Living Without Health Insurance! Oh my!

(UPDATE: In 2020 I  finally began to receive my healthcare benefits, but I stand by my views on the healthcare system stated below. I was without healthcare insurance for just over five years)

I am one of many uninsured Americans. It’s a strange and unusual predicament for me. I have had the same health care insurer  throughout my working life, thirty years to be exact. Now like so many others I wonder what will happen if I have a major health crisis.

At the tender age of 56 I reached financial independence and  left my career behind. In an effort to maximize my retirement pay, I deferred all benefits until I turn 62. Deferment means that everything is on hold. Unfortunately when I arrived back to states the original quote of $290.00 a month had soared to $750.00 a month for healthcare, which was well above the amount for which I budgeted and the amount I was quoted. So here I sit without healthcare coverage. Unlike so many Americans I am fortunate enough to have options. 

How do I take care of my health care needs on the road you might ask. I have insurance for travelers but it does not cover me in all situations. If I have a heart attack or break a leg I am one hundred percent covered as long as I am over 100 miles from home; worldwide coverage. It costs $700.00 for the year, I repeat for the year!!! But if I come up with the big c, cancer, or any other major illness I am on my own. Since leaving my job I have paid out of pocket for my annual checkups. Going to the doctor just because I sneeze is no longer an option.

Medical Care on the Road

I take care of my medical needs as I travel and it has proven to be the most cost effective method. My travel insurance is World Nomads (WN). Whenever I need a doctor or my prescriptions refilled I call WN and within thirty minutes to an hour I either have an appointment or the name and phone number of a local physician who speaks English. I have had doctor’s appointments and prescriptions filled in Mexico, Germany and South Africa. The doctors were fabulous and their service efficient and affordable. In spite of Americans’ tendency to lean deep into ethnocentrism there are places in the world where healthcare is not only safe, clean, and delivered by well trained expert doctors, the services are more affordable and the quality of service is same or better than healthcare in the U.S.

My recent Health Scare and the Doctors in Thailand

My recent health scare started with a general discomfort in my gut that became increasingly more uncomfortable. Cancer tends to run in my family. So, if I sneeze I start thinking oh no, I think I’m catching a bit of cancer! In Germany at the time, I started thinking that I should fly to the states and get a check up. Realizing the potential cost, I thought of a recommendation from Lori and Randy,  nomadic retired teachers like me, who told me about their hospital visit in Thailand. I decided instead of flying home and paying an enormous amount of money for a small check up, I chose Thailand, and boy am I glad I did. 

Concierge Healthcare at Its Best

I arrived in Thailand on Monday, made a phone call and arrived at the hospital Tuesday morning  for my full check up. Never have I had such a well organized carefully planned hospital visit. They don’t call it concierge healthcare but in my opinion it is. I reported at 9:15. By 9:25, I was registered and at my first appointment of the day. I was impressed. Gently guided and delivered to my first appointment by a special attendant I assumed we would part once I was in place. For each new doctor or procedure an attendant was waiting for me when I finished and I was delivered to the next stop. The hospital is huge so I appreciated the extra touch. Sometimes it was the same attendant and other times a new smiling attendant waiting to greet me with Sawasdi (hello in Thai), clasped hands and a slight bow. On to the next doctor.  This went on for seven and a half hours with a half an hour break for lunch at which time I was reminded of the food coupon given to me that morning and guided to the mini food court where I was given a sandwich and a juice. I was kindly reminded to stay away from coffee because I still had the EKG and stress test coming up after lunch, so I made my choices with thought.  I rarely had to wait. I would say the most I waited throughout the day was maybe four or five minutes at best. This was the best service and the best treatment I have ever experienced. Upon completion of the tests I was then delivered to individual consultations with the Gynecologist, Internist, General Physician and the Nutritionist for an explanation of my results and recommendations where required.  The Audiologist and Ophthalmologist gave results on the spot after my examinations.The pap smear takes two weeks so I had to wait on that.

Money, money, money………imagine the O’Jays singing in the background

So now we get to the really juicy part of this post. Here you will learn exactly what I was tested for and how much it cost. Remember that this was a state of the art facility only three years old. I went for the Ultimate Checkup for Women Over 40.

ULTIMATE CHECKUP for Women over 40

Complete Blood Count                  Blood Sugar Profile

Lipid Profile                                     Kidney Function

Liver Function                                 Thyroid Function

Tumors Markers                             Uric Acid

Urine Examination                         Stool Examination and Occult Blood

Chest x-ray                                        EKG Electrocardiogram

EST Exercise Stress Test                ABI Ankle Brachial index

Body Mass Index                              Eye Exam

Hearing Test                                      Physical Examination

Ultrasound Whole Abdomen         Digital mammogram and ultrasound breasts

Thin Prep Pap Test/HPV high risk mRNA test (APTIMA HPV)

Bone mineral density (Lumbar Spine & Hip)

Medical Report Book

Food Coupon

Drum roll please!  The total cost was……………wait for it…………….. $559.00 U.S. Can you imagine what this would cost in the United States? I make a point to stay away from politics on this blog but I can’t help but acknowledge that health care in America is off the charts. It’s not just that we need healthcare insurance, we need total reform for unregulated increasing  healthcare costs. We wouldn’t be in the mess we are in if healthcare was affordable. Since I have been uninsured I go home every summer and I pay my Rheumatologist $110.00 for a five minute conversation (usually about my travels)  and a written prescription. That is highway robbery. But I have to see him because I need the prescription for arthritis. In Germany I went to the Rheumatologist because I ran out of medication, I gave the doctor my empty bottle of medication and my most recent blood tests. When it was all said and done I had an appointment that lasted 10 minutes. When I asked how much it would cost I steadied myself for the impending blow, in euros! The doctor shrugged his shoulders and said,”I only saw you for ten minutes it’s 10.00 euro (about $11.50). It was then that I realized I can take care of healthcare on the road. The same thing happened in South Africa recently and I can’t  remember the rand price but I had a doctor’s appointment for about $15.00 U.S. In Mexico I received a complete blood count test and the price was under $100.00, in America that same blood test could run upwards to $1,500.00 depending on the hospital or state you are living.

Shame, shame, shame on the American healthcare system.

The quality of the services I received in Thailand was above and beyond anything I have ever received at any time in my life in the U.S. and it cost $559.00 

It is understandable that healthcare is a business but there has to be limits because the costs are out of control and the disparities in costs from hospital to hospital and state to state are without explanation. Medical costs are not transparent. Where is the world can you go for services or goods without getting prices ahead of time? When you go shopping for clothes or shoes do you wait to find out the price of your items when you get to the cash register or even worse, weeks later? A store like that would go out of business in a heartbeat. But hospitals get away with this all the time. I challenge you to call any hospital in America and try to request the cost of services. Rarely will you be able to get a quote. I understand the individual nature of patient care, but there has to be a baseline cost with necessary increases that account for the differences in service delivery for each patient. There should be more transparency in patient billing. The hospital in Thailand has been filling the ever increasing requests for internationally accredited healthcare as people are looking outside of the U.S. and other countries for good affordable health care.

As long as health care insurance hovers at $750.00 a month I will continue to get my healthcare services overseas and keep my fingers crossed. It’s a new medical insurance service model that I call the “Crossed Fingers/Prayer Pose Healthcare Insurance Policy”. Hahaha. Y’all pray for me!

UPDATE: In hindsight, the crossed finger approach is not one I would recommend. But if I had bought into this crazy American healthcare system I would have paid $45,000 US dollars over the course of the five years while waiting for my health care benefits to kick back in. Not having it was a big gamble and not one I would recommend.