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Old 24-06-2011, 13:48   #16
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Re: Health care for older sailors

Sorry if I moved the thread off to the American political situation.

I have found getting health care outside the US to be far simpler, quicker, and yes, less expensive. It is amazing how much easier things are when you take insurance out of the equation.

Examples:

Sailing up the Italian Adriatic a big gold inlay came out while eating. When I arrived at the next harbor I asked the yacht club manager how I might see a dentist. He directed me to an office a few blocks away where a dentist worked who had a boat at the club. I showed him the inlay, he looked in the mouth, smiled (he didn't speak English and my Italian is rudimentary), mixed up the glue and put it back in - no charge. It took a few minutes total. It wasn't about money, and it was no big thing. Had that happen in the US lately?

I need to check serum cholesterol levels and liver function every 6 months or so (statin user). In Spain I went to a pharmacy, they drew blood and sent it to the lab, and in a few days I went back and picked up the results. No doctor, no prescription, modest expense. Of course I take responsibility for getting things done, not wait until I am reminded of an appointment.

Perhaps the most telling example is a tooth I have that has a large, old silver filling. Every time I visit my American dentist he tells me I should cut it down and put a crown on it before it fails. (He is "proactive".) Every foreign dentist I asked told me to leave it alone; it may never fail, and if it does it can be fixed then.

The point I am trying to make is that the experience of getting medical care is often quite different than our experiences here. Of course there will be times when getting care is an inconvenience, and language can be an issue, but overall you are likely to be happier with the experience. YMMV
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Old 24-06-2011, 14:16   #17
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Re: Health care for older sailors

As for health maintenance, you should be able to keep up as you travel - as long as you take charge and make it happen. You may want to modify your itinerary in order to be at places with good hospitals/doctors when needed - this is common among cruisers with health issues (probably most of us). My experience has been that if I had a need, I could get appropriate medical care. This may not always be the case: clearly you cannot count on a chopper dropping out of the sky and swooping you off to a state-of-the-art hospital. OTOH you will probably be a lot healthier than if you stayed home on the couch waiting for the grim reaper.

When I crossed the Atlantic 2 1/2 years ago I met a solo sailor in Las Palmas who had made 2 or 3 Atlantic crossings since retiring a few years earlier. He too had a heart attack in his past, but wasn't letting that slow him down either. He had another heart attack out in the middle and didn't make it across alive. Had he stayed home near a hospital he might (or might not) have survived. But he wouldn't have lived his dream. The only outcome that is guaranteed is death, at some point. (Sorry if this comes out sounding bad - I think it is inspirational.) :-)

Ultimately going cruising is a leap of faith into the unknown, and has unquantifiable risks. All I can say is that you will find among those who have done it that somehow things work out for most of us. Medical issues may cause you to modify how you cruise, but shouldn't stop you from cruising unless you have demanding needs. Consider this: it is usually easier to find a competent doctor or dentist than it is to find a good mechanic (electrician, plumber, etc) in much of the world.
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Old 24-06-2011, 14:24   #18
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Re: Health care for older sailors

I read the story about the ailing older fellow who couldn't afford health care. So he walked into a bank, told the teller "this is a stickup" and demanded one dollar. The police came and arrested him, and as soon as they did he asked to see doctor and was provided with one free of charge. He said the only way he could afford medical care was to go to prison.

The two sisters who clean my house are Brazilian. Both are naturalized U.S. citizens. But every year they go back to Brazil to have their medical and dental checkups and to address any health problems. In Brazil, the care is free (and pretty good if you happen to be in Sao Paulo or Rio).
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Old 24-06-2011, 14:48   #19
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But what about major medical? What happens if when you are say 55. Below retirement age so not qualified for Medicare and you've been diagnosed with cancer or heart disease needing extensive treatments? I'm betting as a US citizen I'll never be able to retire just in case and because I can't afford care.
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Old 24-06-2011, 15:11   #20
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Re: Health care for older sailors

Don't worry. When they eliminate medicare you won't be able to retire at 65 either.
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Old 24-06-2011, 15:12   #21
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Re: Health care for older sailors

