tag:blogger.com,1999:blog-8778001285727771343.post4372772192528164305..comments2009-10-10T09:36:00.306-07:00Ercolehttp://www.blogger.com/profile/07624336130332596024noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-8778001285727771343.post-23202344881850260932009-10-09T08:59:33.069-07:002009-10-09T08:59:33.069-07:00Gentlemen,<br /><br /> The World Health Organization evaluates the health care systems of all UN countries on a regular basis and Italy has always figured 1st or 2nd on a global scoring scale. Of course reactions coming from countries like yours and mine can be generally characterized as being dismissive, citing anti-Americanism as a reason for the relatively low scores despite spending 1.5 trillion dollars per year on health care expenditures. Canada has a universal “Medicare” system with a single government payer and near complete physician participation; there are some physicians who have opted for private practice and are generally paid by government and private insurance plans. Rather than ridiculing and trivializing the Italian health car system (actually the main target is Italians themselves), it may be worth looking at hard statistics. The country has among, if not the, longest life expectancy particularly for women, lowest infant mortality, lowest adolescent death rate, and highest levels of live births. Italy (and France) has a universal health care system with both government and private participation. <br /> There are a few observations I’ve made while traveling there (as a visiting clinician/scientist) that may be significant. Even hospitals in relatively small towns have advanced diagnostic equipment (often paid by religious groups) with the capacity to offer tertiary care for all citizens, eliminating the need for referrals to large and crowded university hospitals. Salaries for physicians are relatively low by North American standards meaning that they can supplement their base salaries by serving as often as they wish in community clinics that provide primary care. Interestingly, certain pharmacies have doctors that serve on staff so that minor ailments (e.g., eye, ear infections) can be dealt with quickly and inexpensively with little or no waiting times. Perhaps my least objective observation is that Italian medical schools seem to instil a passion for the practice of medicine; one peculiarity is the lack of formal written exams, instead using oral examinations likely to determine the communication skills of the students. Lastly, their health care system is based on PREVENTION and Italians have been practicing medicine for millennia.<br /><br />CheersJohnhttp://www.blogger.com/profile/16558424820424726809noreply@blogger.com