Dealing with a cut forehead in Antigua, Guatemala
Quick note: The book is finished!! Hurray! Living Deliberately: Your Guide to a Ridiculously Awesome Life. Over 230 pages. Get it here on Amazon!
Travel seems so exotic. The images of white sandy beaches; romantic street-side cafes; ancient ruins with stories to tell of peoples long ago. The notion is so appealing.
But when you get down to the nitty-gritty, travel is about a lot more than the exhilarating highs. There's plenty of grating, irritating or down right overwhelming lows.
There's sand in your shorts (or in eyes, mouth and nose if you're traveling with kids). And if you are traveling with kids, forget any moments of romance. Most often you're trying to quiet their incessant screams while you all wait impatiently for food prepared by someone who doesn't know the meaning of 'fast' (which is what makes the food so good).
And climbing those ancient ruins eager to absorb the aura of people long ago dead? In reality you reach the tippy-top, out of breath, only to be told by your 6 year old that they have to go "number two", RIGHT NOW! Talk about 'aura'.
Beyond the idiosyncrasies of traveling with children, there's the logistical side as well - mail, taxes, banks, and the one people have often ask about... health insurance.
The question, "What do you do about health insurance?" might become less of a concern for American citizens who may be required to hold federally mandated? insurance policies.
(What it means for American citizens living outside of the U.S., I have no idea. Perhaps we'll have to show proof of insurance before we can return. In that case, I guess we won't be back for awhile. 😉 )
Most people have a job (although statistically 80% of them hate it). And with that job comes health insurance. But there's also a large percentage of people who don't have 'regular employment', and therefore, 'regular' health insurance coverage.
This 'problem' isn't unique to people who travel. It's something that countless families deal with who do something that's at all outside the 'norm'.
And I'm sure the solutions are as varied as the individuals who seek the answers.
I can't answer for others, but I can tell you the approach we take. It may not be very 'reasonable' for some, but it absolutely works for us. (And if you don't like what I have to say about it, I apologize in advance. I have no intention of offending, I'm just telling it like I see it.)
1. The best insurance is prevention
The approach that too many Americans take toward health insurance is somewhat absurd. Stuff my body with processed, unnatural foods, avoid exercise, pop pills to mask the message my body is sending me, and then pay money every month to a private company (that is raking it in) to cover my butt so that when my body finally reaches a breaking point and experiences failure in one of it's systems, my insurance will pay my exorbitant medical bills that I didn't avoid incurring through proper diet and exercise.
To me, that approach shows a lack of personal responsibility. It's looking to someone or something else to pay for life-long mistakes.
Now I know that not every medical expense can be avoided through prevention. Accidents can and do happen. But the majority of medical costs are incurred through procedures that could have been prevented with a healthy lifestyle. We believe that that's the best 'insurance' we can have.
We live by this Healthy Lifestyle Pyramid to ensure that we take care of ourselves so we can prevent the highest causes of death and disease - obesity, diabetes, heart disease and cancer, among others.
It is possible to prevent visits to doctors and hospitals through a healthy lifestyle. Eat an apple a day (i.e. make good daily choices about your health) and you really will keep the doctor away. But eat a Hershey bar a day (i.e. make poor health choices everyday), and you'll see the opposite results.
I (Rachel) have not been to see a doctor or to a hospital since I had my wisdom teeth removed as a teenager. I attribute this to the lifestyle choices I make on a daily basis.
2. Proactive Self-Care
After building a healthy foundation, you add to the pyramid with Proactive Self-Care and, when needed, Professional Medical Care.
We believe that part of a healthy life-style includes proactive self-care. Turning to 'experts' to have all the answers for us as individuals isn't always the best course of action. Of course, experts have a lot to offer, and can have very helpful advice. But as much as possible, we should pursue information and education that will help us to treat illness, injury and disease for ourselves and our families.
Greg has received emergency medical training (EMT), so he has the skills necessary to handle trauma and emergencies. I am educating myself in natural healing. Over the past year I have naturally treated my family for the many things.
It wasn't always like this. When we first moved to Costa Rica, or lived in the Dominican Republic or India I didn't have the skills I do now to help my family when we needed medical care. In those situations, we turned to medical professionals and visited local clinics when necessary (like the time when we were living in the Dominican Republic and Greg had a staph infection that spread from his shoulder to his fingertips. He had to receive five shots of penicillin at the local clinic to conquer it. Most recently, I staved off a staph infection in eight year old Parker's arm with natural remedies.)
Greg's arm before
There are times when you need professional medical help, like when we were in a car accident in Alaska and our three year old broke her femur and our six year old cut his head open. We RAN to the hospital then (well, we were in an ambulance), and were VERY grateful for the competence of skilled medical professionals. (And Providently, the medical bills were all covered by the other driver's insurance).
But for most of life's bumps, bruises and maladies, becoming educated about natural remedies has literally opened opportunities for our family that we haven't know before. In the past, I did experience fear of something 'bad' happening to my kids while we traveled. Now I know that for most of the things that we'll encounter, I have the resources to combat them.
