Thursday, March 12, 2020

Coronavirus in Italy is a snapshot of America if Democrats win in November

Newsweek has published what is purported to be an op-ed from an "anonymous doctor" who lives and works in Italy. The op-ed is long on finger-shaking at western laissez faire culture and short on science and medicine, so let that guide you in deciding whether you're reading the opinion of an MD or that of an ethics-challenged journo with an axe to grind.

It does give us some insight on how a socialized, "free" healthcare system actually works.
Fast-forward two months, and we are drowning. Statistically speaking—judging by the curve in China—we are not even at the peak yet, but our fatality rate is at over 6 percent, double the known global average.

Put aside statistics. Here is how it looks in practice. Most of my childhood friends are now doctors working in north Italy. In Milan, in Bergamo, in Padua, they are having to choose between intubating a 40-year-old with two kids, a 40-year old who is fit and healthy with no co-morbidities, and a 60-year-old with high blood pressure, because they don't have enough beds. In the hallway, meanwhile, there are another 15 people waiting who are already hardly breathing and need oxygen.

The army is trying to bring some of them to other regions with helicopters but it's not enough: the flow is just too much, too many people are getting sick at the same time.
The Italian public healthcare system is heavily regulated and care is strictly rationed. Here's a synopsis from AllianzCare, an international health insurance provider that caters to expats and people who spend a lot of time abroad for both work and leisure.
The healthcare system in Italy is a regionally based national health service known as Servizio Sanitario Nazionale (SSN). It provides universal coverage to citizens and residents, with public healthcare largely free of charge. Treatments which are covered by the public system and a small co-payment include tests, medications, surgeries during hospitalisation, family doctor visits and medical assistance provided by paediatricians and other specialists. Furthermore, medication, out-patient treatments, and dental treatments are also available. However, public healthcare facilities in Italy vary in terms of quality depending on the region.

While the standard of public hospitals in Italy is generally adequate there are some state hospitals that fall well below the standards that some expats would be accustomed to. Therefore, regardless of where one comes from, it is best to organise health insurance before moving to Italy. Without it, issuance of a Permesso di Soggiorno (permit to stay) may not be possible.


If moving to Italy as a non-European Union citizen, travellers will be required to have private insurance cover (sic). Upon arrival, there is an eight-day window to visit the local police station and present a health policy that is valid throughout the duration of one’s stay.
Italian healthcare is thus free for Italians. Everyone else...

When everyone is healthy and demand for medical services is low, the system may work just fine. Deficiencies in the level of care have fewer harsh consequences. But in the midst of an international health emergency, uh oh. From WSJ (subscription required):
“I never was at war, but that’s how I imagine it,” said Federica Brena, a medical oncologist at a hospital in Bergamo, another hard-hit area in northern Italy, on Facebook. “The health-care system risks collapse.”

A photo showing a sleeping nurse slumped over a computer while still wearing protective gear was widely shared on social media, becoming a symbol of the emergency and the strain the epidemic has put on medical personnel.

“We are doing everything humanly possible,” said Dr. Mangiatordi, who took the photo. “But sometimes I feel powerless.”

Medical staff risk getting the infection themselves. Despite protective equipment—double gloves, tightened face masks and scrubs—medical personnel account for about 12% of those infected in Lombardy.
The following is from The Atlantic, a publication that is far from being accused of right-wing propaganda.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.

Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of “catastrophe medicine.” Instead of providing intensive care to all patients who need it, its authors suggest, it may become necessary to follow “the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources.”

The principle they settle upon is utilitarian. “Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”
This is what socialized, public, "free" healthcare looks like, y'all. It's a clear snapshot of what the U.S. healthcare system will look like if the left gains control of the levers of power in November and implements their wacked out plans for our healthcare system. "Medicare for All" or the "public option" will transform the world's greatest healthcare marketplace into a third world system of rationing; where doctors and their bosses decide whether you live or die. Our system is great because it's private sector financed, despite the burdens already placed on it by the Obamacare debacle.

Make no mistake about this truth as well--if you're rich enough, powerful enough and connected enough, you will be treated in Italy today. If tomorrow's U.S. system looks anything like today's Italian mess, do you really think the Mike Bloombergs, Warren Buffets and Robert DeNiros will have to stand in line with the rest of us schmucks?


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