Sunday, June 30, 2013

A Little Progress

Feeling much better after the little medical issue (well, except for the whole health insurance thing and what "The Affordable Healthcare Act" may or may not mean...still need to research that).  We are pushing along on a couple fronts, but progress has been limited.

Having done a fair amount of looking at various boats, we definitely like the Lagoon 37 and the Tobago 35.  We think we would prefer the Lagoon 37 as it is just a bit larger and has better storage options, particularly in the galley.  Unfortunately, there are very few of them on the market right now. We do have a couple leads we are pursuing so hopefully there will be some good news to report in the near future.

Realizing that we haven't sailed a boat in over 6 months, we did manage to remedy that this weekend.  We rented one of our Colorado sailing school's J/22 boats (the same boats we used during the ASA 101 and 103 courses) for a half day to help knock the rust off of our basic sailing skills. No, it's not a catamaran and is far smaller than anything we can live aboard, but it is the right size for the reservoirs around here.

It took us a bit longer to get the boat setup than it did the last time we were on one, but things came back to us fairly quickly.  Can't say the winds were any better than in the past, over the course of 4 hours we saw everything from 0 to 20 knots from numerous directions.  It is probably a good thing that it started out on the calmer side.  We were able to practice a number of the basic maneuvers.  After the winds picked up and seemed to be sticking around, we decided to tuck a reef in the main.  Knock a little more dust off of old memories and we got the reef of course the wind dies down about a minute later...and we get to practice shaking out the reef.

We get back to the dock, get fenders deployed and dock lines set and docking the boat went off without a hitch.  Almost looked like we knew what we were doing...almost.  I'm sure no one noticed that I probably should have started with the stern dock line instead of the bow one (they like us to enter the slip bow first).  But no fiberglass was chipped or paint was scratched and only the fenders touched the dock so it went well.  Overall, other than a few glitches that were to be expected, we met our goal and had some fun in the process.

Now if we can only find "our" boat.

Sunday, June 16, 2013

Health Insurance

What is it they say about the best made plans?  Well, in the middle of my search  for a boat, life has thrown me a little curve ball.  A few days ago I had to go in for a minor outpatient surgery.  I'm at home recovering now and everything should be OK, but it has put my search on hold for just a little bit.

This got me thinking about healthcare again.  Of course right now I, like many working stiffs in the U.S., have health insurance provided by my employer.  Over the past years the portion of this insurance that the employee pays for has gone up considerably while the coverage seems to have gone down.  While I haven't received the final bill, between all the deductibles and copayments and multiple billings. I expect I will owe several thousand dollars...for this outpatient procedure.

I'm pretty sure that for the cost I'll end up paying myself, I probably could have flown to one of a number of places where healthcare is both decent and affordable.  If I had been able to think straight at the time, I should have looked into this.  Maybe I could have been recuperating in some tropical locale where I could look at some boats instead of sitting at home.  Oh well.
General Hospital in St George's, Grenada
In the U.S. we always hear that we have the best healthcare in the world. (We should tout that we have the best propaganda and advertising in the world).  While I'm sure we have some very cutting edge research and procedures that can better save lives here, I think the truth is that for most of the average working stiffs in the U.S. our medical care is determined mostly by an insurance company that works as a for-profit business. Their primary concern is to make a profit for their shareholders and their secondary concern is selling their insurance to the companies we work for as a reasonably cost-effective "benefit".  The end result is that I doubt most of us actually have direct access to the "best" due to the prohibitive cost and lack of coverage by our insurance providers.  When pitting my well-being against the profit of a corporation, I don't think I'll be betting on my well-being as the insurance company's primary motivating factor.  So, this leaves most of us with more "average" healthcare.

I have a friend whose father retired to Mexico a number of years ago.  As with most traditional retirement-aged folks, they have had somewhat regular experience with the medical care there.  The father is happy with the healthcare he has received and finds that the quality of care is very similar to that found in the U.S., with many of the doctors and specialists actually U.S. trained. The difference is that the cost is significantly less, on the order of 25% to 33% of what comparable care costs in the U.S.  By the time I calculate what I've paid in insurance premiums and what I'll pay in deductibles, co-payments, and co-insurance (a fancy term for a percentage that you will have to pay out-of-pocket anyway), I'm pretty sure I'll have paid for more than 33% of my U.S. priced medical care this year.

