On the Italian Public Healthcare System and Becoming a Human Pinball

This is the Ospedale Nuovo Regina Margherita. Definitely better than Policlinico!
This is the Ospedale Nuovo Regina Margherita. Definitely better than Policlinico!

That feeling of being so sick that you breathe through your mouth to get sufficient oxygen, so sick that the floor blends like a chemical reaction and you feel like a ballerina on drugs.

That feeling when your throat has closed up and you literally have no voice and literally do not know how to communicate with anyone.

That feeling that even though you may throw up at any moment, you get up anyway and go to the ASL appointment you’ve waited two months for to finally (hopefully) get your insulin prescription.

No, that feeling was not diabetes but rather some viral infection that was overwhelming me today as I visited the faraway Ospedale Nuovo Regina Margherita for my long-awaited appointment.

I wrote rather optimistically about diabetic care in Italy before— Free insulin! Free glucose testing kits! Free blood tests!— all you need to do embody a human pinball and ricochet madly around various agencies until you somehow collect all your papers in the right order. Two months ago I was told that all I needed to do was wait for my appointment with the specialist and all would be well. Not so!

To sum, there are the steps you need to take if you’re a diabetic living in Italy who needs medication, or are dependent on medication of any kind:

  1. Apply for a tessera sanitaria. This will take multiple visits, lengthy explanations of what exactly a doctoral student is and why said students deserve health benefits, and possibly a long trek to the Agenzia dell’Entrate. Be prepared.
  2. At the ASL, choose a family doctor. Ideally someone who speaks your language, but as the list only shows addresses, just choose the person closest to you.
  3. Book an appointment with your family doctor. Anything beyond a cold and they’ll write you a referral to see a specialist, in my case, a diabetologist.
  4. Return to the ASL with your doctor’s referral to book an appointment with said specialist. Why you need to do this instead of going straight to the doctor, I have no idea. Waiting times vary, usually two to three months.
  5. Wait two to three months. Ration your medication if you must.
  6. Pay the €36,77 specialist fee.
  7. Visit your specialist wherever they may be— in my case, in the extremely faraway Ospedale Nuovo Regina Margherita in Trastevere.
  8. Congratulations! The specialist will then confirm that you indeed have diabetes! They will print this “ticket” on a piece of paper for you to show at the ASL.
  9. Return to the ASL yet again with proof of diabetes. By now you are on first-name basis with everyone there. The ASL staff will then print out another “ticket” that is the real proof that you do actually have diabetes. Be amazed at how many people it takes to tell you something you already know.
  10. Split your body into two and send half to your family doctor to get your insulin prescription, and half to the diabetic specialist to grab the prescription for your assorted diabetic needs (needles being very important, but also lancets, testing strips, alcohol swabs, etc.).
  11. Arrive exhausted at the nearest farmacia and grab all the things.* Rejoice.

* At least, that’s the general idea. Who knows how many more agencies I’ll need to bounce around. I’ll keep you updated.

I must say though that while it’s incredibly difficult to secure an appointment, once you’re in the hospital they really don’t let you go! I was passed around by three different doctors and nurses who took everything from my blood pressure to vital statistics to actual blood and scheduled a checkup and blood test for January. Hopefully I’ll have my insulin by then.


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