Health Insurance ?

[bobfnbw]

Also, remember that you do not need to use expensive glucose tablets. Just use squeeze tubes of cake icing. Also you should be able to give it IV if your wife, or someone can give it to you, if unconscious. But rubbing the cake icing on the gums will help some. Best to give it slow iv push. Make sure its in the vein though, as glucose can be very damaging to the sq tissue if it Extravasates. Not a good thing.
Any voyager should have some way to start a iv if needed.

And Mike, I understand where you are coming from with the "brittle" but lighten up a bit. Many people use terms that they hear from either their doctors, or their family.
At least he didn't say "sugar diabetes"... lol which I hear a lot in the south.

How about walking pneumonia?

[YOGAO]

bobfnbw,

As long as I am hijacking this thread, some conventional thoughts on diabetes as I know them (of course, you are probably an Endocrinologist, if so, EXCUUUSE ME!)

Cake icing tubes v. glucose tabs? Yes, if you can't find any (Martinique anyone?). I get 50 glucose tabs for about $5 on-line v. $2 for a tube of icing using refined sugar - I'll take the glucose tabs anytime. I know what I'm getting, can accurately control the dose and it's fast acting. Normally 3 tablets (30 cents) gets me from a 60 BG reading to 95 in about 15 - 20 minutes.

I am testing 6+ times a day, I should never be unconscious, but I do have a glucagon set (yes, they have their own issues). It's similar to an epi pen; mix it and jab it in a leg, arm, wherever - no IV required.

Sorry if you were put off by my, "Say NO to brittle diabetes as a term", but this term is like waving a red flag in front of a bull. 'nuff said?

Fair Winds,
Mike

[bobfnbw]

Hey mike, no reason to be sarcastic.
You probably know more about diabetes than I do living with it, but then again maybe not. I have found that many diabetics don't know enough. If that isn't you, then good.
I don't know about marinique and cake icing vs glucose tabs. Personally, you should seldom ever need either if managed properly.
I suggest that you not let those red flags drive you. People that let small stuff get to them get early heart disease. MI, Stroke. Not fun.
After 12 hours in the ICU, I am tired, so goodnight.

[YOGAO]

Bob,

There is always someone who knows more, and when you're comparing someone to me, they most assuredly know more, but I don't believe it.

I will try and go colorblind on the red flags. Keep up the good work.

Fair Winds,
Mike

[Extemporaneous]

Originally Posted by bobfnbw

At least he didn't say "sugar diabetes"... lol which I hear a lot in the south.

Originally Posted by YOGAO

Sorry if you were put off by my, "Say NO to brittle diabetes as a term", but this term is like waving a red flag in front of a bull. 'nuff said?

Fair Winds,
Mike

Please, educate me.
If it's not the right term/name, okay.
But help me understand why it's so offensive.

Thanks,
Extemp.

[YOGAO]

Originally Posted by Extemporaneous

Please, educate me.
If it's not the right term/name, okay.
But help me understand why it's so offensive.

Thanks,
Extemp.

In my own experience, "brittle" was used as short-hand to describe a Type 1 diabetic (me) who wasn't managing their condition well. IOW, my problems were ONLY due to my poor behavior, not because of the "specifics" of the disease.

In a broader sense, all Type 1 diabetics require insulin and currently the "state of the art" management is via insulin pump with a continuous glucose monitor system validated with a "finger-stick" blood glucometer. While there are other treatment methods and debates about diet, throwing the word "brittle" adds nothing to managing the disease.

I am probably not explaining it well, sorry. I guess the bottom line is T1 diabetes is hard enough without being told you have it "worse" than others since you are "brittle!"

Hope this helps - Fair Winds,
Mike

[Extemporaneous]

That does help.

Thanks Mike.

Extemp.

[Sailsarefull]

There are several international health insurance companies available that will cover you anywhere BUT the US. That is because of the expense of care in the US. Not sure you can buy if living in the US though. As for self-insuring, that is great for anything but major expenses. I hope those self-insured don't expect to get care in the US for major issues. Then you are sponging off the system and making those of us that are responsible and have insurance pay for your care. Is care/insurance in the US expensive-yes. But, one night in the hospital costs more than a full-year of premiums so the exchange is definitely worth it if you need it.

[sck5]

THere is a reasonable path for US citizens who are travelling abroad. While it doesnt necessarily work for those with chronic conditions like diabetes it works well for everything else. It has three parts

1. Ordinary medical care (routine infections, broken bones, cuts, etc.) is FAR cheaper outside of the US. Dont buy insurance to cover this. Simply go to the local clinic and buy your medical care a la carte. It will be cheap and perfectly good. I have tried this everywhere I have gone, from Africa to the Caribbean to Europe. There are competent doctores in all of these places. Buying insurance to cover this stuff is WAY more expensive. Not only that but the rest of the world won't have a clue what to do with your insurance card so you will end up paying out of pocket anyway.

