Why I Don’t Want Health Insurance Personal / Travel

We frequently hear the question, especially from those looking to move abroad, “What do you guys do about health insurance?” My answer: “We don’t have any type of health insurance, and I think it’s a waste of money.”

While many of my international friends will nod in agreement, or at least understand this statement, those back in the U.S. are most likely cocking their heads wondering how I can say such a thing. Because, truthfully, it’s hard to survive (financially or otherwise) any medical problem in the U.S., including a minor one, without health insurance. And even with insurance, the cost can be prohibitive, causing some people to forego getting the care they need.

When we were in the U.S., we paid about $500/month for a high deductible insurance plan that only started covering us once we had $10,000 in health care expenses in a given year. That means I would pay $6,000/year for insurance, plus any health expenses up to $10,000 before insurance even kicked in (ie. $16,000/year)! Unfortunately, without health insurance, we feared some medical catastrophe costing $50,000 or more, so we continued paying into the system, even though we never really used it. When compared to the cost of healthcare in other countries, these numbers are completely ridiculous!

Healthcare is affordable without insurance in most countries

The past two years as we’ve lived abroad and traveled to seven different countries in Central and South America, there has only been one occasion when we’ve needed to call on a doctor for sickness. It was in Guayaquil, Ecuador, and Emily had an ear infection. A doctor drove one hour to our hotel (and back) to check her out and write us a prescription.

The cost? Just $70 for the visit, and $8 for the medicine at the pharmacy. We also had some dental work done in Costa Rica, each cavity costing $40 to fill. And this year, we spent about $2,500 total for a wonderful English-speaking doctor and midwife to attend our home birth in Escazú, Costa Rica. This included all of the pre- and post-birth appointments, monthly ultrasounds, the delivery itself, and all other costs associated with birthing a healthy baby. Sure, it would have cost less than half that to do it in a private hospital, and basically free if we went to a public hospital. But isn’t it nice that we had the choice to do things our way for a reasonable cost?

You can get health insurance in Costa Rica for under $50/month, but I didn’t really see the point, since we almost never visit the doctor, and we have a large enough cushion to cover any medical problems that may arise. With costs so low, even the most horrific medical problem wouldn’t break the bank for us, and I see no point in having health insurance, as long as we remain outside the U.S. Even if we returned, I still don’t know if I would get it. I’ll explain why below.

Granted, our family is very healthy. We eat well, have no major health issues, no allergies (that we know of, besides cats), no chronic conditions, and we generally avoid dangerous activities. We also try to let our bodies heal themselves where possible. Some studies show that 85% of our physical problems heal on their own, without any medical intervention*. If we catch a virus or a stomach bug, much of the time there isn’t much a doctor can do to make it go away any faster, although they can prescribe drugs to help relieve symptoms.

Cut out the middle-man and pay directly for the service

After having experienced the low cost and fantastic quality of health care in other countries, I now feel completely ripped off for having paid into the U.S. insurance system for so long. If I had taken that $500/month and saved it instead, after 5 years, I would have had $30,000 saved up. I doubt I would have spent that much on healthcare in the U.S. during that 5 year period, even without insurance. And if I did have an expensive medical problem, I could do what many others are now doing — fly to Mexico, Costa Rica, or numerous other countries to receive medical care at a fraction of the cost, along with a nice hotel stay and a mini vacation — and still spend less than I would have in the states. I’d rather keep my money safe than give it to an insurance company, who will fight tooth and nail so they don’t have to pay the medicals bills they said they’d cover.

I suppose we have been lucky. I know there are people who have serious medical problems, and without insurance they would be severely in debt, perhaps even if they received care abroad. So I can’t really say that it’s best for everyone to stop paying for insurance. But one thing is certain — continuing to give money to U.S. insurance companies is not going to make healthcare any cheaper nor fix the broken system.

One thing I’ve learned from our travels is that I feel much happier when I don’t hold onto items or continue paying for things that I don’t use regularly. That’s why all my possessions can fit into a carry-on suitcase, and it’s one more reason why I don’t have health insurance.