I use the DOJ Preventative Health Care Plan for my Father

Today he power washed my hull (only 30' - but with triple keels), earlier in the day he did same for his motorboat (33')......me was mostly having a kip

He be 77 next month - the trick is to keep 'em moving
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Old 24-06-2011, 16:37   #22
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Re: Health care for older sailors

Quote:
Originally Posted by CarinaPDX View Post
As for health maintenance, you should be able to keep up as you travel - as long as you take charge and make it happen. You may want to modify your itinerary in order to be at places with good hospitals/doctors when needed - this is common among cruisers with health issues (probably most of us). My experience has been that if I had a need, I could get appropriate medical care. This may not always be the case: clearly you cannot count on a chopper dropping out of the sky and swooping you off to a state-of-the-art hospital. OTOH you will probably be a lot healthier than if you stayed home on the couch waiting for the grim reaper.

When I crossed the Atlantic 2 1/2 years ago I met a solo sailor in Las Palmas who had made 2 or 3 Atlantic crossings since retiring a few years earlier. He too had a heart attack in his past, but wasn't letting that slow him down either. He had another heart attack out in the middle and didn't make it across alive. Had he stayed home near a hospital he might (or might not) have survived. But he wouldn't have lived his dream. The only outcome that is guaranteed is death, at some point. (Sorry if this comes out sounding bad - I think it is inspirational.) :-)

Ultimately going cruising is a leap of faith into the unknown, and has unquantifiable risks. All I can say is that you will find among those who have done it that somehow things work out for most of us. Medical issues may cause you to modify how you cruise, but shouldn't stop you from cruising unless you have demanding needs. Consider this: it is usually easier to find a competent doctor or dentist than it is to find a good mechanic (electrician, plumber, etc) in much of the world.
I think its inspirational as well. It's of course all been said before but its good for me to have the reminders ... its all about risk and what you can tolerate. There is a famous commencement speech by Steve Jobs and I always keep handy a passage from it that sums it up nice I think.


Quote:
"Remembering that I'll be dead soon is the most important tool I've ever encountered to help me make the big choices in life. Because almost everything - all external expectations, all pride, all fear of embarrassment or failure - these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart."

- Steve Jobs
I think we need to be careful that insurance and medical care doesn't become the tail that wages the dog.
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Old 24-06-2011, 17:13   #23
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Re: Health care for older sailors

Gadagirl - And what about major medical? I paid for insurance right up until I left the States - they told me to drop out once I left because they wouldn't cover me (something absurd like they couldn't control costs overseas). Having had a heart attack at 55 (in Turkey - great care!) I return to the US to find I can't buy insurance; if I could get into the state/federal high risk pool it would cost about $14k/year. To put that in perspective, I paid about $15k to put two stents in while in Turkey (of which half of the cost was the US-made stents). One of the reasons I want to get back out cruising is that it is much cheaper to get health care pretty much anywhere other than the good ole' USA. And no, quality need not be an issue.

In a couple of years I will qualify for Medicare (in whatever form it will be then). By the time I make all of the premiums and co-pays it will not be much of a bargain compared to self-insuring overseas.

I guess the bottom line is that sitting stateside the world outside looks like a problem to deal with; once out cruising you will appreciate that it is life inside the US that is difficult and expensive. The largest potential problem is returning to the US, not leaving.
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Old 24-06-2011, 17:27   #24
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Re: Health care for older sailors

Here's an article I picked up today from the WSJ. Using this as a guide you would might never think you could retired, at least not in the US. As CarinaPDX points out, you have to think outside the box.

