Healthcare for Cruisers

It’s one of those questions that comes up again and again—‘are we covered by health insurance, if so which insurance, what does it cost, and what does it cover?’

First off a caveat—we’re Canadian so our worst case scenario is even if we have been out of the country long enough that we’ve lost our healthcare coverage (this varies from province—but the cut-off is typically 183 days per year with some provinces allowing you to be out longer as long as you have an intent to return) our coverage will resume after a waiting period (typically three mos—but there are provinces with no wait period).

cruisers need to take preventative measures when it comes to staying healthy--rescues are hard to come by

That said, this is what we’ve done:

US West Coast—We were insured beyond our basic Canadian insurance. Our Canadian insurance reimburses costs up to what it pays in Canada—which comes no where close to the US cost of healthcare, so we decided ages ago never to be in the US without some sort of additional coverage—we always have visitors insurance for the US no matter how brief the visit might be. On the trip down the coast we didn’t need to use it.

Mexico—We maintained our Canadian coverage but had no supplemental coverage for Mexico. We had one bad experience in Mexico—we needed to update vaccines and in Santa Rosalia the Doctor offered to get us them—charged $80 in advance, then failed to get the vaxes or to reimburse us. But this was an exception.

Mexico is one of the countries that is considered great for routine healthcare (others we've heard raves about include French Polynesia (we got free vaxes in Nuku Hiva), and Malaysia). And both La Paz and La Cruz are popular for check-ups. Typically treatment was excellent and modern—my skin cancer checks (I went for two, Ev had one) were accurate and affordable ($125 for a full screen and biopsy). Treatment for pneumonia was straightforward--two doctor visits ($30, $50), x-rays ($25), inhalers ($50).

During our 18 months we also visited local dentists every six mos—basic cleanings were around $30, fillings another $30 and Evan needed a root canal which ended up in the $600 range. Keep in mind Mexican dentists rarely use x-rays and rely on physical signs of decay. So our rule of thumb is to visit the same dentist at the same time as another family. If too many cavities are found we know we’ve hit on someone who’s too enthusiastic with the drill and we all move on.

Between preventative care, prescriptions, two eye doctor visits and glasses and contacts for Ev (we got Maia's glasses in Canada), skin-cancer check-ups and a root canal, treatment for pneumonia our expenses were about $1200 for the 16 months we were in Mexico. We could have squeezed in check-ups on a visit home the first year, but we were confident enough in the Mexican system that for preventative care and day-to-day follow-up care we were happy.

Crossing the South Pacific we carried Dan evacuation insurance. This insurance can evacuate us to a place we can be treated—but it doesn’t cover treatment costs once you’re there—so having a plan about where to go is vital. We did get some prescription drugs—anti-malarials in Vanuatu ($20), cream for a skin infection in French Poly $30.

In Australia we have bought basic insurance (ranges from $150/per month per family up). Dental is out of pocket—Ev and I went to the school and had checkups for $60 each, Maia went to a local dentist and her check-up and cleaning was $200 and a filling was $210. I’ve had a ‘well-woman’ check-up $110 and a skin check for $185. Evan saw a Dr. for sore knees which came to $75 plus $133 for x-rays (should get some of these expenditures back).

So all this said—there really is no one medical insurance answer. It varies according to how long you are away from your home country and where you spend your time while away. Our basic plan is to keep up to date on all preventative healthcare—we vaccinate for whatever the locals are vaxing against (assuming we may be even more susceptible), we take our anti-malarials or whatever preventative drugs are needed, we get check-ups, we don’t let things linger (too long…)and we buy insurance when we're in more expensive countries.


Staying on top of things is vital to staying healthy though.

Why is my Cruising Boat So Slow?

It's probably because of the junk cruising boats carry. When compared to weekend cruisers who carry enough to be comfortable, or racing boats that carry the bare essentials, long term cruising boats are overloaded.  REALLY heavily overloaded. We're carrying pretty much our worldly posessions around with us. Let's look at what Ceilydh carries, when compared to a typical short term cruising boat.

