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ABOUT THIS BLOG

In the summer of 2009, Nicolas Rapp decided to take a break from his Art Director job at The Associated Press to attempt a one-year overland travel around the world in a 1996 Toyota Land Cruiser. He was back in New York in February 2011 after traveling 15 months and 37,000 miles.

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  • Escaping the American health care system

    Posted on October 13th, 2009 Nicolas No comments
    A commercial medical kit and the lantern I plan to use to do surgery on myself at night

    A commercial medical kit and the lantern I plan to use to do surgery on myself at night

    I can’t tell that I like needles and doctors, and even going to buy glasses make me sick, but one thing I hate more is to get sick. And getting sick when you are bush camping is definitely not the most relaxing experience.

    Since few weeks now, I have been visiting doctors and made sure I will take my last chance to enjoy medical coverage before I leave the America’s health care paradise.

    Medical check-up

    Having it done is a must before leaving for a long trip. In the ideal, it should be done at least two months in advance, so they can try to fix you up if they see something wrong. If you have to leave for such a trip, pay a visit to your doctor, get a blood analysis, and take it from there. What is great now is that they can tell you your level of immunization, which can help you decide what shot you should get.

    The travel shots

    In addition to the classic ones, there are few more that are one should definitely get:

    – Yellow fever. Required for South America and Africa. You need to have a proof of the shot to go through many borders

    The yellow fever areas

    The yellow fever areas

    – Hepatitis A and B. A is done with two shots, B with three. So you need to start early. Good for ten years. Sometimes Hep A and B are bundled together with typhoid.

    – Typhoid fever. Now available as pills.

    – Tetanus. Everyone usually gets it as a child, but needs a new one every ten years.

    – Japanese Encephalitis. Carried by mosquitoes in rural areas. Three shots.

    – Cholera is also mandatory in some African’s country if coming from a area or country with a cholera outbreak.

    The Japanese Encephalitis areas

    The Japanese Encephalitis areas

    Ask your doctor which one you can get for free. Here in the U.S., probably nothing, except if your insurance is generous. Getting all these shots will cost you more than $500.

    Plan B, for cheap people like me, involves going south, pass the border, and get the shots in Mexico where it cost half the price. It would even have cost less than that anywhere in Europe.

    Also, it is important to go see the dentist before leaving and do whatever he think you should do because you don’t want to get you mouth fixed in Bolivia – even if it would cost you less. Dr Schnall in NY gave me a full round of X-ray, and provided me with enough toothbrushes for the year.

    Your doc should also prescribe you a lung x-ray, and you can try to ask him for prescriptions of a strong antibiotic to take with you (Cipro). You can also ask him a letter authorizing you to carry a syringe in case you need a blodd test or other in a place you find shady.

    Malaria
    There are two choices. Taking pills with heavy side effects for many months, or take a heavier dose of the drug if affected. As many other travelers, I will choose the second option, and take measures to avoid mosquito bites whenever I can.

    The Malaria areas

    The Malaria areas

    Staying Healthy on the road
    A good list here, from the HUBB, and another one here, from the CDC. The goal is to build a kit that will be in the car at all time.

    Medical Insurance
    There are many choices for medial insurance. And if you come from Europe, you can just for with Mondial Assistance or Worldnomads.com, which should be around 600 euros.

    In my case, French expatriate in the U.S., with no more insurance at the end of November, I’m not eligible for healthcare in any country. So it would not be helpful to survive an accident only to have a heart attack when I receive a crazy bill after being evacuated and treated in my home country. If you are in a more trickier situation, like me, you should call or email William Cole from insurancetogo.com, he can be more creative and help you out. Other world travelers used him and were happy about it. He will provide you with choice between a lot of different premiums and deductibles. A good coverage for me should run at around $1,000 for the year, not including legal assistance that are usually part of such package.

    In general, I hope if I get sick in these countries I can get overall good care by local doctors, and not pay much. The insurance is really for the super bad events requiring – for example – an evacuation.

    UPDATE: I chose to take a coverage with $500 deductible for an annual premium of only $548. Basically, that means i will pay out of pocket my medical expenses, and use the insurance only if my head fall from my shoulders.


6 Responses to “Escaping the American health care system”

  1. Best of luck on your trip…I traveled alot at a kid and do not miss all the vacinations…I remember our arms hurting for days from all the shots. My dad was in the military and he was able to pick where ever we wanted to go…we had a globe in the house all the time and he’d spin it to see where we’d “land” next. I was born in Ethiopia and we lived in Taiwan, Panama and stateside till I got married and then I was lucky to live in Italy where my son was born. Hope to travel again real soon…my husband and I are in the process of “downsizing” so we can travel the world…my son works for US Air now so we want to take advantage while we can. btw…a medical tip for you…and mosquitos…place unpeeled onions in your car while you travel…no kidding…here’s more on it:

    PREVENTING THE FLU

    For those of you who do not wish to take the flu vaccine (suggest not taking because of side effects unknown at this time), Sandi forwarded this to me. Perhaps you may wish to experiment with this yourself.

