The other day I was in the doctor's office, and I was thinking about the time I went for pharyngitis and she asked me "How many days off do you want? With pharyngitis you get five..." At that point I still worked for a company but I've suffered from pharyngitis once a year every year for most of my adult life and I've never taken five days off work. So I asked for a note to get me out of one day of work because I knew that once the antibiotics kicked in, I'd be fine. In Italy, the doctor's note is the golden ticket that can get you out of an endless number of days of work. When I worked at a company here, I covered a two-year maternity leave, a six-month back operation leave and a ten-month skiing accident (broken leg - in contrast, when my roommate in New York broke her leg snowboarding on a Saturday, she was in a taxi Monday morning going to work with her crutches) leave. This is yet another reason companies are wary of hiring. Someone can go out on sick leave (whether he is sick or not, as long as he has the doctor's note) and leave the company in the lurch for an indefinite amount of time.This got me to thinking about my neighbor. Let's call him Light Fixture Man. He works for a company that distributes light fixtures and told us when we were restructuring our apartment that he could get us light fixtures at wholesale prices. He brought us catalogs, we ordered the light fixtures and paid him the money. Quite a bit of time passed and our light fixtures never materialized. We finally pinned him down one day and he promised to bring the light fixtures "on Monday." Monday came and went with no sign of him. On Tuesday I could have sworn I glimpsed him through the window riding his bike down the street. On Wednesday I definitely saw him riding his bike down the street with one of his daughters on the front and the other daughter on the back. On Thursday I saw him riding his bike and I stopped him.
Me: Sorry to disturb you on your bike but you said you'd bring the light fixtures on Monday.
LFM: Yeah, well, I'm not in the office this week...
Me: Oh, are you on vacation?
LFM: No, I was sick on Monday with pharyngitis and the doctor gave me "five days" so...
Me: Oh!
LFM (sensing I was worried about his health): No, no, don't worry. I felt better right away but I had the note for five days so...
Me: Uh, OK. Well, whenever you can bring us the light fixtures.
I walked away disgusted thinking, "All those times in Italy when things take forever it's because some idiot has taken his 'five days' when he only needed one. What about the extra burden he's placing on his coworkers? What about the people waiting around for their orders? Has he no shame?" I know that in Italy when you are out sick, they can send someone to check up on you. It's unfortunate in his case that he wasn't busted out riding his bike. But, honestly, this is one of the minor abuses of the system.
I had an English student who told me the story of his receptionist/assistant. He owned a small business and had one employee to answer phones and provide administrative support. For the first two years, she was a good worker. At one point she told her boss that her boyfriend was being transferred to Liguria and she'd like to move with him and do her job from home. Considering the fact that she was the receptionist and needed to answer the phones and greet clients in the office, he explained that it'd be impossible to do the job from home. Suddenly, she began calling in sick. After a week, she turned up with a note saying she had "mental distress" and would be out indefinitely as her doctor had advised her to "spend time at the sea" (what a coincidence - Liguria is on the sea!).
This created enormous problems for the small business owner and he had to pay the "sick" woman's salary (though with help from the government, if I understand correctly) as well as that of her replacement. One day the employee called from Liguria to say she was "still sick" but if only she had a new car, she'd probably begin to feel better. And if she felt better, she'd be inclined to turn in her resignation. Wanting to unburden himself of this woman and the strain she was causing on his business, he went ahead and bought her a new car. He told me that the cost of the new car was nothing in comparison to what it would have cost him had she stayed out on sick leave for years on end.
P.S. Speaking of health care systems that don't work (to the opposite extreme), I just realized the new Michael Moore movie Sicko is out. I hear that he slams the U.S. system and raves on and on about how great France's health care is. Before I moved here, I also was a big proponent of universal health care - and for the most part, I still am. But here it's so inefficient and costly tax-wise (with embarrassingly bloated government and some of the world's highest-paid politicians) I think it gives socialized health care a bad name. You even have to bring your own urine cups and Band-Aids to the brutally ugly hospitals here. There are other socialized systems where it is not like that.
20 comments:
Ugh - I really hate that attitude which unfortunately seems to be really prevalent amongst Italians who are lucky enough to have "permanent contracts." They don't seem to realise that THIS is the main reason businesses are so afraid to hire someone and resort to contratti a progetto etc.
One of my friends told me about a book called something like "Solo volevo vendere la pizza!" about a guy who opened a pizza a taglio place and all the incredible hassles he had with bureaucracy and his employees. Apparently at one point an employee went out "sick" and opened up a competing pizza place across the street!