* Thomas E. Kida, Don’t Believe Everything You Think, p. 59. Kindle edition.

Brandon is a location independent entrepreneur, musician, worldschooling father, and the principal author of this blog. He's all about reaching his potential and enjoying life to the fullest in each moment.


  1. Brandon — I agree with your assessment, to a point. The beauty of many of the countries you visit is that you do have a good public fallback for healthcare. The US is one of the worst places in the world when it comes to healthcare.

    All major countries provide some form of Universal Healthcare for their residents except the United States. See: http://en.wikipedia.org/wiki/Universal_health_care

    Our health outcome and longevity is well below other developed countries. http://www.truthabouthealthcarereform.org/international-comparisons-p3/

    We pay significantly more for health insurance/care in the US http://ucatlas.ucsc.edu/spend.php

    The problem is that when people are relatively young and healthy, they don’t see a need to “pay into a system” for healthcare and if they are not insured (in the US) they end up not doing the right early prevention and intervention. This makes costs in later life much higher and with a largely unregulated private insurance it becomes very expensive or unavailable as they become older.

    If people in the US would realize that their health and well being should not be subject to someone else’s investment portfolio and get over the free market is always better mentality (for example Medicare is well regarded and has much lower administrative costs than private insurance), they would demand a universal system in the US, which would reduce costs and improve outcomes. Until then, we are stuck in servitude to the insurance companies who’s primary purpose is to maximize profits.

    • Thanks for the comment and the great links. Some form of universal health care in the US would be great. But even without that, simply having more affordable private health care, like many countries do, would also solve a large part of the issue, in my opinion. (How to get there is another problem, however).

      In most countries, I can pay a small fee to see a private doctor or visit a private hospital, or I can go to a public hospital for free. No need for insurance. The problem comes when the cost of private care is so high that very few can afford it, as is currently the case in the U.S. And insurance only seems to be making it more expensive.

  2. Sabina King Says: August 30, 2011 at 3:02 pm

    We are also an expat family that just returned from a visit to the US. We were sadly amazed at how many conversations we overheard that had the phrase “Well, at least you have a job and health insurance”. It saddened us to hear that people are working at jobs that don’t care for just to have health insurance.

    I imagine the fear of not having insurance in the US causes enough stress to put one in the hospital. :)

    Living a clean, simple life is the best prevention, not doctors visits and testing. Unfortunately, living that way is nearly impossible for most in the United States, with all its temptations of processed food.

    Unfortunately, “paying into the system” is not benefiting a functioning medical system…it is encouraging the growth of insurance company power and mass.

    I love that we do not worry about our health or the expense of it. What a huge stress relief…and THAT is a wonderful thing for your health.

    • Sabina, points well taken. “Paying into the system” is a general term, whether the system is private insurance or some publicly funded universal health care system.

      Your last paragraph sums it up perfectly. Health care should be available to all and the most cost efficient way to do that is to fund it publicly (e.g. taxes) or by mandatory but non-profit private insurance — with cost controls put into place that allow practitioners to receive just compensation but to eliminate unnecessary costs.

      There are many other factors to health besides the “simple life” — some countries where people have the “simple life” have worse longevity than the US. One must also consider genetic issues, infectious disease, accidents, stress, etc. for which an individual has little control.

  3. Well, I’m seriously grateful I have medical insurance. I can’t imagine living the life you do now that I have a daughter that has type 1 diabetes and is insulin dependent. Also, I can’t imagine the thought of taking Gleevec without good insurance. It costs $5,500 for a 30 day supply. My insurance pays for all of it. I suspect without insurance I just wouldn’t be able to afford it and the odds of my tumor coming back go up significantly – and I can’t bear the thought of doing that surgery again.

    Yeah there are some major issues with the health care system, but I’m not a socialist and I am totally against universal health care. I think the whole system would suffer.

