 |
| This is the wing of the hospital my wife went to in Kuwait - fitting. |
Medical tourism or medical retirement or a combination of both? Medical tourism: going to another country, combining a vacation to get some level of medical care that is much cheaper than you could obtain in the U.S. Medical retirement: moving to another country because the level of care you need well, there won't be any tourism when you get to that stage. So the premise is that it's cheaper to move there and live there to obtain the medical treatment than it is to live in the U.S. and get decent medical care. I'm close to retirement. I'm 52. How did I get here? The short version is best described by a Dickens quote: "Annual income twenty pounds, annual expenditure nineteen six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery." Save more more money than you make every year, it's a pretty simple equation. As I get older, the cost of medical care is a huge component and concern of retirement. There are a few options for medical retirement, that's next. But I think it's a damning indictment for health care in the U.S. that it can be cheaper to fly to Thailand (or a number of other countries), have a bit of a vacation
and get medical care that would be cheaper than the whole kit and kaboddle would be in the U.S. There are, of course, thresholds that have to be passed and you have to have some pretty major work that you need/want to be done to pass the cost/benefit analysis to make it work in your favor. But if you are going to retire unconventionally (without medicare and a pension prior to age 62) in the U.S., then you have to have health insurance, or you are a huge gambler. The insurance business makes money from you being healthy. It's pretty simple, much like weight loss and gain. If you take in more calories than you expend, you will gain weight. If you expend more calories then you take in, you will lose weight. There are a few ways to skin that cat, but that's really the basics. And with insurance companies, if they take in more money than they pay out in claims, they make money. If they pay out more in claims than they take in premiums, then they lose. And the healthier you are, in general, the less you use medical services. So insurance companies want you to keep that weight off. Again, a broad brush stroke of the industry, but accurate.
And for either medical tourism or medical retirement, as a rule, you're probably going to have to get on a plane. And from my earlier travels, here's a bit about airline travel:
The Middle Seat
We are, of course all familiar with Newton's third law of motion, for every action, there is an equal and opposite reaction. Well, here's Alan's law: for every piece of good news, there is an equal and opposite tidbit of bad news, and here's mine - I live in an absolutely magical place. Unfortunately, I also happen to live in the middle of the Pacific Ocean, and to get anywhere in the world, I have to fly. For the record, I am not particularly fond of flying. But I am also a logical guy, and when I have to cross 2500 miles of ocean to get from point A to point B, well, I hop on that plane like a gibbon.
Now the last trip I took, as usual, I made reservations in advance for an aisle seat. I'm a restless fellow and I like to get up and walk up and down the aisle without disturbing my seat mates. I should make mention at this point that I flew about a month after 9/11. I was anticipating a less than full flight, and was even hoping for ghetto first class - a luscious empty row to myself.
Of course, you are thinking there were problems. You are right. Otherwise, where would the story be? As I checked in, I was informed that there were no aisle seats left. I pleaded, I whined, I cajoled, I begged. I had made the reservation, they said there was no problem, an aisle seat was reserved for me, can you check again, is there any way there might be an aisle seat on another computer reservation system? Please? Is there any kind of special fee I could pay to get an aisle seat? Can you upgrade me to business class? No. No, no, no and no. I was stuck in the middle seat. Now I know there is no written protocol about the middle seat, but I really think there should be. Here's the way I see it: The person in the window seat has the side of the plane to lean on, and an armrest all of their own. The person in the aisle seat has unfettered access to the aisle, and an armrest, their own personal armrest, on the aisle. The passenger in the squeezed in between, the occupant of the lowly middle seat should get both remaining armrests to compensate for the advantages the window and aisle seat passengers have. It's not written, but we all know that's the way it should be, right?
When you have just boarded the plane, you are really only focused on looking for your seat, finding where you will spend the next 5 hours of your life and getting as comfortable as possible. But when you are already sitting down, and there is an empty seat or two next to you, every passenger strolling towards you becomes a possible interloper. Don't deny it, I know we all think like this. We try to casually observe the other passengers as they approach your aisle and wonder: Is someone going to occupy the precious empty seat next to you? If so, then who? Is it going to be a pretty girl or guy, if you go that way? (Chances are slim) Will it be the elderly lady with stories of canning vegetables in Iowa and pictures of her grandchildren? (Odds are improving) The family of four, will they sit next to you, and will their 4 year old sit directly behind you, kicking your chair and lifting and letting the tray slam down, again and again and again? (A savvy Vegas gambler would be happy to take that bet) Or is it going to be the man who plops down in the seat next to you and says, "It's going to be a long flight. I just had 12 beers and I need to piss like a racehorse, so I'm going to be hopping over you all night long." (This actually happened to me before)
As I boarded the plane, intent on finding my seat, I saw, much to my dismay, two men nervously watching the passengers sauntering down the aisle. My seat, the dreaded middle seat, beckoned. Both had their elbows firmly ensconced on the armrests of the middle seat, which was understandable at that point because the seat was not yet claimed. They look at me and I at them, then at the seat. I put my briefcase under the seat in front of me and sat down. Their elbows, amazingly enough, remained firmly on the armrests that clearly belonged to me. A grievous breach of middle seat protocol. "Okay," I thought to myself, "let the games begin."
