medical care preparedness

We opted out of full-time work and it's health care coverage 3 years ago. We've been without coverage for 18 months now. Sometimes I worry about it but I resist at a deep level, participating in such a broken system. I'll spare you my long and personal rant on it. We're in our mid 40s with 2 kids. A few ideas about all this:

I was inspired to urge my husband to make the leap out of employer based health insurance and the attendant 40+ hour a week sedentary unhealthy lifestyle by a therapist I know, who left the world of physical therapy in a hospital context to do bodywork. She's in her late 50s and is thoroughly disenchanted with the health care system. She has her own lengthy rant about how patients are treated based on whether they have coverage or not (and interestingly, having coverage doesn't mean they get better treatment -- often just more invasive treatment) Her approach -- max out her car insurance medical coverage, eat well and exercise effectively, use www.planethospital.com if she needs major medical in a non-emergency situation, and enjoy her life. (I'm not sure how long planet hospital's model remains viable in a world of post-peak oil, however.) She's willing to forgo expensive, life-extending treatment if she becomes seriously ill.

 There are a few physicians out there who want out of the system as well and are setting up cash-based practices with reasonable medical fees. I think handling evening and weekend coverage for patients may get a bit tricky for them, but you might search around for an area that has a cash-based medical practice.

 I'm waiting to see what happens with the new administration -- I was deeply frustrated to read Obama's first proposal was to digitize medical records, which has nothing to do with getting affordable health coverage to people and would only allow insurance companies to continue selectively denying coverage and dropping insured patients who have medical issues.

For what its worth,

Warmly,

Sue

Sue and Jerry,

As your Northern neighbour I never could figure out why the US has so vehemently resisted Nation medical coverage.  Every major industrial country offers it.  I recall one incident with a US work colleague who was rude and condescending when it came up in a conversation while working in Europe in an automotive capacity.  Given the state of the automotive industry I am sure his opinion has changed.  

 As for any advice on general health every thing I have read indicates a strong correlation with exercise and health.  Make sure you get enough.  Also recent articles have mentioned that one multi vitamin daily is better than a fist full of specialized supplements.  One exception I make is Hyaluronic Acid for joint pain in my foot.  I am astounded how well it works.  One pill a day.  The research I have done also recommends Omega 3 fish oil for men.  I take this in oil form.  Make sure it is mercury free if from a fish source.  I have also read that learning how to make home tinctures will be a great help in the future although I have yet to do any research into it but do plan to do so.

 I am lucky enough to have purchased a hobby farm in a sweet spot.  Close enough but far enough away from major population centres.  There are a lot of aging farmers around me.  My point to this is that it seems that a good dose of physical work does wonders as there are several in their 80s and 90s  still actively farming. 

I currently grow some grapes (sell some and make some wine with the rest)  I plan to put in a small greenhouse (1000 square metres about 10,000 square ft) and the equipment to produce enough bio diesel to run my spread and power my house and greenhouse.  I figure that I will be able to trad off a bit of fuel and or high value crops for services if things take a turn for the worst and our government has no money for health care. 

E

Thanks Sue and thanks eb.

We eat a vegan diet while paying attention to needs for protein, vitamin B12, etc. We get our omega3 from ground flaxseed sprinkled on our oatmeal every morning. I agree with the exercise component, but still need to get into a regular discipline. I have 2 bad knees which adds to the challenge.

Knowing a good herbalist or becoming one will likely be a big benefit.

Jerry,

When I learned about Peak Oil 4 years ago, I decided to study herbalism because having worked in biotechnology for many years, I knew first hand how totally unsustainable our medical system is.  Similar to growing our own food, I believe we can grow a lot of our basic medicines relatively easily with a focus on prevention rather than reaction to something going wrong.  Using plants as medicine reduces the risk of side effects and helps us become empowered around our own healthcare.  I recommend Andrew Chevalier's "Encyclopedia of Medicinal Plants" as a good place to start.

 --Suzie

Jerry_Lee - those are all excellent.  You are many steps ahead of those who still look to the medical/pharmaceutical industrial complex for all healthcare. (They certainly have their place, such as when one is injured).