2. Buy medical evacuation insurance for those problems which require a US hospital or an extended stay in the hospital. I have Medjet right now but have used SOS in the past. Note: Medjet is ONLY for the transportation back to your home in the US. Nothing else. But it isnt that expensive

3. Buy a high deductible catastrophic policy back in the US for those major issues (e.g. a policy with a 5k deductible but no upper limit) Yes, you might someday be out 5k if a major illness or accident strikes but that will be it. Your transportation back home and unlimited care once you get there is already taken care of.

I have done this for years. Never had to use the medjet but I have known people who did and they were happy with it. A la carte care is perfectly OK for all the routine stuff that pops up. In fact, local doctors are much more in touch with local diseases, infections, etc. than are US doctors. We are money ahead as a result

[Seaadventurers]

Originally Posted by sck5

THere is a reasonable path for US citizens who are travelling abroad. While it doesnt necessarily work for those with chronic conditions like diabetes it works well for everything else. It has three parts

1. Ordinary medical care (routine infections, broken bones, cuts, etc.) is FAR cheaper outside of the US. Dont buy insurance to cover this. Simply go to the local clinic and buy your medical care a la carte. It will be cheap and perfectly good. I have tried this everywhere I have gone, from Africa to the Caribbean to Europe. There are competent doctores in all of these places. Buying insurance to cover this stuff is WAY more expensive. Not only that but the rest of the world won't have a clue what to do with your insurance card so you will end up paying out of pocket anyway.

2. Buy medical evacuation insurance for those problems which require a US hospital or an extended stay in the hospital. I have Medjet right now but have used SOS in the past. Note: Medjet is ONLY for the transportation back to your home in the US. Nothing else. But it isnt that expensive

3. Buy a high deductible catastrophic policy back in the US for those major issues (e.g. a policy with a 5k deductible but no upper limit) Yes, you might someday be out 5k if a major illness or accident strikes but that will be it. Your transportation back home and unlimited care once you get there is already taken care of.

I have done this for years. Never had to use the medjet but I have known people who did and they were happy with it. A la carte care is perfectly OK for all the routine stuff that pops up. In fact, local doctors are much more in touch with local diseases, infections, etc. than are US doctors. We are money ahead as a result

I don't know if I would call high deductible health insurance in the US reasonable anymore. I just got a quote from BCBS of Texas for medical insurance with a $6,500 deductible and it was $1,300 per month starting in January. That means my healthcare costs have to be $22,100 before I get anything from insurance. Is that reasonable?

[Sailsarefull]

I hear you there. Depends on your definition of "reasonable". I guess you can rationalize by accepting that one night in the hospital eats up that $22,000 quickly. No easy answer other than to take good care of your body.

[Seaadventurers]

Originally Posted by Sailsarefull

I hear you there. Depends on your definition of "reasonable". I guess you can rationalize by accepting that one night in the hospital eats up that $22,000 quickly. No easy answer other than to take good care of your body.

I'm not arguing that insurance is not needed, just that the price in the US is grossly unreasonable. The insurance in our state is rising 40% this year. Unless something is done to reverse Obamacare and find a better system, we will have a total healthcare collapse within a few years!

[Paul L]

Originally Posted by Seaadventurers

I'm not arguing that insurance is not needed, just that the price in the US is grossly unreasonable. The insurance in our state is rising 40% this year. Unless something is done to reverse Obamacare and find a better system, we will have a total healthcare collapse within a few years!

You imply that the increases are do to Obamacare without any evidence.. Health insurance in the US has been increasing in costs at a rate far above inflation for decades. Keeping this cruising related, when we left to start full time cruising health insurance was our largest single expense. Prior to leaving it was going up 10-15% a year. A few years latter we got a BlueCross policy from the ACA exchange (Obamacare). This was 50% less expensive and better coverage. For this year our ACA policy costs went down by about 10-15%.
Now the repeal and replace crowd has had 6 years to develop an improved, more cost effective system - so it should be easy to roll it out quickly and live up to the incoming administration's promise to have a much better and much cheaper insurance that covers more people ---- OK I can dream.

[Seaadventurers]

Originally Posted by Paul L

You imply that the increases are do to Obamacare without any evidence.. Health insurance in the US has been increasing in costs at a rate far above inflation for decades. Keeping this cruising related, when we left to start full time cruising health insurance was our largest single expense. Prior to leaving it was going up 10-15% a year. A few years latter we got a BlueCross policy from the ACA exchange (Obamacare). This was 50% less expensive and better coverage. For this year our ACA policy costs went down by about 10-15%.

Now the repeal and replace crowd has had 6 years to develop an improved, more cost effective system - so it should be easy to roll it out quickly and live up to the incoming administration's promise to have a much better and much cheaper insurance that covers more people ---- OK I can dream.

Fact: the US has Obamacare

Fact: my health insurance costs went up 25% in 2016 and will increase 40% in 2017.

If you think the two are unrelated, then that is your prerogative.

[smj]

Originally Posted by Seaadventurers

Fact: the US has Obamacare

Fact: my health insurance costs went up 25% in 2016 and will increase 40% in 2017.

If you think the two are unrelated, then that is your prerogative.

Fact: my insurance is less expensive this year than 2 years ago.