The only thing that the insurance companies seem to really do for us is to negotiate somewhat more reasonable rates with medical providers (you know, when the doctor charges you $100 for something, the insurance says they apply a "discount" and the charge is reduced to $10).  Ironically, this isn't that different from the cost controls used in many of the public healthcare systems in the rest of the world.

When I was doing research on this subject a while ago, I ran across an insurance company that would provide international health insurance.  I don't recall the exact figures but from what I could remember at the time, I could get insurance for my wife and me that would cover us everywhere except the U.S. and it seemed fairly reasonable.  If we wanted to add coverage in the U.S., the cost of coverage was multiplied by a factor of about 8.  So, apparently the U.S. does have the most expensive healthcare in the world.

It seems in most cases we plan to be in places that will have decent healthcare at reasonable prices.  So, do we simply "self insure" (a.k.a. pay our own way)? Buy a policy with a high deductible that would cover more catastrophic issues? Should we consider some sort of evacuation plan (can fly you to somewhere with better medical care if you are not near facilities that can help)?  Lots of questions to be answered.  Depending on the cost, I think we will likely do some catastrophic/self insure combination.  If we do include an evacuation plan, would we evacuate from the U.S. to find reasonable healthcare.  Hmmm...

Here are a couple links for health insurance for cruisers/travelers:
Health Care International
International Medical Group
Diver Alert Network (DAN) - Scuba-oriented, but covers other issues as well.

Sunday, June 2, 2013

If you're going to live on a boat, you should know how to swim.

Makes sense doesn't it?  If you are going to live surrounded by water, might make sense to know how to swim.  Of course, my wife and I know how to swim (we are actually PADI certified divers) but our two dogs haven't been raised around water. So, how does one introduce dogs that don't even like baths to swimming?  Lessons, of course.

When our oldest dog had surgery on her leg a number of months back, the doctor recommended physical therapy and gave us the name of a place that actually does PT for pets.  They did conventional stretching and exercises and they also had water treadmills and a pool. We found that, in addition to their clinical work, they offered open swimming and private swims for dogs as well (like a public swimming pool for pets). So, while we work on other aspects of our plan, we figured that we might as well get them introduced to the water. This weekend we did just that...our dogs had their first swimming lesson.
The "lesson" was reserved private pool time with one of their employees. We weren't sure how the dogs would do.  Our oldest dog has had exposure to their water treadmills during her treatment and in general is more of an adventurous free spirit so we figured she might do OK.  Our other dog is very timid and we wondered if he would even get in the water at all.

So, we start off by just introducing them to the pool area.  It is an above ground pool with a ramp leading up to a deck that partially wraps around the pool. While I was walking our timid dog around the pool deck to get him comfortable and my wife was talking to the employee, we hear a splash and there was our older dog in the water flailing around. She didn't look happy and was trying to get out so  I run over and grab onto the handle of the life vest as the employee (wearing waders in the pool) comes over to get her.  The employee then leads her over to the ramp across the pool so she could easily get out on her own.  Not the best start, but at least she was swimming.  I can only presume she fell in, but I wonder what she was doing.  The employee thought maybe she was trying to sniff at the water and lost traction on the slippery edge of the soft sided pool.

We managed to coax our older dog into the pool a couple more times, and she was picking up the whole swimming thing pretty fast.  When she wants to head to the ramp to get out, she can swim faster than the employee can keep up walking in the waders.  Overall, I think it went well, at least she found out she can swim (and hopefully when to hold her breath).

Our younger, more timid dog was another case.  In the half hour we had the pool, it was all we could to to coax him to walk down the ramp towards the water.  We did manage to get him, of his own accord, to step into the water.  We consider this a win (did I mention that he's timid?).  I think it will be a few more lessons to get him comfortable, but hopefully he'll get there.

Overall I think it was a good thing to do. Introducing them to water and swimming in a reasonably safe and controlled environment seems like it should pay dividends down the road.