3. Focus on 'What Is', Not 'What If'
Health insurance exists to cover your butt for the 'what ifs' of life. That's why it's a profitable business model. Believe it or not (!), insurance companies are in business to make money!!
And they do make money, because the majority of people who pay them large sums every month never actually collect - they never use the coverage they pay for.
Watch an insurance commercial, and you'll notice that they're selling you on 'fear'.
"You better buy insurance because something really bad could happen, like a tree falling on your house, or your car, or heaven forbid, your child."
Those things do happen. But what is the likelihood that they will happen? Actually very small. If there was a high likelihood, than the insurance company wouldn't be in business. It would be too risky for them.
Our approach is simply this: Rather than paying money every month to a big corporation who's already raking in the dough, 'just in case' something bad happens to us sometime, we'd rather pay the money to ourselves to use if and/or when we actually need it.
We'd rather pay for 'what is' than 'what if'. If we have to go to the hospital for some emergency, than we'll pay the bill out of our savings, or make payments on it.
If as a result, we end up in debt paying for a medical bill for the rest of our life, well, how is that any different than paying an insurance premium every month? At least we're paying for something we actually needed, rather than paying for the 'fear' of something happening.
Like I said, this approach doesn't work for everyone. People have different needs and desires. We choose to focus on a healthy lifestyle, choosing natural solutions for our health-care needs (versus prescriptions, etc.), and being reverse optimists - believing that the universe is conspiring for our best good. This is what works for us.
How have you addressed the issue of health insurance? What is your strategy?
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Oh, my goodness!!! May I stand up and give you an standing ovation??!!!
Oh, I wish more people would have the guts to speak the truth!!
We do the exact same as you guys do. We practice preventive medicine not fear medicine. Each year I see we are growing in knowledge of self-care and health. I have lost 30 pounds in the last year just by changing my eating habits and by consequence my family’s too.
the kids have a green smoothie everyday. The last time we went to the doctor was when my now 2.5 year old was 6 months and had the 5th disease. the doctor had no clue about it, but I did because my son had had it 4 years before so I knew exactly what to do. I went to the doctor to get the prescription medication I needed to treat her in case she had an allergic reaction to the virus. Everything went smooth with no complications or ER visits. 🙂 Praise Jesus!
Like your family, instead of giving our money to a company to “manage” and negotiate our medical needs, we do it ourselves. I have had 3 babies at the hospital (unfortunately! 🙁 ) and we paid them all from our own pockets. We negotiated rates and/ or made payments. one time we were able to pay the same amount that Medicaid patients “pay”.
My husband had to have a surgery to correct a hernia and we negotiated rates with the hospital and surgeon ourselves. It cost us $5,000 8 years ago.
unfortunately, we are living in a time and age where more and more people are giving their freedoms away. They rather have someone or the government take care of them and make all their decisions for them. All this based in fear. What if??
Clapping…and still clapping!!! I will be contacting you about the oils too. thank you for speaking out!!
Thank YOU for your passionate response. It’s great to hear your ‘medical plan’ 🙂
We don’t have any! Five years ago my wife was in the hospital with pnuemonia. We made interest free payments. This year while in Honduras my wife had an emergency surgery. They removed the benign tumor wrapped around her ovary. 3 days in a hospital, surgery, test, meds…$1700 USD!!!!!! Unbelievable. And the care was excellent, better than we have received in the States. Besides that, we had bought a trip ins policy for $25 per person which covered 100% of the bill. There is very resonable ex pat ins out there if it gives you peace of mind. To me, the reduced health cost available in third world countries is an unbelievable bargain and another reason to live abroad…at least for those of us who haven’t maintained our bofies like we should have. Yikes! Sorry Rachel, I know you’re right though.
Thanks Michael, I like reading your stories. And you’re right, great (inexpensive) medical coverage can be found outside the U.S. (which I guess is part of our ‘plan’ as well).
Maybe we’ll have to check into some type of ‘trip insurance’, but it’s difficult when you’re ‘trip’ lasts for years, like ours. 😉
Trip ins is a great way to protect yourself, luggage, tickets and health ins for short term travelers. My sister who traveled the world for years relied on what is called expat ins. Very inexpensive compared to ins in the US. We plan on continuing to go with out whether here or in Honduras. It will be interesting to see what Obamacare does to those living abroad.
Hmmm… maybe we’ll check into it. Thanks!
This is so true! I have been trying to figure out what to do about health insurance and of course I already knew to take care of my body but had never considered the ridiculous amount of money taken out of my pay check for those “what if” situations. My daughter fell off her bike and had to get seven stitches. Our insurance company didn’t pay a dime because our deductible was so high. And that high deductible was supposed to make the monthly payments affordable! I am still paying the hospital bill and paying the insurance company. Thanks for the light bulb moment! Now I plan on allocating this money to fulfilling our travel dreams! Great post!
