Friday, June 10, 2011

Encountering "socialized medicine" enroute to Africa

Terry Rosell
June 10, 2011

Enroute to East Africa, the Lofgren Rosell family has stopped in Firenze (Florence), Italy for a few days. Daughter Hannah spent the past semester here studying art, so we are able to see where she has been and some of what she experienced. Like pasta and pizza and gelato.

And Italian hospitality.

While hiking in a coastal area yesterday, beautiful Cinque Terre, our son Nehemiah slipped and injured his foot. It is bruised, swollen and painful—perhaps a sprain but possibly a small fracture. He has plans to backpack Europe for three months upon return here from Africa, including several weeks at Thich Nhat Hanh’s Plum Village (a monastery) in France. Non-ambulatory status is not good for such plans, or those of our family for this month’s travel either. So today Miah and I rode a couple buses (convenient and inexpensive public transportation) from our hostel campground on the south side of Firenze Centrale, and easily found Careggi Hospital on the north side.

Arriving about 4:00 p.m. or so, we are here still, at 6:00 p.m. on Friday, June 3. We will wait several hours, probably, to see a physician. While disappointing relative to sight-seeing lost opportunity, this is appropriate triage for a “non-critico” condition since there are others waiting also who are more needy or were here first.

Actually, Nehemiah was seen immediately by a nurse in the Emergency Department, and then was kindly directed to Centro Traumatologico Ortopedico (First Aid) by a registration clerk. We were accompanied to this building by a physician from whom we asked further directions a bit later, and who then proceeded to sit down and enter Nehemiah’s personal data into the CTO registration computer, making sure we were well taken care of before continuing on his way. He and I had a brief bioethics discussion while walking over here, slowly on account of Miah’s injury. I noted that this doctor exhibited significant virtues, including an admirable “bedside manner.” Indeed, we have received only graciousness and compassion from everyone here thus far, and an apology for the long wait.

Earlier today Ruth asked someone what all this would cost. The answer received is familiar to those who have traveled outside the United States and required urgent care. Those queried here smiled and said, “Free, of course! Healthcare is for everyone in Italy.” Even American tourists.

We learn in CTO that we will encounter some charges anyway, for X-rays, crutches (from a Farmacia), an Ace bandage, and a small doctor’s fee on account of being in the next to lowest priority code of triage. But for the most part, universal healthcare means that those who are injured or ill get seen by a doctor as a matter of course, a human right. If any worse than a minor hiking injury, your neighbors will take care of you completely. When it’s their turn to need help, we all take care of them. How could one argue that this sort of “socialized medicine” is inferior to the American way of healthcare commodification? I am disinclined to do so.

All communication has been accomplished with accommodation to our language handicap, not having learned to speak Italian while in Italy. We are grateful, and a bit embarrassed, by the hospitality of those who cater patiently to our own ignorance. My better educated son gets by, somewhat, speaking Spanish. But his daddy is still pretty much mono-lingual.

And gratefully waiting.


P.S. Nehemiah was seen by a doctor, after a few hours wait. X-rays were normal. No fracture, just a bad sprain. Total cost to us for ER and urgent care visit, radiology, elastic bandage, nursing and physicians, English and kindness = 46 Euros ($67). Grazie.



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