2 (uninsured) trips to the ER in 1 week! Wait 'til you see the bills...

These past few weeks have tested my functioning-in-Italy prowess as I needed to take Caiden to the Pronto Soccorso (ER), twice, in two different cities. He started complaining of pain in his groin area so I did what any Mom might do-- & called his (male, same parts) Dad, my husband. I asked if this was normal & neither of us knew. But, we assumed it could be a growing pain & thought we’d take a wait-and-see approach. Three days go by & Caiden’s pain had gotten worse, but it was only in one testicle, which seemed odd, so I did the thing you’re not supposed to do & I Googled the situation. Immediately, article after article popped up that said this is NOT normal & can be a sign of a serious, emergency situation. I quickly learned that his testicle could be twisted & if this occurs we have, perhaps, 8 hours to surgically fix this, otherwise it can die & it would then need to be removed (ummmm, HOW was this not in the ‘I have a son & here are the cliff notes of what you must know to raise your little man’???). I hurriedly decided to take Caiden to the ER, but we were on vacanza (vacation) in Otranto, Puglia (think heel of the boot of Italy) so I consulted with the folks at the front desk of our masseria (Pugliese farmhouse) who directed us to an ospedale (hospital) about 25 minutes away in Scorrano. My head spun as I made the drive; mostly with worry for my child, but also, because I knew I was staring at the base of a steep, craggy & difficult mountain. Questions spun in my head like: Will they even admit or look at him given the Covid situation?, I don’t have Italian health insurance so HOW much is this going to cost?, Can I clearly tell these medical professionals what’s going on in my broken Italian & then, understand the diagnosis & recommended treatment? Mama Mia, this was going to be challenging, to say the least, but I swam in an ocean of guilt knowing that my stall of action could cost my boy a very essential body part & perhaps impact him, someday, if he hoped to have children of his own. Yes, my mind went A to Z, but I kept all this inside & calmly said to Caiden that we really needed to have his testicle examined & get to the bottom of whatever was going on.

Once at the small, local hospital I was pleasantly surprised & mildly relieved when I encountered no problems with the check-in. In a hushed voice I explained that mio figlio ha dolore in un testicolo (my son has pain in one testicle). Apparently, everyone’s in the know about how urgent this problem can be as we were rapidly ushered into a waiting room & about 10 minutes later a doctor & nurse had Caiden lying pant-less on a bed, behind a curtain, & were roughly examining his crowned jewel. My kid nearly hit the ceiling as he writhed in pain, tears in his eyes, while his hand squeezed mine in a vice-like grip. In rapid Italian the doctor relayed that the testicle was not twisted & that there was an infection. To be sure I heard correctly I said “non??” & did the charade-like, two-handed gesture of twisting a rope. He nodded no & then I was handed 2 pages of paperwork with Caiden’s vitals & their findings. I said to the nurse “ho bisogno pagare” (I need to pay) & she nodded & said “no”. Confused, I waited a beat & then said “dove io pago?” (where do I pay?). She smiled, nodded no, said buona giornata (have a nice day) & pointed to the uscita (exit).

Dumbfounded, I left the hospital. We stood in the parking lot & suddenly tears streamed down… a release of my pent-up stress, fear & guilt, relief that Caiden was OK and that these kind & competent Italian health professionals didn’t slap me with a 1,000+ Euro bill, after all, I’d stepped foot in an ER & we all know that incurs an automatic $500+ charge in the US. They treated Caiden like an important human being; one who was in pain & hurting. He was swiftly & competently cared for & the aftermath wasn’t muddled with a combo of digesting the diagnosis while grappling with the mammoth medical bill(s) that were sure to follow.

We returned to Florence on a Sunday & Caiden seemed to be doing well, his infection seemed to have subsided. But then on Monday morning it was back, and with a stronger-than-before vengeance; he could barely walk. He was so fearful of going back to the doctor (& undergoing another excruciating exam) that he begged me to let him be & continue with the wait-and-see. Well, I had an “I’m the parent & as such at times we must make very adult & responsible decisions” & overrode him, saying we were going to Florence’s children’s hospital (University Hospital Meyer) to resolve this issue once & for all.

Interestingly, I have an odd fondness for children’s hospitals. I supposed this came after Caiden’s time spent at Lucille Packard Children’s Hospital at Stanford (Palo Alto, California) where he had brain surgery in 2015. We had the most incredible experience there, so seeing Meyer’s bright colors, animated signs & animal topiary that surrounded the parking lot, I knew instantly we were in the right place.

We repeated the check-in & waiting room processes & were, again, seen to a room where a doctor cranked on Caiden’s inflamed testicle, this time with even more gusto than before; the poor kid was fighting every urge to scream & jump off that bed. The doctor agreed that it was not twisted (I’d shared the report from the pronto soccorso in Scorrano) & called a second doctor who came & concurred with his evaluation. This time, however, they prescribed Caiden a pain reliever & antibiotic (children’s penicillin). I repeated my same efforts as the week previous & whipped out my Mastercard in expectation of a deservedly hefty bill, but I was again told no charge, buona serata (have a nice evening) & directed to the way out. I could not believe we were 2 for 2 in evading what would’ve been massive ER bills in the US… I almost felt like we were shoplifting, or going to be pummeled by security guards once we slipped though the automatic exit doors. Gone was the concern for Caiden’s health & never was a concern even allowed to hatch of HOW are we going to afford these big bills that will accompany this visit.

So, what we ended up paying for 2 visits to the ER, seeing 3 doctors on an emergency basis was 1,50 Euros, the equivalent of $2 US. This was the hospital’s parking fee. And all this got me thinking—in the US we’re so utterly petrified of any sort of universal healthcare or socialized medicine. We’re consuming ourselves with nightmarish visions of throngs of thousands of sick, needy & undocumented people clogging doctor’s offices, urgent cares & hospitals – eager to camp at these medical facilities & take advantage of such a “freebie”. With my experiences in Italy & seeing 2 truly minimally occupied, socialized healthcare hospitals, I am certain this would not be the case. Sure, if the US ever switched to a universal or socialized form of healthcare the first few months or year we may see a large influx of folks who have needed treatment but could never afford it before, but in time it’d become our new normal. As is the case now, people would only visit the doctor when they really needed to. It simply wouldn’t become this forbidden fruit that’s now consumable.

I’ve also realized that quality health care is really only available to:

a) those who work in the public sector/government

b) those who are lucky enough to be employed by a big company, or one with good health insurance

c) the wealthy—i.e. those who can afford the astronomical price of health insurance, coupled with the accompanying, equally astronomically expensive deductibles, annual out of pocket maxes, etc.

When you stop & really think this through it’s absolutely flabbergasting that healthcare in the United States is considered a privilege, & not a right. We don’t have – as human beings – a RIGHT to be healthy, or, more importantly, to be sufficiently taken care of when we’re not. That’s nuts, truly insane. But then, it begs the question, how will hospital C-level execs, doctors, pharmaceutical companies, etc. make their millions if we’re not charged ridiculous gobs of money for the most basic of services?? And that there, the answer to that simple question, is the reason Americans will never have fair, affordable & reasonable access to healthcare.

As always, stay safe & healthy out there everyone—especially in light of the fact that you could go broke should you fall ill.

We’re hunkered down & riding out Italy’s latest lockdown, but I’m breathing some relief in the knowledge that should we succumb to Covid, the foreign country we’re residing in will care for us as they would their own. We’ll be treated with the most basic of human kindness & our lives, not our pocketbooks, will be prioritized, & valued.