• 3 scuba tanks, BCs, regs, and weights
• scuba compressor
• big heavy RIB dinghy with a 15 HP instead of a small inflatable with a small outboard
• about 300 books for our daughter. (Yes she has an ebook too)
• 2 inflatable kayaks, 1 surfboard
• spares. Lots of spares. a case of fuel filters, watermaker filters, engine oil, outboard oil, spare outboard props, alternator, electrical black boxes for the outboard, fans, pressure water pumps, yes even a spare depthsounder and VHF, VHF antenna, GPS, shortwave radio. That reminds me I've got to pick up a starter motor for the diesel.  Yes spare parts are heavy and expensive but damm do I feel clever when I say "no worries honey, I'll just get out the spare XXX".
• 3 anchors and rodes
• extra snorkeling gear for guests
• extra big fenders for rough docks
• tools. Wow do I have tools. Power tools like sanders: big orbital, small orbital, detail sander, drill, jigsaw, router, angle grinder, heat gun. Hand tools are pretty standard, but I have a nice little set of specialized bicycle tools (we don't carry bikes but did buy cheap second hand ones here in Brisbane). "Nice to have" tools like a big torque wrench or gear pullers. More esoteric tools like a one sided pull saw, or a 100' tape to measure rigging and sails, 
• pipe wrenches to uhh I don't know - I used it on the last boat to tighten the stuffing box but I have a dripless shaft seal so don't need a big wrench like this. At least it's aluminium.
• cameras. I wrote a blog post about how many cameras we have. It adds up, 2 DSLR bodies, multiple lenses, tripod, flash, a big Pelican box to store them, big camera backpack.
• clothes for winter in BC or summer in the tropics and everything in between
• solar panels and bigger batteries
• extensive paper charts

All this adds up to 1000's of pounds of stuff aboard. It helps to do an annual purge to get rid of junk aboard. I think I'm gonna get rid of that aluminum pipe wrench....and we haven't been using the double inflatable kayak very much...

Ev

Boat Bashing, Dinghy Thieving and Monkey Feet

Maia’s school throws an awesomely fun fundraising garden party. There was a petting farm, bake sale, sausage sizzle and a bar. The three of us had a lovely night—Maia volunteered to run the petting farm—then ran free with the other kids in the dark. Meanwhile Ev and I volunteered at the sausage sizzle—then helped clean up (which included assisting to empty the opened wine.) It was a great night—until my phone rang.

“Diane? There was a big yacht—it tried to turn but got caught by the current—we heard a lot of crunching and people are on their way to your boat to see how bad it is.”

I surprised myself by how calmly I took the news; and really that’s been one of my biggest areas of growth in the past few years. It seems if you throw me enough whoppers eventually I learn to take a big breath and start dealing. So I bummed us a ride home, all the while soothing Maia, and pondering what to do if the boat wasn’t habitable.

When we got to the boat the neighbourhood was out in force—and the consensus—no one knew how or why but we were unscathed—the crunching must have been the pile mooring astern of us. Our only casualty was a dock line.

learning to drive

 Bad news that turns good is a good thing, but unfortunately it turned bad again the next night. After a nice day that included a birthday party, circus class for Maia, followed by a lovely dinner out we got home an hour after dark. As Maia and I walked down the break water I couldn’t see our dinghy—Evan, who arrived by bike before us, confirmed that I couldn’t see it because it wasn’t there.

 Stolen dinghies are a bit of an issue in Oz. Actually they’re a huge issue—but all the dinghies we’ve heard of going astray have been stolen late at night. We wrongly assumed our combination of a unique—slightly battered look, older motor and locking at night was enough to protect us—but as we stood on the dock looking out at our boat we realized it obviously wasn’t.

groceries for a trip

 Dinghies are more than a family car to cruisers—they are a tether between land and sea. So they are a utility vehicle—but they’re also imbued with a bit of that magic that every boat has. And we built ours. Actually Ev designed and built it for our specific needs.

But it was gone. And we were still on the dock. And the only way to get home was to steal someone else’s dinghy. So we did. Actually Evan insists we ‘borrowed’ it—and just to ensure the owner understood the distinction I stayed on the dock while Ev and Maia went home to blow up our two-person kayak.

