions than I found in the US. And while maybe no faster, at least they are no slower. A constant focus on what I call the negatives, which are really little more than complaints, will likely negatively affect future dealings with the same or other bureaucracies. Sometimes attitude predetermines outcome. Put another way, a negative attitude precludes a positive outcome. Or so it seems to me.

Cheers, John.

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quietrider
11/11/2019 11:17 EST

This is a topic I believe to be of interest to many single people, esp. those of us who are of retirement age who would benefit from living in a place with others who can help each other as you describe. I would join that conversation. I have sent a PM to Shelly with some thoughts. Please do PM me should anyone else wish to begin one.

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