Saturday 20 November 2010

The cost of having a baby in Italy

Before falling pregnant, I had often heard that having a baby in Italy is free. Since becoming pregnant I have found out that for most people this is not the case. The cost of medical care varies from region to region and I can only speak of my experience being pregnant here in Calabria.

In Italy you can choose to go private or public. Private means you call and book your own appointments with a gynecologist in his/her private clinic. The majority of these doctors work in the public hospitals and have a private practice on the side. You will be looking at paying around 100 euro per visit - and this is without a receipt. If you ask for a receipt then you'll pay more, about 120 euro. Why...well - I'll let you figure that out, don't forget this is Italy we are talking about! You can have visits, and also ultrasounds at these private clinics, but don't be shocked if you get charged as much as 150 euro for an ultrasound. Also, don't be expecting a calm, orderly experience. Yes, it may be more calm then a lot of hospitals but you still have to wait your turn. When I went for a private visit, I was given an appointment at 10:30am. Stupidly thinking it would be like a doctors appointment in Australia, I assumed at about 10:45-11:00 I would be seen. I did not expect to walk into a waiting room full of women who had all been given a 10:30am appointment. It is then first come, first served of the batch of women with the same appointment time.

If you don't go private then the other option is to go public, which means booking your appointments with the public hospital. Here in Calabria gynecologist visits during pregnancy are free at the public hospital for all pregnant women. A lot of people prefer to go private since often you have to wait for an appointment at the public hospitals, and also you may see a different doctor each time. If you go private you can call and mostly make an appointment for the next few days. If you go to a big public hospital (such as Cosenza) then you need to wait about 3-4 weeks for a visit. If you're closest public hospital is smaller and less busy then the wait it much less. Bel fidanzato and went private for our first appointment, were shocked by the price for all 2 minutes of the gynecologists time, and since then have gone public. We have seen the same gynecologist each time and although she may not be the most happy, friendly person, at least she is always the same person, and at least she is free and seems to know what she is talking about.

Having ultrasounds and getting your blood/urine tests are charged depending on your circumstances. If you want to have anything done at a public hospital then you need to go to your general doctor and get them to write you a receipt/ticket. In Italy you register with a doctor, and this also is a free service for all Italians. If you visit another doctor then you pay, but if you see 'your' doctor, it is free. For example, your gynecologist will say you need to get X,Y,Z blood tests, you then visit your doctor who writes these on a ticket, and you then either go to a private clinic and pay, or make an appointment at the public hospital. If you go public, you will need to pay for this ticket. The price of a ticket depends on what you are getting done. If you need to have an operation, anything at all (not just pregnancy things), you must get a ticket and make the necessary payment. This can be anything from 2 euro - 40 euro, and possibly more as I don't pay for a ticket.

Now, why don't I pay for tickets? Well, thankfully here there is help for those on lower incomes. When we moved to Malito, bel fidanzato and I went to the comune to see what assistance there was. A friend had told us that she has this health care card of sorts which also gives you a discount on the electricity bill and medicine. To request this assistance you have to declare your earnings (as an individual/couple/family) for the previous financial year. If you fall below the threshold then you are entitled to this aid. Bel fidanzato and I fall into the bracket of low income. You also have to declare all assets, which unfortunately for us is next to nothing at the moment! I would recommend that those of you living in Italy go and speak to your comune to see if you can get this benefit.

It has been a god send for me since I have so far only paid 105 euro during my pregnancy (100 euro for my first private visit, then 5 euro later for this special sugar drink test to see if I had diabetes.) Since developing diabetes, I've had to have extra ultrasounds to make sure the baby is not growing too big, I also have to visit the diabetes specialist nearly every week, on top of my monthly gynecologist visits, and blood tests. I've recently been put on insulin and have not had to pay as much as one cent for my blood level testing kit, my testing strips, little needle things, and the actual insulin-pen like contraption thing I have. I do pay for my multi vitamins, but then that is to be expected as they are not a necessity, but a choice! In this sense, for me, having a baby in Italy has been money wise, stress free.

