OK, I’ll keep this short and sweet.  All of the time I run into people who are full-timing in an RV, and who don’t have health insurance.

Sure, you may be young and healthy.  Sure, it’s expensive. But you have to keep something in mind:  our health system is insane.

We were lucky during our three years on the road.  Our medical issues were few.  But nothing lasts forever.  I went to see the local doc for a routine checkup in December.  No procedures were done.  I had a 15-minute exam and some blood tests and urinalysis, all routine stuff.

The physician’s office billed my insurance company $1,046.09 for that.

No typo.

We are still in the deductible of our “high deductible health plan,” so theoretically we’re on the hook for the whole thing.  But there’s a trick.  Simply having health insurance, even if it isn’t covering your bill, is what’s really important.  See, the insurance company has negotiated rates with the medical providers (meaning in this case, the doctor’s office).  Their pre-negotiated rate knocked the bill down to $238.00.  That’s what we’ll actually pay.

So what happens to the $808.09 that the doctor’s office forgave?  No worries — it will get passed on to some poor sap who doesn’t have medical insurance.  Sooner or later they’ll find someone who doesn’t have a negotiated rate, and if necessary they’ll garnish his wages to get it.

That’s why people who don’t have health insurance in this country are screwed.  A huge percentage of bankruptcies in this country result from being what is termed, “medically indigent,” meaning sucked dry by medical bills.   No health insurance?  You’ll go down fast.  At the rate of $1,000 per simple office visit, it won’t take long. Imagine what happens when you get hit by a car, or have a heart attack.  You’ve never paid as much for an Tylenol as you will when you buy one from a hospital bed.

Don’t kid yourselves.  Get health insurance and join the club of people who pay 80% less.  This has nothing to do with “socialized medicine,” or Obama — it has been the system for decades.  The health care system in this country is rigged, and the only way you can survive the cost is to join the game.  Or, you can move to France.


  1. says

    Actually, we’re watching a good number of friends who are INSURED getting screwed, namely friends with big-ticket medical issues who suddenly get an envelope in the mail saying “oh, sorry, we not going cover you anymore”. Once you’re labeled with a pre-existing condition, you’re not insurable any longer.

    As someone uninsured who paid off a $32000 dollar medical bill BY MYSELF (no typo) I can assure you that at least I knew what I was getting into when I ended up in the ER.

    Also, as someone who assists others who are uninsured with their medical bills (through a non-profit that works with performers like us) I can tell you that the FIRST thing we do is negotiate with the hospital and other providers to get our clients the rate that Medicare (read: the government health system) pays.

    Which, interestingly enough, happens to almost always be 80% LESS than what the initial bill says.

    Again, no typo.

    Add to that the fact that nearly all health insurance companies are now compiling databases of mail forwarding services (which most of us on the road use at one time or another) in order to DENY applications from “indigent” people, and you realize the rigged game isn’t about the haves and have-nots. It’s about the choices we make in how we wish to live our lives.

    I’ll take my chances with the ER, especially knowing who to call and speak to and what my bills actually say. And I’ll support the nurse-practitioners who sit in the Minute Clinics and Take Care Clinics because I am my best health insurance policy and I treasure my ability to live my life on my terms. I’ll also keep seeing my own doctor for $120 per visit, self-pay.

    Join a game I KNOW is rigged? THAT’S insane. But it is unfortunately very, very American.

  2. says

    The new health care bill will prevent health insurers from discontinuing coverage for pre-existing conditions, as of Jan 2014. See

    Likewise, denial of coverage is an issue addressed in the bill. Good thing, because it has been on the rise in recent years.

    We traveled full-time with no permanent residence and have used mail forwarding services for years. I don’t believe we have ever been discriminated against on that basis.

  3. says

    Not only in theory but now in practice, the new Health Care bill is unconstitutional until a higher court rules overrules. That used to mean that things came to a halt. What of the rule of law?

  4. Brett says

    Also on the whole “pre-existing condition” issue. If you can prove continuous coverage with no lapse as you jump form plan to plan they cannot exclude you, even before the “new” health care law kicked in.

    I am waiting for the rules to be that if your doc gets it wrong the first time and has to “do-over” you get the do over for free… Medicare gets that why don’t we?

  5. Pat says

    I moved to Toronto from Cali 6 years ago. That same physical is gratis as is any emergency treatment required. So the system up here is quite good. Other costs up here are quite high though. I pay both us and cdn federal taxes + Ontario!

    cheers and come visit….

  6. says

    Good advice Rich. I’m using interim insurance with a high deductible which is better than nothing, but I’ve got until June to find other options. Scares me to death. The out-of-pocket on some simple cold medicine I had to buy this week cost more than TWO HUNDRED dollars on my plan. Makes it hard for people to choose the entrepreneurial path, doesn’t it?