4 Health-Care Questions Every Boomer Needs to Ask - Encore - SmartMoney
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Old 24-06-2011, 17:35   #25
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Re: Health care for older sailors

As stated in other Cf threads on Healthcare and medical insurance, it is really a personal decision you have to make about how much and how far you want to go in staying alive should a serious medical condition arise.
- - When young (under 60) we naturally think we are imperious and will stay healthy forever so we don't need to spend precious resources (money) on something (health insurance) that we won't use.
- - As a single-hander, there is even more of a mind-set that if one gets seriously sick, you just step off the side of the boat in the middle of the ocean. There have been such instances in the recent past where rather old world racers have done just that during the race.
- - But when you have a "significant other" on board the whole situation changes. Although I have known many older cruising couples that have agreed to let "nature" determine their exit from this existence, when one partner is seriously struck down, the other's resolve disappears and anything, anywhere that will keep the partner alive kicks into play. Without insurance, that is difficult unless you are close or in countries that have advanced medical care facilities.
- - And there aren't that many of those countries outside North America and Europe. So maintaining medical coverage from your home country is a very difficult decision for older cruisers, especially if they are on a limited budget.
- - I was lucky in that I could afford to keep and pay for my coverages in the USA while I spent a decade cruising the Caribbean - where the coverage was unusable. When the "sh*t hit the fan" and I had to make an emergency flight back to Florida and enter the advanced cancer care hospital the bills mounted up at US$3000 per day for two weeks followed by US$1000 per week for outpatient care. That would have wiped out all my financial resources if I did not have Medicare and the Supplemental coverages active. The alternative was simply to cease existing.
- - So deciding how and how much Healthcare access and what it will cost is a really tough decision that is really personal. And changes as you age and transition from the "immortal" young person to the old fart with the pony-tail and beard.
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Old 24-06-2011, 17:49   #26
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Re: Health care for older sailors

Quote:
Originally Posted by CarinaPDX View Post
Gadagirl - And what about major medical? I paid for insurance right up until I left the States - they told me to drop out once I left because they wouldn't cover me (something absurd like they couldn't control costs overseas). Having had a heart attack at 55 (in Turkey - great care!) I return to the US to find I can't buy insurance; if I could get into the state/federal high risk pool it would cost about $14k/year. . . .
I guess the bottom line is that sitting stateside the world outside looks like a problem to deal with; once out cruising you will appreciate that it is life inside the US that is difficult and expensive. The largest potential problem is returning to the US, not leaving.
Actually thanks to the Healtcare Insurance Reform Act that some politicians are trying to abolish/repeal - you can get reasonable/affordable medical coverage in the USA now - even with "pre-existing" conditions. Go to PCIP.gov and you will find the new interim program for coverage for those citizens/legal residents who are refused coverage by the big medical insurance companies. It is an interim program as in 2014 the Act requires the big medical insurance companies to accept everybody regardless of pre-exising conditions.
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Old 24-06-2011, 17:53   #27
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Re: Health care for older sailors

With all due respect, it's not a personal decision, it's a political decision. The current U.S. health care system is fueled by the greed of the providers and insurers. As the system is currently structured, you have two choices: pay or die. And it does not matter that you have contributed hundreds of thousands of dollars to social security and medicare over the course of your working life. The current system is a tribute to the power and influence of the health care lobbyists.

My wife's neice married a man who contracted cancer at age 27. Thank God they had insurance, because the cost of a single dose of the drug they used in chemotherapy was over $100,000. At least it worked, and now he's in remission. If he were over 65 he would be dead.

Sure, the new health care bill improves the system. It's not perfect, but it's better. That's why the Republicans want to repeal it. After all, the big hospitals, drug companies and medical insurers will make less money.
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Old 24-06-2011, 18:06   #28
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Re: Health care for older sailors

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With all due respect, it's not a personal decision, it's a political decision. . . . .
Although I agree with you, CF policy is to not interject politics into the discussion which then usually ends up in a heated shouting match that benefits nobody. So I use "personal decision" to include whether or not you are one way or the other on the USA medical debate/situation. Political opinions/interpretations are indeed very "personal."
- - As are the cruising itineraries mentioned by other posters to keep them within reasonable distance of outside North American/European health care facilities/services that can provide the services needed.
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Old 24-06-2011, 18:22   #29
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Re: Health care for older sailors

To say it is a "political decision" simply means that it is a collective choice, not an individual choice.
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Old 24-06-2011, 19:14   #30
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Re: Health care for older sailors

Blue Cross/Blue Shield (with whom I have an individual policy) has programs for covering medical care outside the state/country:

BlueCard® Worldwide - When Traveling Outside of the U.S.
BlueCard®
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