May all your travel dreams come true 🙂
Thanks for the post! I never had a good response to the “what if you go into debt from a huge accident” scenario before.
Yeah, to me it’s better than ‘debt’ aka insurance payments ‘just in case’.
Thanks for writing about this! I”m traveling sans insurance, and I really try to focus on whole foods and avoiding stupid dangerous things. Its really too bad that this is the way that it is though. Happy Travels!
Yes, I agree with you on the vast majority of what you said. No, I don’t agree with the last bit.
We do travel with health insurance and – after what we’ve been through – would never go without. I traveled on my bike for a whole year through Pakistan, India, Nepal, and Bangladesh with absolutely no insurance whatsoever. I thank God that nothing happened and realize now just how foolish I was back then.
When my husband’s heart suddenly went into arrhythmia while we were in Ethiopia, we learned real quick that insurance was something we needed – even if we hoped we never needed it. Long story short, they couldn’t deal with his issue in Ethiopia, so he was evacuated out to Israel via an air ambulance (a specially equipped plane that flew 7 hours to pick us up, then 7 hours back). That air ambulance came at a cost of nearly $100,000, but the insurance company did way more than just pay the dollars. My husband’s very life was saved by the professionals working there. I’ve written the whole story here: http://familyonbikes.org/blog/2012/03/a-medical-evacuation-story-and-why-you-should-never-travel-without-evacuation-insurance/
So yes, we do need to take responsibility for our own health. We need to eat right and exercise and treat small boo-boos on our own. But when we’re in remote corners of the world and your heart decides to start flip-flopping, you will want to be evacuated out to a place that can deal with it. Trust me, you will. And all that money you saved earlier won’t mean diddly squat.
@Nancy Sathre-Vogel: great points…so…are you saying that if you didn’t have health insurance, your husband wouldn’t have been treated or flown to where he needed to be? I thought what the Dennings were saying is that they would still get treated, but that you would just have a bill now instead of a premium payment.
I am also wondering because we are about to spend 4 mths/yr in the Dominican Republic and our health insurance is with HUMANA with a $10,400 deductable…do I need travel health insurance or if something major happened…would I be able to do as your husband had done?
In our case, my husband would have died. Read the post I linked to above and you’ll understand why I say that.
The local, Ethiopian doctors knew what needed to be done, but they were not prepared to do it. They did not have the capability of putting in a pacemaker if his heart had stopped when they tried to convert it, so they simply refused to treat him. Granted, if he didn’t have insurance they probably would have tried and it may or may not have worked.
As it was, they said we needed to evacuate. Again, you COULD possibly pay for that (in our case $100K) if you had the money, but for us the bigger deal with their connections and expertise. There was NO WAY we would have had any idea who to contact or how to contact them to make the evacuation happen.
My husband was not allowed to travel on commercial airlines because it was a heart condition, so the only way he ever would have gotten out of Ethiopia was on an air ambulance – and he very nearly didn’t make it out that way either. It only through high-level diplomatic negotiations that he was allowed to leave the country.
I can understand the temptation to go without insurance, but would never do it personally after what we experienced. At the very, VERY least, pick up a medical evacuation policy so that you can get out of remote areas if you need to.
Your plan, or lack of a plan, sounds very risky. I assume none in your family have a chronic condition requiring expensive medicine or regular treatments.
You’re not alone by not carrying insurance. There are way too many people in the US not carrying insurance. That is a big part of why medical costs are so high. Those who have insurance foot bridge the gap for those who never paid their bill.
Well meaning as you might be to pay your bills, if a catastrophic event does happen, it is unlikely you would ever really be able to pay the bill.
I wish you the best of luck and hope your family never has any medical problems.
Risk is relative.
Many people think it’s risky for us to be driving through Central and South America with our children. We’ve learned through experience that it’s not as risky as most people believe.
Thanks for your wishes of luck, but ‘never’ is a very long time. I’m sure we’ll encounter some sort of medical needs along the way. 😉
@Nancy Sathre-VogelNancy, it seems to me you overlooked most of the main topics of Rachel’s article: like prevention, self-care, personal responsibility and PROPER exercise (which means not only “good workout”, but also “safe workout”).
From what I read in your blog, your husband showed none of these in that situation: he cycled 60 miles in Ethiopia with little water, if any; the following days went on with his life even if the symptom was serious enough to prevent a “normal” life, and, most important, he ignored a HEART symptom for NINE days, in the middle of ETHIOPIA!!!
Don’t misunderstand me, I’m not judging, I’ve done worse! That’s why I cringe when I read “your heart decides to start flip-flopping”…In the situation you describe, no heart decided anything, your husband had all the signals, since the first day. For nine days. He just refused to listen to them.
From what Rachel writes, I get the feeling that none of the Dennings would risk their lives the way he has done. And if you hadn’t any insurance you probably wouldn’t have either!