    Generally speaking, what’s wrong with America is lawyers. If the Government would protect doctors & hospitals better so they couldn’t be sued for ridiculous amounts of money for mistakes then I think you would see the cost of health care drop dramatically. But you won’t see that because all our politicians are lawyers. Even our president is a lawyer.

    • My thoughts exactly. The more freedom we have the more likely all will benefit. I’m glad Brandon has the chance to choose whether or not to pay for health insurance. A universal health care system doesn’t give you the choice. Someone has to pay for the health care so they raise your taxes and take away that choice by making you pay for it through your higher taxes.

      • Paying for healthcare via taxes would have to be weighed with the cost. If it increases taxes only $100/year, but saves me $6,000/year in insurance costs, isn’t that worth it? I can still pay for private care if I want it, but those who can’t afford it can still get care. However, if it increases taxes by $10,000/year, then it may not be such a good idea.

    • Bingo. I know this post is old. Still an interesting debate. A lot has happened since this post was written with US healthcare system. Brandon’s situation and rationale are actually sound. His family is healthy, young, and likelihood of major, catastrophic, expensive illness, is low.

      That being said. Legality and fear of lawsuit permeates the medical system in the US. This drives costs (beginning with drug development)

      However, Brandon and his family have one more advantage to consider. Less stress, greater control of their day to day lives, and a focus on nutrition. Poor nutrition, high stress, and lack of control of day to day lives clinically contributes to many of the “expensive” care that we see in the US.

      As a medical doctor practicing in a cash based practice, I see the value of patients simply paying for their care. It’s way more affordable, cutting out the middle man and the insurance company that doesn’t want to help you anyway.

      In the US a large portion of the country refuse to adhere to proper nutrition and lifestyle. Universal health care / Obama care will bankrupt the US.

  4. Uncle John Says: August 31, 2011 at 1:21 am

    Dustin, Sorry to hear of your daughter’s diabetes (I am an insulin taking type 2 diabetic myself) and your need for Gleevec. To give you an idea of the disparity of pricing of insulin in the world, look at http://www.haiweb.org/medicineprices/07072010/Table_of_results.pdf — you will see that the exact same brand and amount of insulin in the US costs over 20 times as much as it does in Egypt. I’m sure Brandon could do comparison shopping in Costa Rica for common prescription drugs (some of which are sold over the counter in other countries — only prescription here in the US to improve the profit margins. Look how quickly the price of Prilosec went as soon as it went over the counter — and Lisinopril which will go generic in a little over a month).

    Unfortunately, the reasons for healthcare costs are not what the industry and a particular political view’s propaganda would suggest.

    Malpractice settlements and medical malpractice insurance contribute about 2% to the cost of healthcare in the US and defensive medicine adds perhaps a couple percent more. See: http://www.consumerreports.org/health/doctors-hospitals/health-care-security/who-is-to-blame-for-high-costs/health-care-security-costs.htm – We are a litigious society, but do you really want your neighbor to be permanently disabled (or killed) by malpractice and have no ability to be compensated? This is a “red herring” of the for profit insurance industry, whose goal is to minimize payments.

    Another contributor is uninsured emergency care (uninsured must be treated if they show up in the Emergency Room at the highest possible cost).

    What Americans need to do is start looking at facts, not ideology. If you will review the information on the links of my previous comment and this one, you will see that clearly and contrary to the political and industry generated propaganda, universal healthcare is by far less costly and provides for better health for the citizens of the civilized countries that provide it.

    The whole “socialist” political argument is bogus. What has happened is Americans have been taught for generations that socialism is evil and capitalism is good — neither is absolutely true. We associate “socialism” with totalitarian regimes (bad and often evil) and capitalism with democracy (good and sometimes evil), but for the most part “social programs” (what the propagandists call socialism for a visceral response) are very prevalent and successful in democracies and many totalitarian regimes practice capitalism. The reality is most every successful democracy has a mixed economy, with elements being public (what some propagandists would have you believe is socialism) and some elements being private. The key is acknowledging some things are better performed in the private sector and some things are better in the public sector and then deciding which is best. (BTW, many countries have universal healthcare which is delivered and sometimes insured by private companies — universal doesn’t necessarily mean government run — it just means it is available to all, including the poor.)