Ramona,
I think it goes back to that old "I've got mine" attitude. I have my permanent contract so why should I care about anyone who doesn't have his? I think this can also be applied to women who take ridiculous amounts of maternity leave (and I said this long before I even imagined getting pregnant) and abuse the "breastfeeding time" up to when the kid is five. They are hurting other women who won't even have ANY maternity leave, much less be paid to breastfeed. But then what do they care? They got theirs! There's a real lack of the sense of how your actions affect everybody. I took one day off with pharyngitis NOT because I'm the most fantastic human being but because my thought was about my coworkers who'd have to pick up my slack. Same thing when I didn't take my entire two week marriage leave (I'm such a sucker - I should have taken it!). It was a really busy period at work so I only took one week and obviously was not compensated or didn't get to make up the other week. I would never make that mistake in the future because unfortunately now I've started to think with that shrewd "got to get mine" attitude. It's horrible.
Ramona,
Here's a link to that book: "Volevo solo vendere la pizza" - http://www.garzantilibri.it/default.php?page=visu_libro&CPID=2183
FYI, be on the lookout for my book on the friggin' maternity wards in th hospitals here to be called "Volevo solo far nascere mio figlio e non in un corridoio" (I just wanted to have my baby and not in a corridor) or "All I wanted was an epidural..." I'm half joking, half not. If anyone knows any publishers...
I was up in Scotland in May visiting a friend who had a doctor's appointment while I was there. Yes the appointment just happened to be where the eventual car bomb was at at the hospital near Glasgow. Anyways, the hospital was impeccable and efficient! It could compare to a quasi upscale hospital in the States! And to think that this was in the UK, with a public health system!
Ann - it's not a privatised health care system vs public health care system thing. It's just that Italy's health care system sucks.
In Australia it's like in Scotland - shiny, new, state of the art hospitals, the latest equipment, professional nurses etc. And the whole thing is paid through your taxes which are actually lower than in Italy! :)
I didn't see the movie Sicko ut heard that it praises France's universal healthcare and slams the US system. I remember working in a Southern California hospital and having Canadians come all the way down to so. CA only to have procedures done because in Canada, a universalized healthcare system, there are waiting lists. If you are told you will have a heart attack if you don't get a certain proceure and then are told that you have to wait 9 months it is not pleasant. No body wants to gamble with their life. My only personal contact with universal healthcare was in Italy though. Same thing with waiting. I was told to schedule my 5 month sonogram the minute I found out I was pregnant so they could at least do it in my fifth month because the waiting lists were so long (I miscarried and had to cancel my appointment, which made them happy because they had an opening). Bringing silverware, toilet paper and towels to the hospital and paying for urine cups was something I could deal with, but waits for blood test results and everything else just drove me crazy. Thank heavens for those private healthcare clinics (that operate like the US system)that gave good service-although at a cost and there was no insurance to cover it.
Universal healthcare might work in other places but i have not seen any evidence of it.
P.S. I never understood why the doctor in Italy would offer a multiple day sick leave for any illness. Shouldn't the employee request the note from the dr. after seeing how many days were necessary to recover?
Not all "dipendente" are like that! I took a month off after a bad accident - got pressurized into going back to work and now have to pay the consequences health-wise. Plus the stupid rule about having to stay at home for a "controllo" means that being off sick just isn't much fun anyway. Anyway, where I work you always end up having to unofficially make up the time you lose because of the staff shortage.
Forgot to say - I once got a five day sick note for a bad flu. I went back to work after three days because I felt fine - and got a right rollocking from my boss. Apparently you are not allowed to work if you are signed off sick even if you get better!
jdoe - no idea about Canada but I've never heard of anything like that happenning in Australia. In Australia, you only wait for elective procedures not life threatening ones and not that long.
I don't want to get into a big debate here but in the US a huge proportion of people have no insurance (including children!) and they simply don't go to the doctor. My old roommate's mother, who was a waitress in a diner, did not have insurance and developed schizophrenia. After they had sold everything they owned including everything which her late husband had left to her to pay hospital bills (her trailer and her car as well as the roommate's car) she was declared bankrupt and placed in the incredibly grim state mental hospital. As my friend said, even if she got better and were to be released, she would be homeless, jobless, carless and health insurance-less in rural California. Great system! :(
What a wench... that chick from Liguria!
