Health Care, Italian Style

Dealing with slippery slope, the synapse-like labyrinth, the unrequited black hole that is Italian bureaucracy means taking everything you know about sensible behavior and tossing it onto the side of the autostrada like a half eaten piece of stale focaccia.

Michael is a German.  That means he is a citizen of the EU. In Italy, this means that if he has lived here for more than five years (he has) and that he has obtained a Permanent Residency Visa (he has) that he has the legal right to access to the Italian national health care system (SSN), no questions asked. That is Italian Law. 

So, it was with great anticipation that we visited our local office which handles health care (ASL22 ) (are you keeping these straight? I hope so) armed with his Permanent Residency Visa, with his German Passport, with his Italian identification card and with this Stato di Familia con Residenza ( a document proving that he lives with within the geographic area covered by ASL22 and costs 76 centissimi at your local commune) to get his Libretto di Medico (the Doctor Card -- this is the card which allows you access to a doctor who then sends you out to wherever you need to go for treatment).

The ASL22 Dude, as I will refer to the guy behind the counter from now on, glanced fleetingly at the pile of documents we placed before him and said, "No.  The law has changed."

The law has changed?  How?

"You need an E121 card from Germany.  Without that, you can have no coverage." He turned and walked away.

Hearts beating quickly after realizing that this was not going to be the no-brainer we thought it would, we went home and started looking in the Internet.  Anytime the Italian Bureaucracy Dudes ask you for something that begins with an E, it means you need to provide a  document which is part of a European Initiative.

E121 is a card which Non Italian EU member retirees moving for the first time to Italy must present at the local ASL to get enrolled in the health care system.

Micha, however, had been in Italy for five years, and is not yet an official German retiree.  

So, E121 does not apply.

We panicked, started looking for private coverage, requesting quotes from companies all over Europe. But Micha smelled a rat.  He started digging around on the internet to find a copy of the law regarding post-five-year-European-Union residents and the Italian health care system.

Sure enough, he found the clause... that every post-five-year-European-Union-citizen who held the Permanent Residency Certification for Italy has the legal right to be enrolled in the health care system.

Please try to keep this straight. There will be a quiz afterwards.

Our printer cartridge gave out while printing this ridiculously long document out.  Micha went to six stores, including where we bought the very normal, very average HP Deskjet F4180 printer and no one had the cartridge.  This put our return trip to ASL22 on hold while we drove in circles to find the cartridge.  But I digress into another Italian Nightmare -- shopping for necessities other than Food and Wine, specifically things computer related.  Another post.  Another day.

Back to the story.  We finally found the cartridge, printed the document.  This morning we returned to visit the ASL22 Dude.  He sensed our determination and did the only thing an incompetent low level Italian bureaucrat should do at that point - he sent us upstairs. 

We went upstairs to visit Signora Mazzona, the Lady in Charge, who was on the phone trying to solve some Swiss Person's Italian Health Care Horror Story when we arrived.  She looked at our documents, including the Permanent Residence Certification and then said we needed an E121 card.  

We strongly stated that Micha is not retired in the German system, and repeated that Micha is in posssession of the Permanent Residence Certification given only after five years of residence in Italy.  

She then said we needed an E120 card, which is the card given to people who have applied for retiree status and are waiting to hear from the retirement agency of their native EU country. We said no, Micha had not APPLIED for retiree status yet.  

She sighed. This was clearly not what she had in mind this morning.  

We gave her a copy of the law, which we had painfully downloaded from the internet over two days.  Lo and behold, she had the same document sitting on her desk. 

She read.  She blinked.  Oh, she said, you have the Permanent Residence Certification given only after five years of Residency!  I watched Micha's jugular vein. Pa-pump.  Pa-Pump. We bit our tongues and smiled sweetly. Si, we said excitedly, as if she had just split the atom before our very eyes.  

She then proceeded to call downstairs to ASL22 Dude's supervisor and read her the riot act in such a loud tone that it embarrassed us.  

"He has the RIGHT to the system!! WHY ON EARTH DID YOU NOT LOOK AT HIS DOCUMENTS?  WHAT DID YOU SEND HIM UP HERE FOR?  I AM SENDING HIM DOWN AND YOU WILL GIVE HIM THE LIBRETTO DI MEDICO IMMEDIATELY!!!"

We thanked the Signora, and went downstairs.  

By this time, ASL22 Dude's supervisor was on her way upstairs for a formal dressing down.  We walked up to ASL22 Dude's window.  He says, " I'm not giving you anything!  Go back upstairs!" and walked away.  Again.

We went back up stairs, listening to the screeching coming out of Signora Mazzona's office. I opened the door.  Signora Mazzona stopped shouting at the supervisor, turned to me and said, "Yes, what is it?" and I told her that ASL22 Dude had sent us back up.  Why, she asked.  I have no idea, I said.  

She put her hand on her forehead.  I thought she might faint.  ASL Dude's supervisor took the chance to escape, and led us out of  Signora Mazzona's office and calmy walked with us back downstairs, where she printed out a Libretto di Medico for Micha, and said good-bye to us in the nicest of tones.

ASL22 Dude did not even look up.

So there you have it.  Micha has his libretto, ASL22 Dude still has a job for which he is not the slightest bit qualified, his boss took the heat for him, and we are now buddies with the Lady in Charge.