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Old 27-01-2007, 05:52   #16
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I agree with Brent. Jentine... you're a good guy. Not sure what is meant by the paper ahole statement. I'm not familiar with the expression. Maybe it wasn't as derogatory as it sounds?

Anyway, the cost of healthcare outside the US is signficiantly less expensive and prescriptions in many cases aren't even "prescription!" Just head to the pharmacy and buy them. Forget the prescription.

It's also important to note that the US isn't even close to number 1 in longevity, or quality of healthcare services. We are, however #1 in cost of healthcare. So, this is one case where anything you do will be better than standard USA insurance or medical treatment. Take a look at this article. There are a couple of quotes and a link:
"
Updated: 8:13 p.m. ET Sept 20, 2006

WASHINGTON - The United States spends far more on health care than any other country but gets only mediocre care in return for its investment, according to a report released Wednesday.
The U.S. national average score on 37 separate measures of health care falls far short when compared either to a few centers of excellence within the country, or to other countries, the report from the Commonwealth Fund found.
“Overall, you will see ... that the United States scores poorly — an overall score of 66 (out of 100),” Cathy Schoen, senior vice president for research and evaluation at non-profit health-care research foundation, told a news conference."


...

"There is one area where the United States comes in first, compared to other countries. “We are by far and away the leader on costs,” Schoen said. Americans spend 16 percent of gross domestic product on health care — double the median for all industrialized countries.But the United States scores 15th out of 19 developed nations on deaths from causes that are easily prevented if timely medical care is provided, such as heart attacks. France scores the best, with 75 deaths per 100,000, while the United States weighs in with 115 per 100,000. Only Ireland, Britain and Portugal score worse.


U.S. infant mortality is far higher than in any of the other 23 countries measured, with a rate of 7 deaths per 1,000 births. The next worst is New Zealand, with 5.6 per 1,000, while Iceland scores the best with 2.2 per 1,000."

U.S. gets bad grade on health care scorecard - Health Care - MSNBC.com


So, don't be afraid to get medical coverage and/or treatment outside the US. You can save money and get better care in many cases. The notion that the US is the best country in terms of medical treatment is incorrect and possibly some outdated leftover. It's not what it used to be. Prescription drugs in *every* other country are far superior. Not as much regulation and a small fraction of the cost.




As to health plans, I think I've posted this on the board before, but I have used these people while working on megayachts outside the USA. Never had a claim, but the policty was from Lloyd's of London. From what I understand, they are a fairly reputable outfit.


International travel medical and health insurance, featuring trip cancellation travel insurance online.



They covered me outside the USA and for short visits back into the USA. There were limits on how long I could be covered while in the USA. It was a couple months a year, I think.
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Old 27-01-2007, 06:34   #17
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The term “paper asshole” is a derogatory epithet, suggesting a person who talks a lot, but doesn't say anything, talks nonsense, or is “full of it”.

Jim (Jentine) might be advised to revise or delete his disparaging comment, which does nothing to advance his own reputation.
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Old 27-01-2007, 17:27   #18
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"I just can not find it….unless I want to pay around 5 to 8 thousand dollars a year." That's actually about the norm for any "decent" medical insurance policy for ONE person in the US, it would be cheap for a family (typically 11-14,000).

Typically anything cheaper is literally cheap insurance, i.e. you'll find that if you can extort a copy of a policy from them before buying in, that there's a lifetime limit of $100,000 on the policy, or a per-incident limit of $50,000, or you're getting just a "major medical" policy (which can be good if that's your choice) which covers hospitalization--but only the hospital costs, which do not include the bills from surgeons and anesthetists, etc.

There's no magic way to get cheaper insurance in the US, only policies that provide less and you have to shop carefully for what you anticipate. (i.e. $100,000 lifetime limit may sound good--but you can exceed that in one kidney failure, one car accident, etc.) Usually the only discounts that mean anything are if you can qualify with a group, a trace association, a fraternal, the AARP, etc.

