July 30, 2008 - Medical Care and Insurance while Cruising
by Beth & Al Liggett

Time was when a group of friends gathered in our cockpit for sundowners and snacks at the end of the day, we talked about sailing - the passages, the places, the people we met, mutual cruising friends, and how to fix the latest bit of broken equipment. In our early years, the hot subject was wind vane self-steering gear. Now most boats don't even have one.

Just as boats have changed over the years, the topics in the cockpit conversations have changed too. As years passed, conversations on self-steering faded into discussions about the relative merits of ham radio and the eternal and unending quest for how to build the best antennas. Gradually the topics passed around the cockpit with the cheese and crackers were all about the how-tos of refrigeration equipment and installation. Then solar panels and wind generators. Boat equipment was getting more technical and soon we were talking about satellite navigation systems and GPS! Then there is the whole gamut of computer topics, just as unending as ham radio antennas.

Nowadays it seems that many of our conversations revolve around topics of health and medical care. I guess we're of an age...

We have been blessed with good health all these years of cruising. Somebody asked us the other day if we ever had a serious illness or accident when we were at sea. And, thankfully, we had nothing to report. Oh, of course there have been times of trials and tribulations. I remember once in our early years on Bacchus, Al got slapped in the chest with a whirling winch handle. We suspected he had dislocated a rib from his sternum plate. Nothing we could do really. He took some pain pills, rested a lot, and complained that it hurt when he laughed! Thankfully the passage was an easy one and all was well at the end. But I can still remember the horrific bruise on his chest. And what if it had been his head in the way?

That's the scary stuff - the "what ifs". Accidents happen. Especially in boat yards. We have had more than just a few good friends suffer serious injury while their boat is on the hard. So we are extra careful about things when we haul the boat out of the water. You just have to plan as best as you can and cross your fingers. Illness is another thing. We try to eat healthy, stay current with health issues, and listen to our bodies. But like I said - "we're of an age".

Health insurance. We had never carried any health insurance that wasn't job related. So when we stopped working and left Guam in 1997 to go cruising again, we seriously thought about this issue. Several of our friends had worldwide health coverage with a company based in the UK, and were happy with that. So we signed on too. I say worldwide, but we took the standard policy that excluded the US and Canada. (AXA PPP Healthcare - www.axa-ppp.co.uk . We used an agent - Dale Carroll - uniplan@unitedplans.com .)

The thing about this insurance was that it was for major medical problems that involved hospitalization. Most of our medical needs were for yearly checkups and the odd doctor visit, which we still paid out of pocket. After a few years it got more and more costly to have this insurance - the yearly premiums would raise at least 10%, our ages put us into higher premium categories, and as the premiums were quoted in British Pounds Sterling, the exchange rate was a killer. As we were healthy and had to pay for whatever medical services we needed ourselves anyway, it didn't make sense to spend that kind of money on insurance. So we canceled.

Now that "we're of an age" we are covered with the U.S. Medicare system. We also carry a supplemental health insurance plan through the AARP that covers (hopefully) what the Medicare plans do not. Of course this system is valid in the United States. This is the third year that we will spend 6 months in the States, in Ripley, Ohio, so it makes sense to have medical coverage while we are here. The rest of the year we are on the boat in Malaysia. Fortunately, because of our usual good health, most of our medical needs are preventative or minor and we pay the bills ourselves there. Medical services in Malaysia are a fraction of the costs in the United States.

We have been "based" on the island of Langkawi, Malaysia, for the past 9 years. Langkawi has a very new hospital, with lots of equipment - and nobody who can use it. There are GP's, but no specialists at the hospital except on a rotating basis. For medical services we go to Penang, a two-hour ferry ride south of Langkawi. Penang has a population base that supports five hospitals that I can think of, and many medical specialists. We have been well served there with everything from cataract surgery to chest X-rays. We have confidence in the doctors, most of whom are trained abroad - UK, Australia, Canada, United States, Germany and the like. Their command of English is excellent.

It is a whole lot easier to see the doctor in Penang too - none of this getting an appointment that is three or four weeks down the road. It is usually a case of walking in and waiting your turn. Dentists are more heavily booked, but we have never had to wait more than a few days for service.

Back to the cockpit. The conversations about health continue - who's been to the skin doc lately, how did your dental visit go, a friend needs regular eye exams, another has suffered a series of heart attacks. It helps to know who has been where for what treatment and how it went. And yes, the topics still include the weather, the latest slant on what the officials in Thailand are doing, and discussions of how to fix this or that.

Now, do you know what other topic has spanned the decades of our cruising years? A topic that's been discussed from Mexico to the Mediterranean, from Jamaica to Japan, from Alaska to Australia, Panama to Penang. Can you guess?

Something every boat has to have. Something every boat needs information on. Something simple yet very high tech these days.

It's bottom paint!

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