    If you truly are anti-socialism then it is hypocritical to take advantage of socialist (public) programs like:

    1. Social Security
    2. Public Schools
    3. Public Highways
    4. Public Utilities
    5. Medicare (which is more cost effectively managed than private insurance)
    6. Public sidewalks
    7. Public safety (fire and police)
    8. Public information delivery (US Mail)
    9. Federally insured investments
    10. Federal Flood Insurance
    11. Military protection

    … and so on.

    — John

    • Thank you for your additional comment. I think this is an interesting subject.

      I agree that socialism has acquired a bad reputation of that many look at as evil. I think that is because most the time (I think every time) it has ruled a country more people go hungry, more resources are wasted, and there is less freedom.

      I think the list of 11 programs do have some that are needed but that isn’t because they are socialist. There is nothing socialist about military protection. That is the responsibility of the government. But just to list a few…Social Security, public schools, the post office…do you really think those are run effectively? Plus they limit freedom and I think that is the main point of Brandon’s post. He is free to choose how to provide medical care for his family.

      I realize I am not an expert on this subject but those are some of my thoughts.

      • Kurt,

        Yes most of those are run effectively, but not perfectly.

        Social Security is paid on time and at a very low overhead unless Congress is playing “chicken” with the budget. Congress has wrongfully borrowed from the trust fund but it is basically sound as a safety net. It’s common partner Medicare (which incidentally allows a lot of personal choices) is run more efficiently than private insurance (which wouldn’t cover the elderly because they are a higher risk investment) — Medicare administrative costs are around 3.3% while private insurance ranges from 12.5% for large groups to 30% for individual policies averaging 16.7% — http://www.cahi.org/cahi_contents/resources/pdf/CAHIMedicareTechnicalPaper.pdf

        Try to get any private business to pick up a “letter” at any address in the US and deliver it to any other address in the US for $0.44 (the private enterprises that do so charge in excess of $10-15 per letter, and don’t deliver or pickup at many addresses). It is a highly automated system and runs quite effectively, its revenue short falls are mostly a function of changing demand as more communications happen electronically and they are adapting, such as the proposals to close many facilities and to end Saturday mail delivery.

        Public schools have problems with priorities, but you do have the choice to not use them, but for the dollars they receive they are pretty effective. They are just misdirected — they are oriented toward producing “workers” for industry, rather than citizens with critical thinking skills and a life long desire to understand and learn (which makes more competitive individuals). Brandon is doing the right thing with his girls as he has the financial freedom, personal goals, and resources to create a fabulous educational environment for them.

        It is popular to say anything government runs is inefficient and poorly managed, but the truth is most public employees are hard working people and the management is generally pretty good. We can all find examples where something wasn’t perfect, but you have to take it on the balance. In total “fraud, waste, and abuse” in federal spending is less than 3% (slightly more than 9% in healthcare related government payments)

        And yes, the military is “socialist” in the sense that it is publicly financed (which seems to be the criteria of many who use the term “socialist”). In many periods of history, and in some countries today, private individuals fund and operate their own military.

        In the Constitution of the United States it states that the government must see to the common defense and general welfare of the country. This is the justification for a publicly financed military as well as public funding for other items that are for the general welfare (various interpretations) including publicly funding those things that provide a general benefit to all citizens.

        Nobody likes to pay taxes, but the evidence is clear that a universal healthcare initiative in the US paid for by taxes (with perhaps some copays) would be much more cost effective than the current private insurance system. Look at other countries that have done it — most have the flexibility for individual freedom and choice in getting care, and even permit private supplements but spend considerably less and have better health care results than the US.

      • Kurt – Yes, I agree that the U.S. needs more healthcare options, especially more affordable ones. However, we all have the choice to go overseas to get care now if we want to. So in that respect, we may not be as limited as we think we are. But few are willing to consider that option. Ideally, I’d like to do away with insurance completely and just make healthcare affordable for the majority.

