Escaping the American health care system

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

– 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

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

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.

Do what you like, the money will follow. Or not.

A lot of folks ask me how much it will cost me ­to drive around the world. I think it’s a pretty interesting question, and one of the first that come to mind when preparing such a trip.

What is sure is that it will cost me way more to go around the world driving instead of taking planes. But here are also savings associated with this choice. By using a car, I’ll be able to stay away of urban centers, and camp, sleep and cook out most of the time.

The truck
To begin with, one should expect to spend $10,000 on a car to have something that would be robust enough so it doesn’t have to be fixed every week. I was lucky enough to get a 1996 Land Cruiser for $6,700. The additional equipment for the car I estimate to an additional $3,500.

$4,000 should also be set aside for maintenance or repair work while on the road, while I hope I will only have to use a fraction of it.

This equipment includes a roof rack, a reinforced front bumper, safety devices so people don’t steal my new home, super-strong suspensions to take rough roads with heavy load, a storage system in the back, modifying the cargo area with bars or sheet of metal so my belongings are safe, a safe bolted to the frame, and last but not least a major upgrade of the electrical systems so I can run several devices for days before running out of juice.

An extra battery will power four 12-volts and two 110-volts sockets.

Now people that know me are aware that I’m cheap, meaning what I paid is the barely minimum, and I did all the work on the car myself. Expect to pay at least double if you order pre-made systems, or go to a shop to get things installed.

Bush camping
But to save some money, I first had to invest more. For sleeping out, I chose to go with a roof tent. This is basically a pop up tent that go on the top of your car. It is so much nicer than to sleep on the ground. Unfolding it takes few minutes, and you never have to think about tales featuring scorpions in your shoes or snakes in your sleeping bag you heard from so-called good friends, back in Manhattan breweries. Anyhow, this little joke will cost you a grand.

Other camping equipment includes a fridge that lives in the car, a fuel stove which can run with unleaded gasoline, a small pop up tent to take showers and go to the restroom, water cans, and lanterns. You just added $800 to the bill.

The folded roof tent on the right and some gas cans to extend the range of the Toyota.

Sailing and flying
Shipping a car is expensive, and I will have to do it at least five times, sometimes for 100 miles, sometimes between two continents. The cost I estimate at around $7,000. When the car is on the boat, most of the time you want to fly, so you are not stuck for weeks in a small cabin instead of taking advantage of the time you are not stuck in an office approximately the same size. Add $2,000.

Bureaucracy
The paperwork, insurance, visas costs can bring you down another $8,000. That, of course, if you find people crazy enough to insure your car, which I didn’t yet. The vaccinations can cost you up to $600, but you can save half of this money by getting these shots in Mexico, which will be my first stop outside of the U.S.

I also have to let a deposit to AAA so they know I will not try to sell the car to some prince abroad. That can easily be $20,000 I will only see when I return. This amount is calculated depending of the value of the car, and the paper called a Carnet de Passages.

Also, maps and guidebooks adds up to hundreds of dollars.

Food, lodging, gas
Food should not be more than $10 a day. Same for lodging, as I project to be sleeping for free, but once in a while, while in a big city, I will need an hotel with safe parking for the truck. I think I overestimated these amounts, and plan on spending less.

I estimated gas to $5,000 for the trip, but this is the most difficult to come up with, since gas on my route will range from  38 cents a gallon in Iran to $3.7 a gallon in Portugal.

The bottom line
The estimated grand total for the trip is $46,000, including the price of the car. But that’s the price to pay to go alone. If I find people crazy enough to go on the road with me,  it will bring the tab down.

ITEM	COST
Before Trip
Land Cruiser	$6,700
Roof tent	$1,045
Roof rack	$600
Steering wheel lock	$60
Air compressor (tires)	$55
High-lift jack	$100
Sand ladders, recovery package	$200
Jerrycans	$100
Refrigerator	$500
Batteries, split system	$400
Fuel stove	$75
Foldable toilet	$30
Construction material for boxes	$350
Suspension	$850
Alarm	$220
Shower	$100
Maintenance, repair, small parts	$4,000
Medical kit	$150
Lighting (lanterns)	$100
Insurances and bureaucracy
Visas	$550
Personnal insurance	$550
Vehicle insurance	$2,000
Carnet de passage	$2,500
Vaccination	$400
Maps, guidebooks	$300
Car shipping
From Arg to south Afr	$2,000
From Morocco to spain	$300
From India to Thailand	$1,000
From Indonesia to USA	$2,500
Darien Gap	$1,300
Airfares
From Arg to SA	$700
From India to Thailand	$300
From Indonesia to USA	$1,000
Medellin panama if needed	$200
Lodging (hotels, campgrounds)	$4,000
Food	$4,000
Gas	$6,000
Total	$45,235