Up until my last blood test, I was also able to visit a beautiful private clinic and not pay for tests, but at the end of September there was a change in law here in the region of Calabria that says those of us with this benefit can no longer use private clinics. This is fair enough and not something I can be angry about as I did think it was a little too good to be true that I was able to go to any private blood testing clinic and have my tests done for free. The down side of this is that to book in for blood tests at public hospitals often means a long waiting list. The upside of this downside is that normally when you tell people you are pregnant they give you a little special treatment, and let you bend the rules....most of the time.

Now I've explained private and public costs for appointments, ultrasounds and blood tests, I need to move on to the birth itself. The funny thing that I have found is that the majority of women go private during the pregnancy, but then go public for the birth. This is for a few reasons. As I said above the majority of private gynecologists work in the public hospitals, so will be there to deliver your baby, also the public hospitals are much better equipped to deal with emergencies should they arise. The Cosenza public hospital also has a beautiful maternity ward. The rest of the hospital is as ugly as can be, but as soon as you enter the maternity ward you are put at ease by the pastel colours decorating the place. The corridors, bedrooms, everywhere you look, it painted in pinks, blues, purples, greens and yellows. My friend who has given birth there twice has nothing but positive things to say about the care she received in hospital.

When the baby starts letting you know 'it's time' then you need to go to the emergency ward. If your waters break, or contractions start then you don't book into the hospital. (If you have a C-section, or are going to be induced etc...then you make an appointment but it's still free.) Once you are seen and assessed you'll be sent up to the maternity ward, given a bed in the shared rooms (most of them are 2 or 3 beds) and then discharged after a few days.

So that is my rather confusing description of having a baby in Italy - well, a description of my experience having a baby in Italy! If you have questions I will try and answer them, and I will be posting more on this topic too.

EDIT: You may want to read my comments, as after posting this a fellow blogger has lashed out at me for basically taking advantage of the Italian government, saying that more or less I should not be entitled to this benefit. Perhaps I was not clear with my post, but I would like to say again that healthcare in Italy is more or less free FOR EVERYONE and that people only pay for tickets. In Calabria a gyno visit during pregnancy is always free regardless of your situation.

I would also like to say again that this benefit that I have is for people on a lower income - not just unemployed people, and furthermore I am not unemployed. I work and I pay tax (a lot.) I will apply for this benefit again next year, and I will get it again as my income from 2010 will still be under the threshold. A lot of people have lower incomes in Italy- by saying lower income I don't mean we are poor, starving victims crying out for help. I just mean that the government has at least acknowledged that if you fall below XXX euro per year, then you are able to get a little bit of help with medical care. There is a massive, massive differnece in wages here in Italy, a large division between high and low income earners, and FYI my discount on the electicity bill is a whopping 6 euro if I am lucky - so it's not like I am not paying even for my lap top to work! There are many benefits available in Italy and I do not claim, nor have I ever requested any of them. The differnece between me, and someone without this benefit is that they pay for their ticket and I don't. The operations, the doctor visits, the medical care is always free in Italy, you just pay a minimal amount for a ticket. I hope one day to not have access to this benefit, I hope one day my income is no longer in the lower wage category, I hope to have a finished house which will be a great asset to me...I hope, I hope.


Andrea said...

I don't want to come across as a bitch but I am curious as to why you would choose to have a child when you're not in a financial position to do so and require the government to help you? Honestly, this kind of thing really pisses me off. It was your choice to live in a small town where there aren't many jobs and the salaries are extremely low. You're free to live anywhere in Europe (or Australia) and get a decent job and pay your own way but you're going to get government assistance because you think it's great to live in a poor village. I think that sucks. Government aid should be for people in desperate situations, not for people with all the opportunities you have.

Leanne was in Italy now in Australia said...