The gentleman in the aisle seat was perhaps in his early 50's, slightly built, a hint of an Asian background, longish gray hair, wire frame glasses, polo shirt, khaki pants and deck shoes. I look at my watch. Five minutes, I think to myself, before that armrest is mine, mine mine! The guy sitting in the window seat was probably in his early 40's, about 180 pounds, long pointy nose, clearly Caucasian to the bone, Nike running shoes, short pants with a fancy braided belt and a shirt that had the logo Blue Lagoon Dive Shop Truk over his left pocket. This fellow's elbow was protruding brazenly at least one full inch into my seat, my space. That's right. Not just on the armrest, but on the strategic inner part of the armrest closer to the seat, jutting out so that when I sat back, his pointy elbow, when I sat back, would poke into my back. Hmmmm. I gave him 10 - 15 minutes before I vanquished his elbow to where it belonged: on his lap.
I'm going to be careful a out what I write next, so as not to incur the wrath of women readers. Oh, the hell with it, I'm just going to say it. Women are no problem when it comes to middle seat protocol. There are a couple of reasons for this. Women are much more sensitive and caring creatures than we callous men, they recognize the inherent indignity that the poor mug who has been relegated to the middle seat has to suffer and usually, they withdraw their elbows before you even sit down. Sometimes, however, they don't. What to do? Insinuate your elbow on to her armrest (which, if you are in the middle seat, is by all rights yours anyway) and begin to make skin to skin contact. The elbows of the female species almost always make a hasty retreat, although on rare occasions, you really wish they wouldn't.
But I had no lovely lass to sit next to, no elbows to rub, well not the ones I wanted to rub anyway. I started out by perching my elbows on the armrests, moving them back slowly, centimeter by centimeter until I engaged both men in a little physical contact. Okay, let's get this this thought, the one that must be going through your head right now - I do not enjoy, nor am I entirely comfortable with male to male skin to skin contact. I was just trying to claim what was rightfully mine and was hoping that these guys would get the heebie jeebies quickly when my elbow nestled against theirs because I wanted both of those damn armrests. Middle seat protocol, you know. The older man on my left put his tail between his legs and his arm on his lap after about 30 seconds of elbow to elbow nuzzling. But my opponent on the right was proving to be a much tougher challenge than I anticipated. He seemed to have absolutely no discomfort a out or forearms resting together, and his elbow, his pointy elbow was still encroaching on my personal space. Again, hmmmmmmm. I looked at him, then down at his elbow and turned my back slightly so that it rested against his elbow and began applying slow, increasing pressure. Nothing. The man was like a block of granite. I looked at him again, then down at his elbow. He smiled ever so slightly.
To better assess this worthy adversary, I got up and took a stroll to clear my head. It was an all night flight, he would be asleep soon, perhaps I could pull the push, replace and pretend (push his elbow off, replace it with yours and pretend to be asleep) as soon as he nodded off. I went to the bathroom and washed my hands. I washed all the way up to my elbow and did not bother to completely dry it off. Let's see how he reacts to this, I thought. A damp elbow placed against mine would get an instantaneous reaction. He merely pursed his lips slightly and his elbow remained completely immobile. I had severely underestimated him. I then placed an in flight magazine magazine against his elbow, a pillow over that, and leaned against the pillow, once again with ever so slowly increasing pressure. His elbow seemed to be an immovable force. The man was a master! And so it was that I spent the rest of the night, leaning against the pillow, that was propped against the magazine, that separated me from the maestro's elbow.
The flight mercifully began to descend and finally landed. I had not exchanged a word with this man the entire flight. As the plane taxied to the gate, we stood up and he said in a voice that Michael Jackson would have coveted, "That wasn't a bad flight at all, now was it?" Perhaps from his perspective, but from mine, not so much.