As for your roomate going into work a couple days after breaking her leg, WOW! Maybe if some Italians had a teenie weenie bit of "work work work" attitude like some New Yorkers, things would be a bit better around here?!
Oh, wow, this is NOT an easy topic. Overall I think the U.S. system sucks but that said, I do think that some people who could have insurance don't work enough to have it. I've fought with some of my own relatives who say things like "I could get it through work but they'd take $20 out of each paycheck. And, anyway, I'm never sick!" That's just DUMB reasoning. But children without health care - as an American, I'm ashamed. And those insurance companies that look for ANY reason to not cover you for necessary procedures ("We don't cover appendectomies on Wednesdays..."). It's just become too much of a business.
Then you've got the Italian system. Fortunately, most Italians are honest people and don't cheat the system but even if you think that there's one of those dishonest people in each department, it drags everybody down. I do think people here work hard. At least in Milan - people work harder than in New York and make MUCH less. It's ridiculous. OK, I was being nitpicky about having to bring my own Band-Aids and pee cup but it does make my blood boil that the politicians here make 15,000 Euros a month (and just gave themselves a raise!) when there's a health care system like this. Maybe a shift of taxpayer funds is in order?
what i find even more infuriating is that many of these public health care doctors run their own private practice in the same public structure (AKA "attivita' intra moenia") where regular people have to wait 6 months to get a pap smear... so if you're willing to pay that doctor a private doctor fee, you can get an appointment that same day or the next day, but if you want to take advantage of the public health care system (the one you pay for with your taxes) you have to wait 6 months until your innards rot. Now that is fucked up!
In response to Cath saying:
"Plus the stupid rule about having to stay at home for a "controllo" means that being off sick just isn't much fun anyway."
Sorry but I didn't realize staying home sick from work was supposed to be "fun". I guess Italians have a different work ethic because in my book, if I stay home from work because I'm sick, I'm simply staying home to recover, not to have a jolly old time.
My mom told me that "Sicko" rates Italy just past France in terms of best national health care, but I'd like to know just how that's defined. I have my own frustrating stories about dealing with the Italian health system, but I won't bore you with those here. I did fall into the category Romerican mentions though, having to pay the public doctor for a private visit in order to avoid a month or more wait (it was urgent and demand is overstretched on public health resources).
I'm not complaining too much because I was treated a few times for minor things as a walk in at the emergency room when I was first living here as a "tourist", and didn't pay anything. But once you have to have anything major done, it's better to have private insurance as well. My husband and I are both in our early 30s and each have a policy. Luckily the private insurance costs significantly less here than the States. After you've seen a family member with a grave illness stuck with no choice in certain Italian hospitals... it pays to know you can choose if you need to. Not all hospitals are the same!!
As for the woman in Liguria, all I can say is: and they say organized crime exists only in the South ;)
What bothers me most about the Italian health care system is that it obviously doesn't have to be this way when countries like Australia have figured out how to do socialized health care efficiently and effectively (from all that I've heard). In my perfect world, this would be the type of system both the US and Italy embrace. Mah.
Just one other thing to Anonymous in response to Cath: I don't know Cath, but I really don't think she was implying that sick time should be fun--she seems to be responding to the image of the guy riding around on his bike, and noting that being signed off isn't necessarily this way for everyone.
Shelley,
Yes, I too have paid privately because I couldn't wait for the public system. I think many people have.
Sognatrice,
The story of the woman with the car is not an isolated incident up here. I've heard of others. I've also heard of situations with mobbing where the person being mobbed finally cries uncle and says "I'll leave for X amount of money" or "I'll leave if you buy me a motorbike."
I think the whole "mobbing" phenomenon deserves another post. It only seems to exist in Italy yet it has a pseudo-English name?
The Italian health care system has its problems, but it's there for everyone and when you really need an emergency test etc. (and sometimes even when you don't need it that badly), things happen in a hurry - see http://www.beginningwithi.com/aboutme/difficultbreasts.html
Thank you Sognatrice! I didn't mean my "fun" comment to be taken literally! But I think that the "controllo" system is warped - I have been signed off sick when the doctor told me it would do me good to get out and swim (I was doing daily physio) - but I couldn't because of the "controllo". BTW Anonymous - I think if you are going to criticize someone it is only fair to put a name to your comments - even a made up one :-)
I was talking this subject over with my OH last night and he reminded me of the time I went into work with my "flebo" attached à la Dr Greene. See some dipendenti aren't trying to work the system!
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