        • Brandon – I couldn’t agree more with your statement. I guess my concern is government isn’t the way to do that. I appreciate the discussion. Uncle John seems like a very well read individual and I am glad he has a right to speak his opinion. I was going to respond more but I don’t have all the answer and I have to get some work done so I can get out of my job and do what you are doing.

          I love your blog and your tweets. Keep inspiring!

        • Uncle John Says: August 31, 2011 at 9:31 pm

          Brandon – going overseas is not an option (time and cost of travel, away from work, etc.) for the majority of people and it certainly doesn’t work for emergency care. You are fortunate in that you have the ability to do that.

          I totally agree we should get the insurance companies out of the formula, hence my opening statement about a person’s health should not be governed by another’s investment portfolio. That is why we need to look at what works in other countries and that is generally some form of government supported (or regulated) universal health care combined with reasonable cost controls. (When the same exact medicine costs 20x more in the US than elsewhere, somebody is abusing the market.)

          Kurt – We have to quit listening to politicians and demand that they do the right thing based on clear scientific data rather than ideology or giving their votes to the big money that pays for their election.

          Proper government does some things better and more efficiently than industry. What we have today is a plutocracy where businesses pay for campaigns and in return get tax and regulatory concessions to their advantage. We need to rethink based on what works best for the general welfare of the country, not what works for maximizing profits for insurance companies and Wall Street.

          Don’t get me wrong, I believe a person should profit from their labors and investments, but that must be tempored by what is right and fair — in the case of healthcare in the US it is just the opposite. See who is buying which votes in Congress here — http://maplight.org/

        • Bingo, I could go on and on as I work in the healthcare field. Medicare, medicaid, and other universal healthcare systems have huge percentages of waste. More importantly they don’t address or focus money on “why” people are sick.

          But that debate has been made. We have universal healthcare. I’m with you Brandon. Thanks for opening my eyes to the rest of the world and all the options in it!

  5. I’m an American living in the UK. I’ve lived here for the past three years and I think that universal healthcare has gotten a bad wrap in the States. The National Healthcare Service here isn’t perfect no system really is, but everyone is covered. You pay for it through taxes and the amount you pay in is dependent on your income. You do still have choices. I can choose my doctor. If you want to have private health insurance in addition to NHS treatment you can. If you want to opt for private treatments you can go to a private doctor. National healthcare doesn’t take away your choice it adds to your choices. I think healthcare should be available to all not just the privileged who can afford it. That’s my 2 cents.

  6. Lovelyn — my oldest son and daughter-in-law lived in Scotland for 3 years and thought NHS was wonderful. My oldest grand-daughter was born in Edinburgh and they received excellent care, including 11 in home visits after the birth by a pediatric nurse.

    There are many models for universal health care, the UK has chosen government owned and operated (plus private practice for additional personal cost), other countries have made other choices — first we need to decide that health care is basic human right, and then figure out the best way to deliver that in our own country.

  7. Incidentally we can have lower personal taxes and eliminate personal and employer health premiums by adopting the APT Tax (http://www.apttax.com) and adjusting it to cover a universal healthcare system. This would amount to the equivalent of a 12.5-60% increase in take home pay for most individuals and businesses.

  8. Jennifer Pearce Says: August 31, 2011 at 10:33 pm

    It seems really sad to me that quality healthcare in the U.S. is so cost prohibitive under the current system. Who is this really serving? Obviously not the majority. I hope there is a way to turn things around, and that positive change will happen before the situation gets even worse (if that’s possible).

  9. I agree that it is a sad and broken system. The “quality” of care in the US is great – but the affordability of it is not. And for those of us who are self employed, we can’t even GET full coverage type insurance if we want it.

    I pay over $250 a month for myself only, on a high deductible ($3000 I believe) catastrophic insurance plan. I haven’t been to the doctor in years, but I don’t dare be without it because one major medical issue and I’d be bankrupt.

