and sanitary ware. Within SSN, a “fundamental levels of care” (Livelli essenziali di assistenza or simply LEA) was established to ensure treatments to all necessary illness (with some exemptions) either free of charge or a token fee called a "ticket".
Invariably, citizens and residents alike are able to take advantage of SSN. The system operates in a model that is slightly different from the norm practiced by most Western countries in that physicians are under the payroll of SSN. Registered physicians are required to work five days a week and have a limit of up to 1500 patients. Patients would have to take doctors as assigned by SSN. Nevertheless, there is flexibility so that if a patient finds the assigned doctor to be unsuitable, he or she can opt for doctor change, subject to the fact that the next doctor is available according to the above guideline.
The government also subsidizes prescription drugs, and just a co-payment is expected from the patients of the said drug. The amount of co-payment is dependent on medicine used and the patients’ income bracket. Generally, the poor are usually able to receive prescription drugs free of cost. For over-the-counter drug, patients would need to pay out of pocket. The farmacias (or specialized shops) stocks up both prescription and OTC drugs.
While SSN provides comprehensive healthcare assistance, it faces a situation of slow patient ‘turn-around’ time, partly due to the overwhelming demand of the market. The waiting time of typically a few months to get appointments with the big public facilities has turned many Italians off. For patients who are willing and ready to fork out comparatively more money are able to get their treatments fast through "free market" medical assistance. This option is not covered by SSN and is offered by both public and private hospitals. The exclusion from SSN means that patients pay for the prompt medical attention out-of-pocket, rather than depending on co-payments.
The Italians spend nearly 9% of its GDP within the healthcare industry, with government expenditure makes up close to 75% of this amount. The total expense is not out of-sync with the OECD averages (about 8.9%). Due to SSN, public hospitals are common sights all over Italy, still in all the major cities, private hospitals are flourishing in Italy.