For economic reasons as well as fuel problems, I expect many medical services to deteriorate as we go along, including emergency services like rescue and ambulances.  I suggest taking some courses in (at least) first aid and CPR and staying current with them. 

Those of us with animals should not forget them in this.  In addition to materials covering humans, the American Red Cross has come out with excellent books on  Dog First Aid and Cat First Aid.  Their online store is here: Red Cross Store

I, too, expect most of our medical services to go by the board. And prevention makes a lot of sense. I'll definitely be getting more into herbal solutions (a great name for a website, BTW if it doesn't already exist!).

That being said, I'm about to leave for a pre-op doctor's visit. I'm scheduled to have both knees replaced in 2 weeks. I don't know af any alternative remedies once the cartillage is gone and the structure is damaged. Gardening was extremely difficult last year without a cane to push me up when I was bent down.  Since I expect to be growing food the rest of my life and since we still have health insurance, I'm going forward with the replacements. I do, however, have some concern when I think of how much these operations are costing all of us.

Anyhow, I'll have some time to read and collect resources while I'm rehabbing.

Thanks for the info Suzy and MR Pandabonium.

I still wonder about developing a community plan for caring for one another over the next  20 'massively different' years.

This is a very interesting topic, and, as a physician, one I have been considering lately.  I am a thoracic and vascular surgeon in Iowa.  I own my practice, and employ four others, to include a physician assistant, an ultrasound technologist, and a nurse (my wife, who also serves as my practice manager). We run a fairly conventional practice, with most of our income from traditional private insurers, Medicare, and a trivial amount from Medicaid.  Our practice is very successful, to include from a financial perspective, but I am well aware of the many limitations of the current healthcare system in the U.S., and certainly expect that major changes are coming.  Unfortunately, our current healthcare system is so bulky and entangled (physicians, hospitals, pharmaceutical companies, insurers, the U.S. government) that change will come slowly, in fits and starts, and will likely be very poorly coordinated.  And, most are so inured with our current system, that resistance will continue to be great, even though change is clearly needed.  Still, change will come, and while the U.S. government could have played a large role in this, I think it quite likely that the change will instead come through grassroots efforts.   

I like the idea of a community-based healthcare cooperative, particularly one that focused on primary care and wellness. However, the time may not be ripe for this idea just yet.  Prior to moving to Iowa, we lived in a small community in Colorado, where the shortage of primary care physicians was particularly acute.  The idea of a community healthcare cooperative was considered, but never realized.  Again, I think this is because most people are so accustomed to our current way of doing things, that they couldn't see "outside the box" to effect true change, even though the need for a different system was very real, and the proposed solution seemed viable.  In time, though, with continued deterioration of our current financial system, the limits of our current healthcare system will become more exposed, more will lose their medical insurance, and local community efforts to support the public's health will become more appealing.

As another respondent mentioned, there are some primary care physicians moving to a cash-based practice, some of which offer their own version of an HMO, in which members pay a (fairly) small monthly fee which covers basic services.  I think it is likely that we will see more of this in the future, and perhaps it is those initial efforts at change that will ultimately coalesce to become a community-based healthcare cooperative.  The physician assistant with whom I worked in Colorado, who is also a Chris Martenson fan, has begun storing some basic medical supplies, and already has excellent surgical skills, and he is contemplating the day when he might trade work at the hospital for a cash-based (or, barter-based) clinic that he could run. Again, I think this is likely to develop initially as efforts by individual healthcare providers, or small groups of providers, that in time, might develop into a larger system.

The future of physicians like me, who provide surgical services, is much less clear.  There are some simple surgical procedures that can be performed in the clinic setting, where costs can be easier to control, but major surgical procedures require more resources (an operating room, anesthesia providers, postoperative recovery, etc.), which encumbers efforts at change.  Even when I do perform surgery on a patient without insurance, willing to accept whatever they are willing or able to pay (I frequently receive no payment for such care, by the way), my surgeon costs are a very small fraction of the overall bill the patient eventually receives.  I simply do not have a clear vision of how surgical care is likely to be provided in the future.  Hospital-employed surgeons, with the hospital owned and supported by the community?  A national healthcare system, like in Canada and Europe, given the financial insolvency of our government?  Surgery done on my kitchen table?  It is an unwieldy problem.

