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Differences Between US and Italian Healthcare Systems

On March 15, the Norwegian University of Science and Technology posted on their official Facebook page, to encourage students studying abroad to go back to Norway, if they were “staying in a country with poorly developed health services and infrastructure and/or collective infrastructure, such as the U.S.” 

The post, which has since been edited, was turned into a meme that was passed around the internet for laughs.  Though the message was turned into a joke, it did bring up relevant points and questions about the American healthcare system in a time of crisis.

US Healthcare System

In the U.S., the health insurance industry is privatized.  American citizens are not guaranteed healthcare through the government. Instead, they can purchase health insurance coverage from an insurance company, or it can be awarded to them through their employment.  If they qualify for Medicare (assistance for senior citizens) or Medicaid (assistance for low income individuals and families), which are funded by taxes, they are given a healthcare package, but they may have to pay for partial coverage. Members of the military are also guaranteed healthcare.  The U.S. is the only developed country where an individual is legally allowed to be uninsured.

About one half of insured Americans are insured through their employer.  In this case, the employer generally pays for a large portion of the coverage.  If a tourist or visitor in the U.S. requires medical assistance, they will likely pay for their treatment out of pocket, unless they have travel insurance that covers them.  Because the industry is private, medical care in the U.S. is notorious for being expensive.

Italian Healthcare System

Italy, like every developed country in the world except the U.S., offers universal healthcare for all citizens.  Italy’s Servizio Sanitario Nazionale (the Italian National Service for Health) considers healthcare a human right.  Hospitals are funded with tax revenue, and each region is responsible for fund distribution.  While healthcare systems are organized differently in each region, every citizen is guaranteed basic healthcare to cover livelli essenziali di assistenza (essential levels of care).  Many treatments require a small co-payment from the patient, but the cost is low.

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Legal foreign residents and undocumented immigrants also qualify for these benefits.  Tourists are generally required to pay for their medical services (although emergency medical services in hospitals are universally free), but the cost is much lower than in the U.S.

Private healthcare services exist, but they are supplementary to the automatic national coverage.  According to the Commonwealth Fund, in 2010, only around 5.5% of the Italian population paid for private healthcare services. 

U.S. and Italian Treatments of Coronavirus

As devastating as the coronavirus has been on Italians and the Italian economy, the Italian healthcare system has allowed sick individuals to receive the care they need without costing them financially.

In the U.S., on the other hand, many citizens have expressed concerns about paying for COVID-19 testing and treatment.  According to Human Rights Watch, Covid-19 treatment can cost over $20,000 for each individual.  While insured US citizens will not have to pay for the entirety of their treatment, uninsured individuals have no choice.  The crisis has already taken an enormous economic toll, but many U.S. citizens face personal debt and further financial hardship from treatment costs, if the situation continues without large-scale intervention.

Ph: George Sheldon /

Orchestra dell’Accademia Nazionale di Santa Cecilia
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