Cheaper to hire an ex-Soviet surgeon and give him free room and board on the boat, and the right to take in business while you're in port, yes.
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Old 28-01-2007, 03:22   #19
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unless I want to pay around 5 to 8 thousand dollars a year


Is that really the going rate??
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Old 28-01-2007, 03:35   #20
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Is that really the going rate??
That's accurate. See why medial is so high on our country's refit list?
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Old 28-01-2007, 07:29   #21
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Going to say this again there are better policies.. we pay under $4,500 per year for two of us. Yes it has a high deductible by choice [it's where the added cost for no deductible vs normal annual costs wash]. It has a lifetime max of 5 million so that's reasonable. the other benefits are in line with group stuff etc. The individual plans do exist, you have to work at it to find them. I would search a little harder. And yes you do have to be in reasonable health to get a policy that's the bad news.

The US is different when it comes to medical care - yes we spend more money but we also have better access to lots of things like MRI, CAT scan as routine while the rest of the world does not. You can argue whether they are needed or not..You can also manage your own care to minimize costs within reason.
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Old 28-01-2007, 08:12   #22
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The US is different when it comes to medical care - yes we spend more money but we also have better access to lots of things like MRI, CAT scan as routine while the rest of the world does not. You can argue whether they are needed or not..You can also manage your own care to minimize costs within reason.
Acutally, we don't have better care Jon. Several European countries offer better access to health care. Did you read the articles in the links?
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Old 28-01-2007, 08:22   #23
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I have had medical care in places as odd as Sierra Leone and Laos, Thailand, Switzerland and Egypt and I can say that the health care in Asia is generally better than that in other parts of the developing world. Of course this is a country by country issue too.

Several years ago my son had a mortorcycle accident in Thailand while we were riding around the northern provinces. His arm was badly injured. After a 3 hour ambulance ride to Chaing Mai (major northern City) about 2 hours in surgery, 12 days of returning to the hospital everyday to have it checked and rebandaged and finally the stitches taken out, it cost me about $280 USD. The hospital and doctors were world class (as good as any here in the states) and the level of care and concern for us was just heart warming.

After about 30 years of traveling the world I agree with those that advise getting the insurance from Britain, France or some other EU country and use the local doctors (with discretion and advise from expats living there).

Just a note; many of my friends who work for Swissair all go to Bombay to get dental work done. Apparently there are many fine dentists trained in the US and Europe with practices designed for Westerners. This type of thing is true in many places around the globe.

However for the much more serious things such as cancer, organ failure, stroke etc you probably want to be at home with loved ones anyway.
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Old 28-01-2007, 09:34   #24
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Acutally, we don't have better care Jon. Several European countries offer better access to health care. Did you read the articles in the links?
Sean

Depends on how much money you have or insurance.

The articles don't tell the whole story [what else is new]. And statistics don't tell all either. After all numbers never lie but liars figure. I know that you can make the numbers tell you what you want - I've done it and seen it done lots of times - numbers were never wrong just put together a certain way.

You are correct that certain countries offer universal access [better?] however in most of those countries there also also private clinics for those who can afford better treatment or more immediate treatment. The issue is not that simple - US is not as bad as made out to be - clearly not perfect either.

I am not a big fan of socialize anything as you can see. It means higher taxes and less service in general.

I do believe in open access though -and that raises an issue as to how to get fairly priced medical services for all - I do not have the answer for that. Part of the problem is liability, part of the problem is over testing, part of the problem is greed... aah that's why I dropped out for a while.. and went cruising
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Old 28-01-2007, 10:21   #25
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Jon, what provider and what policy do you have that gives a family of two, who are not employees or group members, whatever you consider "good" insurance under $5k per year?

Broad words like "good" can't be used in discussing insurance, there are simply too many options and variables. Odds are at that price you're not in the norm. Routine coverage or meds or something isn't there, or you are being classed differently for any of the other usual reasons.

I don't doubt you've found something you're happy with--I just know that at least in my corner of the US, what you have could only be a major medical policy, or a subsidized state plan, or another "limited" plan of some type. That's from reading policies and quotes--not articles about them.

And from a friend who's a doctor, who provides me with much comic relief as he tells tales of what his patients come in with. One, with "full chiropractic coverage" according to their policy. Except, the coverage specifically excluded all "spinal manipulation" which of course essentially means zero chiropractic coverage, contrary to the plan declaration.