Finally, and I apologize for the long post, but I would like to point out the success of groups like the Amish, of which we have a fairly large community in Iowa, in dealing with healthcare.  When an Amish patient is ill or requires surgery, the costs are negotiated, and the bills paid, in cash and in full, from the collective wealth of the Amish community.  It seems to be a very good system, and I have no doubt that it is much more cost-effective.  I just don't see that type of system developing on a community level in the near future.

The next 20 years will be very interesting for the healthcare profession, too!

Christopher Peters 

as with any preparation for any of the various scenarios that may or may not occur, community is a very good place to start.

we currently have a group of over 25 here in nwa that is looking at many of the things we need to be prepared. we are looking at food security, local currency etc.

we have several healthcare practioners in our group. we are establishing a database of "gifts" and "needs". this will enable us to know who in our community will be able and willing to share their gifts.

myself in terms of health have been doing yoga for over 40 years, tai chi for almost 20. have been a vegetarian for 40 years. i use herbs regularly, a great place to start is back to eden by jethro kloss. regular fasting is a great way to maintain health as well. herbs can be grown in pots inside in small containers. you can start an herb club where you can grow a few kinds and members of your community can grow others. you then can share. as for no side affects from herbs that is a lie. you should be very careful with any herb as it is medicine. there are many toxic plants and some have allergies which need to be considered. other  decentralized medical strategies include , ayurvedic and chinese medicine which consider food to be medicine. homeopathy, reiki, biofeedback, chiropractic, flower remedies etc..

a very good resource is "prescription for nutritional healing"  by james balch. it is described as a practical a-z reference to drug free remedies using vitamins minerals and supplements.

i highly recommend juicing. the absolutely  best juicer is the norwalk. it was developed by dr. norman walker who lived to be well over 100 (of course if things get really bad we may not wish for long lives) it is a food processor as well. you can make nut butters, grind coffee make desserts, grind flour etc. this juicer is the juicer recommended by the gerson organiztion which happens to be the foremost natural healing organizatio. max gerson was called the greatest medical genius of the 20th century by albert schweitzer whom he cured of diabetes at age 70. many people have successfully battled cancer using the gerson program. norman walker has many books on health and juicing. by the way the norwalk factory is about 30 minutes from my home . they have been attending the alternative cancer therapy conference from the beginning and have a library of tapes containing the presentations of everyone who ever made a presentation. this is a remarkable resource. they sell the tapes. dr. walker devised formulas for specific ailments. on the topic of cancer i also recommend dr. nick gonzalez. he is in n.y. and uses natural means of treating cancer. he has had amazing results. he started at sloan kettering and has been in private practice for many years.

finally i do not have health insurance. i have been living in india part of the year and been having my dental care done there at a fraction of the cost (1/10). i have a medical travel company. i make arrangements for people to travel overseas for medical and dental care. we deal only with jci accredited hospitals that are among the finest in the world. many of our clients go to costa rica, though we also work in india and thailand. for more info you can go to www.globalmedicalreferrals.com. we do not charge for our services as we get reimbursed by our providers. i have already told chris if anyone contacts me from this site i will give him a substantial percentage.

ps. if any of you have any extra money i am on the board of directors of a touch of love. we do charitable work in india,  argentina, ghana. and the dominican republic. we can use all the help we can get. donations and child sposorships are our main ways of raising money and they are starting to drop off. atouchoflove.org. all of the money goes to our program. none of us take one dime.btw many times even if you have insurance it is cheaper to go overseas once deductibles and copays are figured.

best of luck

Thanks for all this info. jerry_lee - thanks for asking these questions.
Medical care is a big "what's the future here?" that's been rolling around in my head too.

cpetersj - Glad to hear from a surgeon. The need for your services is keeping me paying enormous monthly bills. Every time the premium is due I consider whether it's something I can do without. I look at the divot in my shoulder from cancer surgery . . . answer is currently "no". I'm 59 and so is my partner (with no insurance) and I'am really hoping the new administration comes up with some health care changes. Not being a big believer in government problem solving, I feel this is a long shot but also feel this lack of affordable care is one of the biggest "gun to head" tools that keeps US citizens towing the line. Go to work - don't rock the boat. Don't risk independent entrepreneurial adventures. I've spent some time in socialist countries and know there's a big psychological shift when this particular fear factor isn't pervasive.

