The information I have is what I have tried to glean from around in these first years here in the United States, among friends, acquaintances and above all experiencing it on my own skin.
Once, years ago, a person told me “Remember that the civilization of a country is expressed through three great themes: education, security and healthcare.”
At the time I nodded, I was quite young and had little expatriation experience. But that concept remained with me.
Austin is a fairly safe city.
The issue of healthcare, on the other hand, is certainly the hottest, the most ambiguous, the one that splits public opinion and my heart in two.
The United States certainly has some of the best medical facilities in the world, and the latest cutting-edge medical technologies. However, the American legend that as soon as you set foot in the hospital they ask for your credit card and insurance is unfortunately true.
There is also another legend going around: if you have insurance you are safe. Of course, if you have insurance you won't sell your apartment or your kidney to pay for surgery, but equally there is a large part still to pay out of pocket and there is often a deductible above which you begin to enjoy insurance benefits.
Insurance companies have a network of affiliated doctors and if you decide to use a professional outside their network, you pay dearly for this choice.
It seems clear that the entire American healthcare system is predominantly private. The only public programs are Medicare, Medicaid and the Chip.
Medicare is the national assistance program for seniors citizens. It is for anyone and therefore it does not depend on income/retirement plan.
Medicaid, on the other hand, is a program managed by individual states and aimed at some low-income population groups.
The State Children's Health Insurance Program (CHIP) is a program designed to cover medical expenses for children of families with modest incomes who do not qualify for Medicaid.
Those who don't have a job pay for private insurance.
The cost for private insurance starts from a few hundred dollars (however, it covers very few benefits).
It is also fair to say that there are places in Austin (and I say this from reliable sources) where the humanity of some structures and some doctors exists and where those who do not pay (after several attempts to request money and after demonstrating their poverty) are covered for by the hospital itself.
In the United States, healthcare is yet another business where healthcare facilities and insurance companies play a foolish game of economic negotiations. All we residents have to do is watch in the audience, occasionally shout from the stands but basically, despite the monthly insurance expense, hope not to get sick.
I am personally shocked by this system which is very far from Italian culture, which has little to talk about on the topic of healthcare and a lot to work and improve. I have traveled enough to know the limitations of each country. And I am clear that Italy should also review the entire healthcare system. Review priorities, invest more public money, reduce expectations.
But at least, and let me say this, never in our country will you see around anyone's neck what a person once showed me here in the United States: a necklace and a pendant with the writing: “If sick, please don't call an ambulance.” That is very sad indeed.
[For attention: below, my girlfriend’s first aid kit, just in case…(she has a poor health insurance, btw)]