 Or kayak is a good kayak for a grown-up and a child—but it’s a bad kayak for two grown-ups and a very bad kayak for two grown-ups on a dark fast moving river. So it was clear even before Evan changed out of his wet clothes that we were going to need a replacement dinghy really very quickly.

Between talking to the police, “You realize this is a former penal colony? Amazing nothing else has been stolen from you before now. Hahahahaha.” And shopping for dinghies: Cheap tinny and oars? Cheap inflatable, small motor? Decent inflatable? Decent motor? How the heck are we even going to get a dinghy back here if we can find one? How are we going to get enough cash out on a Sunday to pay for one? We didn’t sleep much.

And when I did finally fall asleep I dreamed about living in a house; A nice stable house that other houses didn't run into; A house with streets around it and sidealks--not sharks; A house where if something was broken or stolen I could replace it without having to go through a logistical puzzle. But I woke up living on a boat.

And I woke up in the cruising community—and we had rides to shore, and offers of loner dinghies, and suggested ideas, and a lead on a dinghy that belonged to another Canadian cruising family who was done their trip and ready to trade a dinghy for a car. And the dinghy had the exact motor on it that we planned to eventually buy and it was only one year old, and the dinghy was also fairly new and in good shape. So we rented a ute and went to meet our new dinghy—and its family, SV Monkey Feet. And a deal was struck and Monkey Feet was happy to see Monkey Business go to a good home.

And so we drove our dinghy home—stopping first at the hardware store to buy a length of heavy chain and a very big lock.

How You Know What You Know

 

  So I’m writing this book for new sailors. And as part of the research process I’m reading through every sailing manual I can get my hands on.  Wanna know something? Some of them are really boring. They are filled with all kinds of diagrams and figures explaining the science behind sailing but very few of them come close to articulating the feeling of sailing. If I only read the books, and never sailed, I would assume sailing is this complex, technical activity you need math degree for.

I first learned to sail a really long time ago—despite this I recall some of it like yesterday: Like when I was told to pull in the jib sheet, “hard!”, which I did with all my might, until I was raw handed, and had made it fantastically taut, and was suffused with pride over my skill at sail tightening, and then rather than getting the praise I was sure I deserved, I was told to let it back out again. I recall thinking sailing was a stupid, pointless activity that hurt my hands.

Frustrated I mentioned this to my instructor. He patiently went over points of sail and sail trim, again, then in response to my blank look he guided my hands until I ‘felt’ where the sail needed to be for the boat to get into the groove. “Boats,” he told me, “know when the sails are set right. Sailing theory is just a way of articulating that.”

Even today when I crank in sheets or adjust a fairlead—I recall that moment and rather than actually thinking about boomvang tension, or cunningham adjustments I sort of just tweak things until I feel the boat tell me its happy. On this boat that moment feels like an effortless surge, on our last boat it was more like a happy thrum, but every boat is a bit different

What I don’t recall learning, but know I internalized, is the actual technical stuff, like in moderate winds how far back from the luff the main’s draft should be—as a percentage.* But at some point I did learn all the numbers and I went on to teach them. And I remember classes where the students wanted me to give them formulas for things like exactly how many inches back they needed to move the jib fairlead to move the twist higher up the sail. One student even argued in favour of marks on the sheets that would let him know when the sails were correctly set for close-hauled, close reaching etc…

 

After a few lessons though first one, then the next student would get it: they’d realize that all those diagrams they were trying to memorize were just guidelines that give words to something that’s fundamentally a little magical. It didn’t mean they could become good sailors without the theory—it just meant eventually all that theory would be replaced with a deeper knowing.

So right now, as I’m writing those words of theory and illustrating those technical diagrams, what I’m really thinking about is what comes next for those someday readers of my book. Instead of imagining them trying to make sense of  words describing weather helm or the difference between true and apparent wind—I’m picturing that moment when they’ve put my book away on a back shelf because their hands have learned how to make the boat come alive and they just know how to sail.

 

 *About 45% …