Healthcare in Italy and France: Which Country Has the Best System?
Italy is consistently ranked among the top 10 countries in the world for healthcare. It also has the highest average life expectancy in Europe, according to the U.N. Development Program. These facts verify what I see on the ground every day: Italy is a healthy place to live.
The Italian healthcare system is affordable and accessible; even the smallest of towns has a doctor. You need Italian residency to sign up to the nation’s healthcare system, so count on a year for the paperwork, but once you’re on the state plan, you pay an annual registration fee and you’re covered, regardless of age or pre-existing conditions.
While it is a national system, it is administered regionally, so annual registration fees can vary, but it typically costs €388 ($457) per person per year. Wait times can vary by region or city; regional hospitals aren’t usually as crowded as those in big cities.
The national health system covers everything, from basic doctor visits to emergency care to surgeries and post-surgical rehab. Also included is the guardia medica service, a doctor who is available on weekends and holidays in all towns, as well as annual preventive care, like mammograms, pap tests, and prostate exams. Specialist visits and tests, like MRIs and X-rays, require a low-cost copay called a “ticket” that usually runs €36 ($42). Physical therapy, ophthalmology exams, and even a week of medically ordered spa treatments are also covered by paying the ticket. Dental and optometry aren’t covered, though their prices are certainly affordable. I pay €50 ($59) for a dental cleaning.
Italy also has private health options in addition to the state plan. Some people here choose to buy private health insurance, others opt for a mixed approach by joining the national health system and then paying out of pocket for some specialists or procedures, to be able to choose a specific doctor or to cut down wait times. Even private options are reasonable, with specialist visits running between €75 and €150 ($88 to $176), and a private facility MRI costing only about €120 ($141).
Prescription drugs are also subsidized under the state plan, with most necessary medications costing up to €5 ($6). Over-the-counter type drugs aren’t subsidized and cost more, however. But that’s a small price to pay considering the overall quality and affordability of the health system in Italy.
By Valerie Fortney-Schneider
The healthcare system in France is easy to use, incredibly affordable, and often cited as one of the best in the world. The World Health Organization and the World Population Review have both rated France as No. 1 in health services. With universal care that’s available to all residents after living here for three months, the system is one of the top reasons expats and retirees are attracted to the country.
First off, anyone can join. There are no disqualifications for pre-existing conditions, no age limits, and no stipulations to adhere to a certain provider network. Applicants must hold a long-stay visa, or other authorization to reside in France, and must live in the country for at least six months of the year.
Healthcare is surprisingly cheap. Costs are fixed by the government and are standardized across the country. A doctor’s visit will cost the same whether you visit a practitioner in Paris, Lyon, or Marseille. Currently, and for the last 10 years, an appointment with a general practitioner is €25 ($29). When enrolled in the healthcare system (after the three-month mark), 70% of that cost is reimbursed, meaning a visit to the doctor will actually cost you around $9 out of pocket. Visits to specialists are €50 ($58), an emergency room consultation is €72 ($84), and an ambulance ride costs €125 ($146). And all of these fees are eligible for the 70% reimbursement.
Another astounding feature of French healthcare is that long-term, chronic illnesses are 100% covered under the system. Under French regulations, illnesses including cancer, diabetes (type 1 and 2), heart disorder, dementia, Parkinson’s disease, certain neurological or muscular diseases, and chronic lung disease are fully covered by the state.
In order to pay into the system, residents are charged a portion of their declared income (after a standard deduction). As an example, someone reporting $34,000 a year in income would pay around $1,800 a year for healthcare in France. Due to a tax treaty with the U.S., passive income (pensions and social security benefits) are excluded from these calculations.
By Tuula Rampont