    My friends & family who are from or live abroad in countries with affordable universal care shake their heads in disbelief at the amount of money we have to spend here in order to just visit a doctor. It’s insane.

  10. I don’t think the the quality of US health care is that great. I think Doctors are fear driven by our hyper letigious society. I had a lot of clients and friends in the health care system who all had horror stories of horrific mistakes. Just recently I had some concerns that I went to the doctor for and was misdiagnosed and almost died from a reaction to the wrong dosage on a prescription medication. I think the system is broken from top to bottom.

  11. Uncle John Says: September 3, 2011 at 4:50 pm

    Actually our US Health Care system does not provide good quality or value. Check some of our comparative rates on cost, access, and medical errors. http://tiny.cc/2fi5l

    There are several reasons for this, but I would suggest some key ones:

    1. Providers are paid for volume, not quality or results. When I worked for a major healthcare system, employed doctors were given very agressive “time per patient” goals/quotas.

    2. Success is measured in “profits” rather than medical outcomes. Providers get a fee for service, not a fee for outcome. (One of the few professions where you get paid the same regardless of delivered service.)

    3. Lack of coordinated care. Clinics that use multi-specialty medical teams are much better at getting better outcomes. Where one physician’s experience may suggest a patient has a certain condition another may recognize something different. This happened to me about 15 years ago — I had doctor convinced I was having asthma/allergies on a series of visits, when I was finally bad enough to get my wife to take me to the hospital it was determined I had a massive set of pulmonary embolisms (one lung half full, the other one a third full of blood clots). I could have easily died from that one.

    4. Lack of insurance or high deductibles mean people don’t get the early treatment that would avoid life threatening situations.

    5. Health stigma — since employers are generally the purchasers of health insurance (on a mostly shared cost basis these days), there is a reluctance to be open about medical conditions as it might affect one’s employability. (Higher medical risk employees drive up costs in small to medium businesses for everybody on the plan.)

    6. A political system that allows insurance lobbiests to finance their campaigns, then allows the lobbiests extraordinary influence on regulations (or the lack there of) — including the denial of the government to negotiate prescription discounts.

    We need the people to quit listening to politians, learn the facts and then find candidates who want to deal with facts instead of being bought off by industry groups or who practice fantasy ideology instead of creating policy based on solid, scientifically measured facts.

  12. While on vacation in Panama I wrecked a moped and cut my knee open. I went to the emergency room and was seen immediately. Thirteen stitches cost me a total of $17.00. Total coverage for medical in Costa Rica for my family of four is $37.00 a month. This just goes to prove what you are saying about the cost of health care in the U.S.

    I will get health care insurance in the U.S. because I can’t cover any major illness or injury that may happen to anyone in my family. I will get a job to cover the expense and to get a decent rate through an employee plan.

  13. I’d just like to point out one small point. You lucky Ex-pat’s throw out numbers of how much your care cost. And that’s awesome! But no matter what happens, or how deeply the system might get reformed in the coming years, it’ll NEVER be that cheap in the US. The difference in cost of living, and what people can afford, partially drives costs so low in these 3rd world countries. Plus it’s hard to compare to even 1st world countries like England, because demographically, there’s a very different class structure there, as defined by income levels.

    Plus, numbers are often skewed to fit their purpose: Uncle John’s truthabouthealthcare.org link seems to point to issues with cost. But, for at least the infant mortality rates, it may have more to do with how Doctors are taught to handle birthing, than cost prohibitions. In other words, only alternative methods (like Brandon & Jennifer choosing a midwife & home birth) may get us away from practices that are causing that number to be so high. Many of those countries that rank higher than the US rely heavily on midwives and even home births. Not a decreased cost of health care.

    So as Brandon pointed out, this is more an argument in favor of living abroad, over the US (something I can’t convince my wife is the best thing), where you can get those prices, even on private care. I sincerely hope that something can and will be done in the US.

  14. While I certainly agree with you on many aspects, there is one HUGE one where I disagree. Yes, medical care is way cheaper and (many times) better in other countries than in the USA. For many conditions, it’s certainly worth it to fly to another country to have the work done rather than pay outrageous fees in the USA.