That kind of nonsense in plans is sadly normal these days, and with policies that run 1/2" thick, all near impossible to read much less compare in advance.
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Old 28-01-2007, 11:09   #26
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Thanks for the returns... I would also love to know this "good" insurance that is under $4500 for a family because I can not find it. I have been searching for many years and always come up with about double that with a high deductible if not more. We had a policy for about 6 years with Mutual of Omaha it was a major med only with a $5000 deductible it cost $6000 last year. This we never used because we never had any major issues (knock on wood). We got a cancellation notice last month; they were not going to carry this anymore. So considering that we are going cruising in about two years we have decided to go through my husbands business and pick up insurance through a group. Wow it is expensive even this way but it is great coverage. We have decided to buy insurance for just my husband and I under this policy, which cost $8712 per year, family was $11328. We have two girls in college, one will graduate in May, and so we picked insurance up for them through the colleges, which was only about $800 per year. Sorry to get into this so deep but my point is there just is no way to get a good coverage without spending around $10,000 for the family. We plan on getting checked over this year and having any issues dealt with so if we can’t find a reasonable insurance with high deductible when we leave to go cruising we will feel a little better about self insuring while out there.
I wanted to thank everyone that gave names of insurance companies to check out for cruising, I have been making a list and plan on researching them. I will let everyone know what I came up with before we set out.
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Old 28-01-2007, 15:09   #27
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Jon, what provider and what policy do you have that gives a family of two, who are not employees or group members, whatever you consider "good" insurance under $5k per year?
My policy is through Humana - it is individual health no group, for two adults only. It does not have dental, vision, it does have prescription coverage. I am not going to put my policy up here for discussion but I have had very very good coverage before we dropped out to go cruising and this is not that good. But it is more than adequate. Similar coverage is available through Blue Cross/Blue Shield, Cigna that I know of. Again if you have major medical history that will be an issue and if you expect a $500 deductible it won't happen for those costs. And it takes time and is a PITA to go through the process. It took us a good 6 months from when we started to when it was approved.
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Old 03-04-2007, 05:55   #28
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I have had medical care in places as odd as Sierra Leone and Laos, Thailand, Switzerland and Egypt and I can say that the health care in Asia is generally better than that in other parts of the developing world. Of course this is a country by country issue too.
In fact, dollar for dollar (or baht for baht, as the case may be), I'd say medical care in Thailand is the best value in the world. In Bangkok, several hospitals offer excellent, efficient care and low-cost prescription drugs for a fraction what you'd pay in the states.

Admittedly, this is largely because of two factors a) cheap labor and b) minimal costs incurred from liability insurance.
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Old 27-06-2007, 10:19   #29
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US Health insurance cost is driven by several factors. One of the major ones being liability... to reduce liability many CYA test are performed to protect the medical establishment from the massively excessive law suites that flood our courts.

Another is the non support / no subsidy of medical services by the Federal or State governments AND ironically the need to have everyone who has insurance or ability to pay for services.. Pay for the services of those who use the facilities but never pay.... This alone almost doubles each individual expense. In the US almost every area has a public hospital that MUST provide services with out regard as to a patients ability to pay and this is often abused by citizens and non citizens.

At this time in the US, the massive flood of illegal aliens across our southern boarder has bankrupted many public hospitals and public health organizations.

To make up for these unpaid services, those with insurance or the ability to make payments have to not only cover their own cost but a portion of all the un paid cost. For a capitalist (a good thing) based country... we do fall into many of the Socialist arena but expect individuals and not the governments to actually face the cost.

It is ridiculous but not much is being done to correct it although caps on liability awards are frequently discusses and Federal subsidies to areas where illegal aliens have depleted the local resources are discussed but generally never acted on.

For full time cruisers, it is probably a good thing to get non US coverage or to set up a personal Health Account which is allowable by the IRS as a form of self or semi self coverage with tax benefits. This is far more difficult for those of us that are at the 50/50 or less mark as to in or out of US Cruising and work.

Apple a day seems to be a good choice, probably need to dip it in Rum just to be sure.
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Old 27-06-2007, 14:06   #30
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I usually buy only enough medical innsurance to get past the US. I avoid "Travel Underwriters Worldwide Mediclaim "as they refuse to pay
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