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Trip Report: My Encounter With the Italian Hospital System

Trip Report: My Encounter With the Italian Hospital System

Old Mar 2nd, 2015, 11:28 AM
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We'd never purchased trip insurance prior to our last trip to Paris last Oct., but this was our first trip when my husband was on Medicare and, knowing there's no foreign coverage for Medicare, we decided we should start buying it when we travel. We also were concerned with getting insurance for evacuation home if circumstances required it. We didn't have to use it fortunately, but we will continue to buy it in future -- the cost is quite affordable. Even if medical charges are considerably less than in the US, it seems like a good thing to have in case of emergencies that might require extended care or surgery -- and this can happen to anyone, not just older people.
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Old Mar 2nd, 2015, 11:41 AM
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sandralist

> But I have never heard a consistent case that private hospitals provide better care in any key area.

I am very much a fan of the Humanitas private hospital in Rozzano near Milan, to the point that I often go there for routine tests or visits from Florence. But, as I wrote, it is an exception and generally I am less than enthusiast about private hospitals. A small private hospital in Florence administered to my mother some gynecological surgery that was probably unnecessary; probably a non paying patient would have got a cheaper and less invasive alternative. And I was once friend with a young doctor that had to accept, as one of his first jobs, being the only doctor during all the nights at a private clinic and having to be alone to face all emergencies.

Not that all public hospitals are on the same level. Judging from friends' experience, in Florence Careggi is fairly good (but the hotel treatment not particularly distinguished) and S. Maria Nuova is good also. Another public hospital is not as good. I have already lost three friends there that had various forms of cancer that were diagnosed way too late.
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Old Mar 2nd, 2015, 11:49 AM
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ileen

> Now, I am wondering how many of Fodorites, who don't have any health concerns and are healthy venture on a trip without getting medical insurance.

As an EU citizen I have coverage in EU and Switzerland and this covers most of my ordinary travels. Sometimes I have to travel to more distant places for work, but often there are reciprocal assistance agreements between states and this cover much of other travelling I do.

Then in 2011 I changed mind. I had to do some work in Japan and I was covered by the reciprocal assistance. My wife came with me and I buyed insurance for her - and actually discovered that buying for both of us was about the same price.

Well, we ended to be in the big March 11th Japan earthquake. We did not use the insurance but we still had to leave in an emergency. Since then, I buy insurance for all my travels outside Europe. Do not know why but I feel it is the right thing to do.
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Old Mar 2nd, 2015, 12:12 PM
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We do not purchase medical insurance. Our supplementary insurance covers emergency care, and we have never been denied reimbursement. We are not covered for emergency evacuations. The one time one of us was immobilized for 6 weeks, it was better for us to be in our house in France than it would have been coming back to the States. Now that the house is sold, we would have to look at what options would be available.
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Old Mar 2nd, 2015, 01:23 PM
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tom18, that was a fascinating account, thank you.

********
hi elizabeth_s

i don't know yet if i'll need surgery.have a followup with an ortho this week. thx for asking.

***************

flanner in canada the medical education system changed. b4 all med students qualified as a gp and only then went on, if they so desired, to specialize. now students stream in to their chosen field right away. i don't have stats avail but i have heard the pool of practicing gps has shrunk whereas in some popular cities there is a surplus of very expensive specialists. so on the supply side there may be probs.

on the demand side i never dreamed i'd ever say this, but i'm actually glad of so-called alternative medicine so long as it isn't taxpayer-funded. people who want that stuff are free to pay for it, and judging from sales presumably are paying for it. i encourage them to do so because it leaves the tax paid system less clogged by people wanting whatever it is that a.m. stuff claims it does.

when i dislocated my wrist last week i didn't need 'holistic' care, it was my wrist i'd dislocated and broken and not, thank God, every bone in my body. There are times when narcotics are a good idea and this was one of those times, thank you Big Pharm. a shot of morphine was in me as soon as convenient for the e.r., which fortunately was soon. once plugged into an i.v line and aforesaid narcotic made me stop obsessing about walking off the nearest cliff, i was quite happy to flip open a magazine with my good hand and wait. i expect to be seen when i need to be seen, which may not be when i want to be seen. this is the secret of social health care, all the care you need, not all the care you want, when you want.


as it is i was lucky, i was treated further right away.
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Old Mar 2nd, 2015, 01:41 PM
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Well, this has been fascinating and has reminded me that I am indeed getting older and will need to think about medical insurance coverage next time I travel.