    However – I will never, ever go without emergency evacuation insurance. Ever. My husband would have died in 1996 if we hadn’t had it.

    We, like you, lived in a foreign country. Our country was Ethiopia, but it could have been just about anywhere. We were healthy, active schoolteachers planning to ride our bikes around Kenya and Tanzania for the summer. One day a couple of weeks before the end of the school year we went out for a training ride – and our world suddenly got turned upside down.

    There is no clear explanation for why, but my husband’s heart starting beating irregularly that day. He ignored it for four days before going to the doctor. He went another five days before he collapsed to the ground and was rushed to the clinic and then to the ICU in the local hospital.

    Although the Ethiopian doctors knew exactly what needed to be done (shock him to convert his heart) they were unwilling to take the risk for a foreigner – there was a chance that the shock would stop his heart rather than convert it.

    Long story short – he needed to leave the country, but commercial airlines refused to allow him on the plane. We ended up flying to Israel in an air ambulance – a specially equipped plane that flew 7 hours from Tel Aviv to Addis Ababa, picked us up, then flew 7 hours back.

    To the tune of $100,000.

    Fortunately, we had insurance to cover that, but without it the plane never would have left the ground and it’s entirely likely that my husband would have died.

    I urge you to reconsider your thinking. Yes, the vast majority of medical issues that arise will be easily taken care of anywhere. But – what about those life and death situations? Is that a risk you are willing to take?

    • Brandon Pearce Says: September 10, 2011 at 11:16 pm

      Wow, what an experience! I’m glad your husband was alright. I can see why you would want emergency evacuation insurance if the doctors aren’t willing to perform risky operations on foreign patients. However, I think there is a huge difference between medical care in Ethiopia and countries like Costa Rica or Malaysia where we’re planning to settle. Ethiopa is one of the poorest countries in the world with some of the poorest health and worst medical systems. I would do all I could do avoid going to a hospital there for medical care, if I ever decided to visit. And yes, perhaps that would include evacuation insurance, depending on the length of the trip. But at this point, we’re avoiding long visits to countries that don’t have good medical care. I think most developed countries would be willing to perform emergency care for foreign patients, and for a reasonable fee.

    • This is very wise advice. What people might not realize is that such insurance is relatively inexpensive, an entire family can be covered for an entire year for a few hundred dollars. When I was in India for 3 months on a job assignment (I was there on 9-11-2001) my company made sure I had the coverage. Fortunately, I didn’t need it, but it would be devastating to need emergency care while travelling or living abroad and not be able to get it without an extremely large bill (tens of thousands of dollars) for transport.

      You usually don’t have the luxury of scheduling medical emergencies. These policies are generally good to evacuate you wherever you might be in the world.

  15. I love this! We totally agree, and live by the same philosophy. We call it ‘living by ‘what is’ instead of ‘what if.’ We would rather pay for care as we need it, instead of paying for something ‘just in case’.

    I’m loving your blog, and I can tell your family shares a lot of the same values we do. Hopefully we can meet up somewhere along the way! We will be driving through Costa Rica next year, if you will still be around.

    • I like that. Living by ‘what is’ instead of ‘what if’. Thanks for the comment! We’d love to meet you, too, but we’ll be leaving Costa Rica in October. It’s a small world, though. Chances are we’ll meet up somewhere.

  16. “continuing to give money to U.S. insurance companies is not going to make healthcare any cheaper nor fix the broken system.”

    Amen to that, Brandon. I’m going to have to join you on some of your travels in the near future! This is a fun blog you’ve got going. Looking forward to spending some time digging a little deeper into your posts. :D

  17. I am on disability and get medicaid and i cant get them to cancel it i have sent back the id card back to united healthcare . I dont want healthcare i cant afford to live in this country on disability , as soon as the relative dies i live with i will be homeless and on the streets . Now if healthcare provided euthanasia like animal shelters put unwanted pets out of there misery i would be interested .

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