    Do you know how many people will be unemployed in the flu vaccine business, if this gets out, and it worked?! Actually, there’s lots of sulphur in an onion. My Dad always sautéed or fried a large frying pan full of onions when he was coming down with a cold, ate them up & went to bed, & he was better the next day! Hugs, Marian

    GOOD MORNING…How would you like to try this…it comes from Abbot Peter who lives in Muenster with the Benedictine Monks…Take care….God Bless.

    Keep healthy this winter, the easy way . . .Onions fight flu virus. OK, it is true. After reading this you will think that I have really lost it. However, this is a true story.

    In 1919 when the flu killed 40 million people there was this Doctor that visited the many farmers to see if he could help them combat the flu. Many of the farmers and their family had contracted it and many died. The Doctor came upon this one farmer and to his surprise, everyone was very healthy.

    When the Doctor asked what the farmer was doing that was different the wife replied that she had placed an unpeeled onion in a dish in the rooms of the home, (probably only two rooms back then). The doctor couldn’t believe it and asked if he could have one of the onions and place it under the microscope. She gave him one and when he did this, he did find the flu virus in the onion. It obviously absorbed the bacteria, therefore, keeping the family healthy.

    Now, I heard this story from my hairdresser in AZ. She said that several years ago many of her employees were coming down with the flu and so were many of her customers. The next year she placed several bowls with onions around in her shop. To her surprise, none of her staff got sick. It must work. (And no, she is not in the onion business.)

    The moral of the story is, buy some onions and place them in bowls around your home. If you work at a desk, place one or two in your office or under your desk or even on top somewhere. Try it and see what happens. We did it last year and we never got the flu.

    If this helps you and your loved ones from getting sick, all the better. If you do get the flu, it just might be a mild case. Whatever, what have you to lose? Just a few bucks on onions!

  2. wow… so i have traveled around the united states lived in many different states the only other country i have ever been too is mexico … and i have always thought about traveling the world and quiting school for a year to do it … but i want to be a doctor and there is so much schooling ahead and one year off could really mess me up … so when i read this about this guy at age 33 who is deciding to take off it really interested me and i want to follow up on his adventures and stories. i am 20 right now and when i am 33 i should have graduated med school and be working full time as a doctor by age thirty. this may sound really crazy but as i follow his trip and see how things go for him and when i am his age i may just do the same thing. i mean think about it he may be taking off while the economy is going bad … thats good right … he is leaving what he knows to learn things he doesnt and from what i read about his trip he has done some research and i see he is an artist so there must be some great pictures he will take as a result during his trip. i cant wait to read the first blog…

    sooooooo interested!!!

    Your fan,

    kayt

    p.s. if you read this nicholas ripp email me at

    IMLIVINMYOWNLIFE@AIM.COM

  3. From my round the world trip, I can verify you are not going to get shots for free. Unless you have a community center that is giving out shots you are not going to find it for free.

    Especially the less frequently contracted diseases like Japanese Encephalitis, you will pay a pretty penny for those especially since you need 3 shots.

    Cipro is critical to stop any diarrhea. It can ruin a a few days of your trip. Trust me I know.

    Vaccinations and pills are the hidden cost of travel.

  4. Et en France, tu peux choper H1N1 !!! Le Swine Flu 🙂

  5. Oh, I envy you a lot, I have always considered to do the same. I did it partially trough Colombia, my country, (when was safe) Ecuador and Brasil. As colombian, sorry to say, I strongly recommend you to ship your car directly to Ecuador from Panama. Better to know it trough movies and pictures but not with the killer guerrillas around. We are 42 million kidnapped by one million or much less that are doing the wrong thing. But, if you decide to travel trough it anyways, please take your Bible and the Lord Jesus as you main Pilot, call on His Name every minute and go in peace and rest.

    The Lord Jesus be with your spirit

    Victor, inviting to meet you in the New Jerusalem for eternity with all His redeemed ones.

  6. I was directed to your journey by a friend just an hour ago! I quit my job to travel and pursue bucket list items, too. There are no regrets, and the memories are priceless.

    For anti-malarials, I use doxycycline. It has the fewest side effects and, as a daily anti-biotic, guards against literally dozens of diseases including STDs. I returned this week from 4.5 months in Asia and SE Asia and never once got sick while away from the US.

    It looks like you’ve planned extensively and are set. Keep your eyes open and don’t let anyone pressure you or lead you into decisions. You call EVERY shot. Stay safe!