On the up side - I've developed a great relationship with my G.P., who sees quite clearly the ridiculous situation many of her patients are in due solely to the insurance system they're operating under. She's willing to step outside her prescribed niche. I find this extremely encouraging about what's possible for the future. I understand specialization is the current mode but having grown up with my grandfather as my dentist and the family doctor living down the street, who handled all problems not requiring hospitalization (and some that did), I'd be very happy to see medical professionals be allowed to do more than what's currently acceptable under a "refer to specialist" system.

I know I'm bringing up several different issues here (and perhaps not too clearly), but wanted to point out that it's not only an issue to consider as part of our "what if" scenario but something that is, in my opinion, currently as broken as our financial system. Also want to say to folks younger than myself - s . . .  does happen - no amount of yoga, exercise, or healthy diet stops entropy or just plain bad luck.

Keep in mind keeping an eye on each other, especially older folks in your community. It's one of the best free currently doable preventive care prescriptions I can think of.

Here's an interesting link regarding the effects of the economic crisis on hospital closings:

http://www.msnbc.msn.com/id/28394340/

Jerry Lee, without knowing anything about you, I think your reasoning is sound in proceeding with your knee replacements before going "bare" on medical insurance coverage.  That just makes sense.  In agreement with another respondent, I would advise looking in your area to see if any primary care physicians are conducting a cash-based practice, either in an a la carte type of arrangement, or something with periodic payments for basic healthcare needs.  If there is not something like that where you live know, keep checking, as I suspect we will see more and more of those as time goes on.  For more major health problems, if you decide not to maintain private health insurance, I'd recommend simply setting aside some wealth on a regular basis for that eventuality, perhaps an amount roughly half of what you would have to pay for health insurance, and keep that account sacred, not to be used for anything other than truly unexpected medical problems.  If, at the end of your life, you and your wife don't need it, pass it along to as an inheritance to any beloved family members, friends, or your community.

Echoing Linda K's comments, and while I certainly agree that health maintenance through all avenues available is more valuable and useful than disease treatment, we should plan for the possibility that illness or disease will intervene despite our best efforts.  One of my dear cousins seems much like Joe2Baba, a vegetarian, a follower of Eastern religious practices and alternative medicine, etc.  He has lived within the Adidam community for many years.  However, he is getting up in age, and some physical ailments, to include two hernias, have caught up with him.  He has no savings with which to pay for his care, and while I would be willing to donate my surgical services to my cousin, I don't see how he'll be able to pay for the operating room and anesthesia.  For now, he's content to live with his problem, but that is not ideal. People living in times before modern surgical care lived in discomfort for years from hernias, and some died from complications related to incarcerated hernias.  While there are certainly excesses in our current healthcare system, I don't think we wish to go back to a time in which large proportions of our population suffered or died from conditions that are easily managed or cured today. Imagine what our world would be like without appendectomies, cholecystectomies, antibiotics, etc.

Back briefly to the excesses and imbalances of our current system.  I am a surgeon, and so make most of my money by doing procedures.  Like most procedure-oriented physicians, I make a very comfortable living.  In fact, as well as my practice is going, I don't even have to work full-time.  If broken down to an hourly wage, I much more than primary care physicians, who don't do procedures, have to work full-time, and earn their income by diagnosing ailments, prescribing medications, etc.  Does this make sense?  I'm no more valuable than my colleagues in Internal Medicine, Family Practice, and Pediatrics.  I would even argue that there is very little reason that I should earn more than the teachers who instruct my boys, or the policemen and firemen who protect our community.  Yes, I went to school for a long time, and had extensive subsequent training, and that should be worth something extra, I suppose.  But, before the onset of medical insurance, when physicians were strictly on a cash (or chicken, or whatever) for service basis, the income of physicians was not significantly greater than others in most communities.

I truly don't know any answers, but I do enjoy looking at this problem, and if I do glean some useful insights in the future, I'll be happy to pass them along!