Susan Levenstein

“Italians are blessed with long healthy lives nonetheless, thanks to the combination of a world-class lifestyle and universal access to health care, however unreliable it may be. They also benefit from a more uniform distribution of income and wealth, which has been shown to improve health outcomes. In the US, the world’s most unequal country, the average income of the top ten percent is nineteen times the average income in the bottom ten percent; in Italy that ratio is only eleven to one. Plus, Italian labor laws ensure that parents can take time off to bond with their children without losing their job, sick people don’t have to drag themselves back to work prematurely, and retirement doesn’t equal poverty.”
― Susan Levenstein, Dottoressa: An American Doctor in Rome

“What American Healthcare Can Learn from Italy: Three Lessons It’s easy. First, learn to live like Italians. Eat their famous Mediterranean diet, drink alcohol regularly but in moderation, use feet instead of cars, stop packing pistols and dropping drugs. Second, flatten out the class structure. Shrink the gap between high and low incomes, raise pensions and minimum wages to subsistence level, fix the tax structure to favor the ninety-nine percent. And why not redistribute lifestyle too? Give working stiffs the same freedom to have kids (maternity leave), convalesce (sick leave), and relax (proper vacations) as the rich. Finally, give everybody access to health care. Not just insurance, but actual doctors, medications, and hospitals. As I write, the future of the Affordable Care Act is uncertain, but surely the country will not fall into the abyss that came before. Once they’ve had a taste of what it’s like not to be one heart attack away from bankruptcy, Americans won’t turn back the clock. Even what is lately being called Medicare for All, considered to be on the fringe left a decade ago and slammed as “socialized medicine,” is now supported by a majority of Americans, according to some polls. In practice, there’s little hope for Italian lessons one and two—the United States is making only baby steps toward improving its lifestyle, and its income inequality is worse every year. But the third lesson is more feasible. Like Italy, we can provide universal access to treatment and medications with minimal point-of-service payments and with prices kept down by government negotiation. Financial arrangements could be single-payer like Medicare or use private insurance companies as intermediaries like Switzerland, without copying the full Italian model of doctors on government salaries. Despite the death by a thousand cuts currently being inflicted on the Affordable Care Act, I am convinced that Americans will no longer stand for leaving vast numbers of the population uninsured, or denying medical coverage to people whose only sin is to be sick. The health care genie can’t be put back in the bottle.”
― Susan Levenstein, Dottoressa: An American Doctor in Rome