I am very offended by your comment as you don't know what position I am in. I never said I was not able to afford to pay for a child, nor did I say that I don't have an income. I am not a stupid person who decided to have a baby without thinking first. I am not going to bring a child into this world if I cannot support it.
For your information I work, in Italy now and I pay tax - a lot of tax I'll have you know, as here, unlike Australia there is no tax free threshold. If I make 1 euro then I will pay tax on that, and I will never see that tax coming back my way. In Australia there are tax free brackets are there in Italy you get taxed from 1 cent up and don't get to claim it back at the end of the financial year.
I therefore feel that I am entitled to any benefits that I can, since this benefit is not just for poor unemployed people, it is for people who have a lower income then others. I work, I pay wages and pension contributions but why should I not be entitled to medical assistance????
I also don't appreciate you putting 'words' into my mouth as I never said that it's great to live in a poor village. I never even said my village was poor! It's not some small, poverty striken place which you seem to think.
I pay my taxes, which are very high with no rebate what so ever, I enjoy to live in this village which for your information is not a poor village, and I contribute to society. If the government has a scheme to help people cope, especially during this crisis then I am happy about this and think it is a positve thing for the country. In Australia there are tax breaks and assistance depending on your income, so why on earth should it not be the same in Italy? Why should everyone be treated the same? It depends of circumstance. Like you said government aid should be for people in desperate situations and this is available to them, but this is NOT WHAT i AM TALKING ABOUT AS I AM NOT GETTING GOVERNEMENT AID. If I wanted to cheat the system like millions of people do, I could apply for many differnet types of government aid, unemployment benefits for example but I am not unemployed. There are more government benefits in this country then you surely have heard of, and I have never applied for a single one. I have applied only for this healthcare assistance which hardly makes that much of a dent into a public healthcare system which technically is meant to be free. If you read my post well, you will have noticed I said that public healthcare here is more or less free, except for the cost of the tickets. I am exempt for paying for a ticket, but other then this, if you go to hospital here, even if you are a millionaire - it is free BENEFIT OR NOT. So what difference does it make if I - on a lower wage at the moment - don't pay my 10 euro ticket and Mr X, on a 6 figure salary pays 10 euro for his ticket. Where is the differnece???? I never said have 'saved' thousands of euros with this benefit. I have said I chose NOT TO PAY A PRIVATE GYNO, BUT CHOSE TO GO PUBLIC. Why? Not only for the cost, but because you don't get a receipt unless you pay for it since the private Gyno does not want to declare these who is cheating the system? Me, on a lower wage who pays taxes, or a private gyno making a sack full of money and not declaring it!!!! Not paying tax on it!!!!!
I am no fraud and I am offended by your comment as I pay my own way.

Andrea said...

Well I knew my comment wouldn't be appreciated and I accept it's really none of my business so I probably shouldn't have said anything.

You're taking what you're entitled to by law, I get that, but you could be in a better financial position if you chose to live elsewhere and get a better job so you wouldn't need that money, which was my point I guess. I know you have a job and are not cheating the system but you are on a low income by choice.

By poor village I mean somewhere where the salaries are very low and jobs are hard to come by, which I'm sure is the case in most Italian villages. I doubt many peope earn over 1200 euros a month there.

I pay a lot of tax too you know. I probably pay more in tax than you earn. What do I get for that? Niente. I don't even get 'free' healthcare because I pay more Medicare taxes than other people plus I have to pay for private health insurance or else I'd have to pay even more medicare. All my taxes go to support these people who don't want to search out better jobs like I did. All my hard work benefits other people. Lucky me.

So anyway, I'm sorry to offend you. It's really the system which annoys me more than anything as it discourages people from doing better for themselves when they have all these benefits to fall back on.

I'll go back to minding my own business now and won't comment again. Sorry if I upset you.

Leanne was in Italy now in Australia said...

You are welcome to say what ever you want/feel on this blog but if you are not sure of what you are talking about then you need to check facts etc...first.
In Italy - in Rome for example - the capital would be counted as lucky if you have a salary over 1200 per month. That is a great wage not a poor persons wage. With this wage, if you wanted to rent a bedroom in someones house, you would be looking at about 400 euro up per month. For a studio flat about 800 up so we decided there is no point working up there when the cost of living in too high and you work just to pay rent.
If see your point that if I moved back to Australia, Rome, the north of Italy or even back to the UK then it may be possible to earn more money, but then I would have to pay the better part of my salary towards rent which is not something I want to do. Also I love living in Italy, with all of its problems, it also has a lot of positive aspects.
If I moved out of Calabria I would probably be in a worse financial position. I would have no family in Italy so would have to pay for childcare if I returned to work, I would have to pay rent, I would have to pay for fresh fruit and vegetables when here I have my partners family, we have a place to live, and a farm where fresh fruit and vegetables are grown.
In Australia I know the wages are much higher, but then the cost of buying a house is much higher too.
I know the taxes in Australia are high too and I am glad you have a well paid job - as long as it makes you happy. A lot of people are very money focused in Australia, London, north of Italy etc...and live to work rather then work to live. Perhaps you don't agree with this, as you think we all should live to work but I enjoy my life here, I am happy that with all of the problems I can get a little help with medical care and like a lot of people here I hope to find a better paying job so that I am no longer entitled to this benefit. That is my aim - to find a good, secure job, but being pregnant it is impossible to search for a new job at the moment so I will accept any financial help that comes my way.