Just to put a different spin on this, I had friends visiting from London and one of them fell in Sedona. We had no idea what was wrong so called 911 and they took us to a local emergency room.

To make a long story short, he had broken three ribs. They had travelers' medical insurance through a credit card they used for travel. Because the hospital could not get a US contact number, they requested a $200 deposit and asked my friend to contact their insurance company when we got back to L.A. They did that, received US contact info, and the two insurance companies are working out payment - and reimbursement to my friends less their deductible.

Again, evidence that traveler's medical insurance is a good idea.
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Old Mar 2nd, 2015, 04:33 PM
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Our insurance covers medical expenses outside of the States, so no deed to buy separate travel insurance for us. The few times I have needed to use it the carrier is more than happy to pay the bills as the charges are much less than those charged at home. I, for one, will never purchase evacuation insurance, as I would much rather stay over and be treated in a French hospital than bundled back to the States. DW could bring bring me take out from a nice local French restaurant.

Also, we both have separate international coverage for cremation if I fall over in a foreign land. They come whisk you aay in a cardboard coffin and deliver the ashes to the widow in a much smaller cardboard box. She could even use them to fertilize the Jardin des Plantes or dump them from the Pont des Arts. Better for the plants and to the river than those love lock keys.
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Old Mar 2nd, 2015, 05:53 PM
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I did not have travel insurance when I spent 16 days in the hospitaly in Bologna and I lost significant money due to cancelled hotel reservations and re-booking air tickets. Thereafter, I purchased travel insurance and when I became ill in Japan, the travel insurance paid for all extra hotel costs for me and my husband, plus the cost of re-booking air fare for me and my husband, and also paid for a plane flight for my husband and I inside Japan when the doctors advised me to fly to Tokyo rather than take the train when I was released from the hospital several hundred miles away.

So while medical insurance might cover all your medical costs, it won't cover the costs of interrupted travel or excess costs like needing to stay extra nights in a hotel or upgrading your transport if you are too ill to drive or take public transport.
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Old Mar 2nd, 2015, 05:56 PM
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interesting points, asps.

Also meant to add that I don't think travel insurance is just for senior citizens. I was far from being a senior citizen when I ended up in the hospital in Bologna! But if US senior citizens are covered by Medicare, I am pretty sure that Medicare doesn't pay foreign medical costs.
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Old Mar 2nd, 2015, 10:28 PM
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https://www.youtube.com/watch?v=yVgOl3cETb4
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Old Mar 3rd, 2015, 12:21 AM
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@ tom -- thank you so much for sharing your story!

I wouldn't have been able to even begin to imagine what those days would have been like for you had you not described them, and I can't imagine what they were like for your wife! And "honestly" (<u>NOT</u>!!!), I'm not sure I would have believed your story if you hadn't explained the lousy pasta. ;-) Maybe you had a secret desire to spend days on end in an alien and not particularly welcoming environment solving sudoku puzzles, but if that wasn't your goal, then I commend you for the humor and equanimity with which you approached this untoward event. Mostly, I'm <b><u>very</b></u> glad that you got the care you needed and -- if I understand correctly -- came home no worse for the wear and in time for appropriate treatment.

Kudos, Mr. & Mrs. Tom18! Thanks again for providing a window into this otherwise private experience. Very best wishes for many eventful (if, perhaps, more predictable) future endeavors!
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Old Mar 3rd, 2015, 12:42 AM
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I have never travelled without travel insurance. Have encountered patients that have returned home to Australia after ordeals overseas and enormous bills / horrible experiences once running out of cash to pay medical costs.

Tom, did you get to enjoy Verona eventually?
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Old Mar 3rd, 2015, 12:51 AM
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On the subject of travel insurance, in general pre existing medical conditions are not covered. So even with travel insurance, my father's cancelled holiday due to an unexpected need for an urgent mitral valve replacement was not covered by his insurer as he did have a cardiac history.
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Old Mar 3rd, 2015, 01:05 AM
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A friend of mine had to go to hospital in France and talked of nothing but being offered calf brains for lunch and the main medicine delivery system (not by mouth is the only hint I'm giving).
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Old Mar 3rd, 2015, 03:22 AM
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Knowing what I do about the public and private hospitals in Italy, I would never go to a private clinic for anything serious or for an operation.

