Is Italy inefficient?

Italy is known to have one of the widest, most inclusive, health assurance systems[1].

It is also infamous for its unyielding, extensive bureaucracy apparatus, maybe one of the causes of the populist outcry so common here[2].

I asked myself to what extent this corresponds to the truth, to what extent it is myth.

Unfortunately, I received a clear response to this on my skin.

Here I am going to tell you the weird (and until today, unresolved) story of how I obtained my third dose of anti-covid vaccination.

For the dwellers without official domicile in Italy, „it seems to depend on luck“, as The Local quotes[3]. And it adds an advice: „be tenacious as hell“[4].

I was tenacious as hell: the first day I went to the vaccination hub, I was told I needed an Italian health card. My European one, contrary to what both my EVS sending and receiving organization knew, wasn't enough.

“What about the others”, I asked, “who showed up without an Italian health card?”

“You are not the first one, and indeed they were not vaccinated.”

So the next day I tried to apply for a momentary Italian health card. After I waited for quite a time, I managed to speak with the person who, they told me, would be able to help me with that. When he found out I was doing my EVS in the field of environmentalism, he started to rave about... horse rides. We had a loong conversation in which he told me about every horse riding path he had taken, while there remained many people waiting in the line who had entered the hospital just after me.

I did not receive my provisional Italian health card. To do this I required a fiscal code, and for that a domicile in Italy. It was a matter of weeks at least. (I read of an Italian citizen who has been waiting for the arrival of her health card for more than six months[5]) My greenpass certificate was about to expire – or rather, I expected it to have expired already but it somehow had not; the ever-changing rules were confusing. Without a greenpass I could not visit the schools where I was supposed to do environmental education nor theoretically stay at my EVS housing, or go to my working area in the open space. Nor could I take a bus.

I returned a third day to talk with the head of the vaccination hub. She endowed me with a momentary, e-generated fiscal code. This time I told anyone I encountered on my way:

„I still don't have an Italian health card, but Dr Mona Sonyu allowed me to be vaccinated, here's my fiscal code.“

It worked out.

Almost.

After hours of discussion, I had to leave with just the vaccination – I had no proof of it on paper.

So far the fight had taken three days, three days on which I could neither work nor move, each day three to four hours of waiting and arguing.

The outcome was alarming. The responsible doctor refused to record my concluded vaccination in any way – not even provisionally – as, under Italian law, if I could not produce a verified fiscal code I had received the vaccination „unlawfully“.

That was unjust and not true: a governmental website[6] warrants that all people present in Italy have the right to be vaccinated against covid.

Another one describes the procedure for Italians who, like me, had declared to be resident abroad: they could avoid displaying the fiscal code[7].

But the officer in front of me said this option was not given in his e-registration-program.

It is absurd to me that a person dwelling on Italian ground – an Italian citizen, even – is excluded from legal vaccination; and thus would forfeit his freedom of movement, and his job.

How about other EU citizens?

I had once helped on an event in Berlin on which homeless people could get vaccinated without proof of identity, and received provisional documentation on the spot. And in Italy? Had the state abandoned its immigrants and homeless? If it already failed to provide vaccination for Italian citizens living abroad?

Indeed, the Italian Health Ministry had justified with vaccine shortages why all those unable to exhibit a fiscal code – including the most vulnerable of society – would be vaccinated not yet but „soon“[4].

Without a documented vaccination I was in legal no-man's-land if I would have suffered from side-effects of the vaccination.

My tutor called the mayor of Niscemi. The mayor went to the vaccination hub. And they told me „The mayor solved the problem.“

Wow, how did he do that? I did not care. What a luck I was so privileged – insisting on my right, able to take three days off work, looked after by someone who knew the mayor!

So on Monday I returned to the vaccination hub, sure that the situation had been resolved and I would receive my greenpass. In fact, the mayor had come to the hub to plead my case. The head of the hub had replied to him: „Yes, we already know how to solve it.“ The mayor went home, satisfied. But the head of the hub did not! She was planning to take me to the horse guy, not having understood that I had already talked to him – for hours! When I appeared there on Monday, I realized there was no progress in sight.

To this date I don't know how this mess will be resolved. Next week I have an appointment at the revenue office to finally obtain my fiscal code.

True: if I would have followed the early advice of the officer – whose emphasis, sure enough, was more on „no, you can not get vaccinated“ – and first registered a domicile, activated an Italian health card and fiscal code, I would not have went through this trouble. But the fact is, we – my tutor and me, even the head of the vaccination hub – did not know: we had been sure the European health card and e-generated fiscal code were enough to access anti-covid vaccination. From what I understood through my research, even as an Italian citizen and EVC volunteer I probably would have needed to register a domicile.

Still, I knew I had had the right to be vaccinated.

The intransigence of Italian bureaucracy was frustrating.

I got vaccinated on Friday, the 14th of January. To this date, the 23rd, this problem has not been solved. I cannot prove I was vaccinated.

EVC: European Voluntary Corps

EVS: European Voluntary Service

References:

• [1] https://www.internationalinsurance.com/health/systems/italy.php (internationalinsurance.com)
• [1] https://www.internations.org/go/moving-to-italy/healthcare (InterNations)
• [2] https://theloop.ecpr.eu/why-is-italy-more-populist-than-any-other-country-in-western-europe/ (ecpr.eu):
• “The aggregate proportion of votes for populists increased from 30% in the general election of 1994 to almost 70% in 2018. No other major West European democracy has witnessed such levels of support for populists.”
• [2] Bellodi, Morelli et Vannoni, 07.04.2021. Expelling the experts: The cost of populism for bureaucratic expertise and government performance, https://voxeu.org/article/populism-bureaucratic-expertise-and-government-performance . VOXEU / CEPR.
• [3] https://www.thelocal.it/20210609/it-all-seems-to-depend-on-your-luck-foreigners-in-italy-continue-to-report-problems-getting-the-covid-vaccine/ (thelocal.it)
• [4] https://www.thelocal.it/20210609/how-people-in-italy-have-managed-to-get-vaccinated-without-a-health-card/ (thelocal.it)
• [5] https://www.thelocal.it/20210429/it-felt-like-a-betrayal-the-difficulties-foreign-residents-are-having-getting-vaccinated-in-italy/ (thelocal.it)
• [6] https://www.aifa.gov.it/it/domande-e-risposte-su-vaccini-covid-19 (aifa.gov.it)
• [7] https://www.en.regione.lombardia.it/wps/portal/site/en-regione-lombardia/DettaglioRedazionale/health/covid-19/help-us-with-covid-19 (regione.lombardia.it)
• [7] https://www.en.regione.lombardia.it/wps/portal/site/en-regione-lombardia/DettaglioRedazionale/health/covid-19/help-us-with-covid-19 (esteri.it)
• Galanti, Maria T., 01.11.2011. Is Italian Bureaucracy Exceptional? Comparing the Quality of Southern European Public Administrations, https://www.gla.ac.uk/media/Media_210759_smxx.pdf. Bulletin of Italian Politics, (3).
• https://www.thelocal.it/20210415/opinion-bureaucratic-barriers-must-not-stop-italy-vaccinating-its-foreign-residents/ (thelocal.it)

All last accessed on 03.03.2022. Political science sources quoted at length.

Read part I here (https://www.youthreporter.eu/en/beitrag/is-italy-inefficient.17396/#.YiDvaJYxk2x).

[Update: by now I could solve the problem; two weeks after being in fact vaccinated I obtained my fiscal code and health card and they could register the vaccination]