LindyLouMac said...

Hi Leanne, I found your post very interesting about how the health care system is working for you while you are pregnant. All of us have different experiences to write about, you are Australian but marrying an Italian so quite rightly entitled to these things. I was sad to read the lashing you got for honestly sharing your experiences with us :( Take Care xx

Angela said...

Hi Leanne,
I too find it outrageous that you have been accused of taking advantage of the government benefits when you are 100% entitled to them. I dont see why you should be punished for wanting to live in a different country full of culture and life and a great place to raise a child. Some people clearly have no clue what Calabria offers. You dont have to have high salaries to be able to live a normal relaxed life and raise a family. I wish you all the luck in the world and im sure all your hopes and dreams will come true. Take care xoxo

Kataroma said...

Ummm congratulations on your pregnancy! I'm not going to get into the ins and outs of who is or who is not entitled to government assistance but just wanted to say congrats.

Here in Rome I paid a ton of money for public medical assistance during my pregnancy. :( What a rort!

BTW- I guess you know this already but be really careful about what hospital you go to - I've heard some very negative things about birth (particularly the sky high caesarean rate) in parts of the South.

Carolina said...

Hi Leanne, Thanks for all the info about the private v. public health system. When I had my boys there, I didn't understand it too well, and we chose the private route but fortunately it wasn't as expensive back in the time of the lira. I too am offended by the previous comments and, like you, love the paese and all it has to offer. I can only say too bad that not everyone thinks before speaking and can respect individual choices. Good luck with everything and I am excited to see you and the baby this summer!

Leanne was in Italy now in Australia said...

Hi LindyLou,

I'm glad you liked the post. I found it hard to come by information on the web for the cost of having a baby in Calabria - there was next to no I thought to share my experience to help other people who maybe wanted to know.

Hi Angela,
Thanks so much for your kind comments :)

Hi Kataroma
I thought Rome had some good assistance for pregnant people, or maybe that is just Milan and more north. I read right up north they give all mothers in some village free nappies for the first 6 months. Imagine that!

hI Carolina
Can't wait to see you again this summer! Glad you'll b coming back!

Canedolia said...

Hi Leanne, I don't know what country the person who wrote the original comment comes from but I get the impression that he or she has no idea how healthcare works in most European countries. You pay into the system as much as and when you can and you receive varying benefits at different times in your life and under different circumstances. If I live to an old age, I fully expect to cost the system more and pay into it less than I do now, because that's life.

Unless you go totally private, everybody benefits from government healthcare in some way and the rules are designed to share out the money fairly. I think it's great that in Italy, where in my experience you don't get much in return for your money, you've been able to claim this benefit.

Hope everything is still going well!

Emmina said...

Hi! I can identify with pretty much everything you say in your post - here in Milan it's the same situation with the 100-euro-per- visit gynecologist, long waiting lists at public hospitals and (in my case at least) 38% income tax. I think it's very unfortunate that you were so harshly criticized by someone who obviously doesn't understand the system, but then I guess that's one of the risks of blogging... If people only knew how the benefit system works in the UK they'd never dare criticize a person who works in almost benefit-free Italy, who puts in and then takes out the small amount to which they're entitled!

Glad things are going well with the pregnancy anyway... Take care!

Leanne was in Italy now in Australia said...

Hi Canedolia,
Yes, the person mustn't understand how healthcare works in European countries.
And your right when you say this is a good thing that Italy offers, since there are not that many financial benefits to living here!

Hi Emmina
You are so right - people put in a lot to Italy and like Candolia said too, we get so little back that when we can get something back, then we may as well take advantage of it.