There have been numerous problems in the news about bad outcomes in private clinics. There have also been such stories about public hospitals, but since there are many, many more public hospitals, the number doesn't seem to me to be proportionate. I also know personally some people who haven't, in my opinion, had adequate care in private clinics. I think they're in general understaffed and underequipped to deal with an emergency.
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Old Mar 3rd, 2015, 04:01 AM
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I've had brief experiences within the past 2 years with emergency rooms in Frankfurt, Venice, and Paris. I'll skip all the medical details but key points were: I never thought beforehand about whether or not airports have a medical facility. Frankfurt does, and it was very good.There I learned that when you cancel a flight for medical reasons (I was en route to Venice), you must return to a doctor and get a "fit to fly" piece of paper before the airline lets you back on.

Cost of spending a few hours in the emergency room in Frankfurt was about 20 euros.

I was in the emergency room twice in Venice and then overnight "in observation." My room had two beds and the other was not occupied. I took a pillow from the other bed so I'd have more support. Later, the nurse took it away from me and put it back on the 2nd bed without changing the pillowcase. And the floor was quite dirty; luckily I had my husband bring extra socks for me. But the doctors seemed good and they even brought in a specialist on a Sat. to see me.

Paris was the worst emergency room. I begged and begged for them to call my cardiologist in the US and they simply would not. I said I knew I was dehydrated and they never offered me liquids, much less hooking me up to a drip, even when tests showed I was in afib-- so I managed to get a cup and use water from the bathroom tap. the bathroom door had a few drops of blood on it. No antibacterial stuff anywhere around like we have in the US. The one good thing: it's been 6 months and they haven't billed me.
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Old Mar 3rd, 2015, 05:16 AM
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Thanks for an excellent TR!

I do not generally bother with trip cancelation/interruption insurance - I suppose you could say I self-insure - although I am comsidering it for a forthcoming Hurtigruten cruise with my elder sister. However, medical and medical evacuation insurance are a different matter. I used to be covered for travel abroad by my US medical insurance, but now I am on Medicare, and the megacorp I retired from has stopped its group "top-up" plans, I bought medical insurance for my last trip and will do so again.

Note that I buy evacuation AND repatriation imsurance (usually from Seven Corners). Since I travel alone I definitely want to be returned home. So far I have only needed it once, when I broke my wrist in Switzerland. I got myself (with help from some wonderful bystanders) to the hospital, but the insurance company sent a car and driver to get me to Geneva airport, and provided plane tickets home. I was the only patient in the emergency room (!), and spent the night in a small ward where the beds were arranged in a horseshoe around tall filing cabinets, which afforded more privacy than the long lines I remember from a British hospital stay in the fifties. The hospital did inquire about my insurance status. I noticed (sadly) that the cost of the Xrays, the surgery to insert pins, the one night stay, and the doctors' fees were the same as the cost for out-patient surgery in the US to take the pins out.

I did visit a hospital in Italy (Sorrento) on one trip, and also visited the Guardia Medica (Cefalu), both times for cold and flu type symptoms including a hacking cough. The former charged me 25 euros as a "code white" patient, the second was free. Now I know what the "code white" meant! (My hotel had sent me to the "International Clinic", but I found the ER instead.)
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Old Mar 3rd, 2015, 06:27 AM
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asps, you only have coverage equivalent to that offered in the country you are ill in, and then only if you are taken to a public hospital in an emergency, not a private one.
So if in that country it is normal to pay for certain things then you too have to pay. You also have to produce your EHIC to receive coverage. An EU passport alone is not enough - you have to prove you are insured in your home country.
Extra insurance is always a good idea, even for EU citizens in possession of an EHIC.
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Old Mar 3rd, 2015, 07:12 AM
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<i>the main medicine delivery system </i>

I believe that this is changing. But the theory behind medicine in suppositories is that it gets into the bloodstream more efficiently and by-passes the stomach acids.
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Old Mar 3rd, 2015, 07:30 AM
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You could have told us that, Bilbo! We're all grownups.
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