Tuesday, May 29, 2012

Pssst...You Want Tickets?
By Michael

Peter and his wife Kathy are friends
who cruise aboard their Cal 39, Citla in
Mexico, but retain their home base in San
Diego. Peter dropped by to say hello and
gave Frances and I vouchers he had for the
San Diego Zoo. Frances was clearly pleased.
Thanks again Peter!
Sitting in a San Diego restaurant recently, friends of ours from D.C. were approached at their table.
“You want four tickets to Legoland?”
Turns out the guy had 5-day park passes that he couldn’t use due to a change in plans. He wasn’t selling them, just looking for another family who could use them. The tickets were activated that day and they were valid for only the four following days.
Fortunately for us, our friends couldn’t use them, but accepted them on our behalf. The next day, the Robertsons packed a lunch and headed to Legoland. Like most things spontaneous, it was bound to turn out well. And especially because we had no vaulted expectations that couldn’t be met, there was no weighing the quality of the event against the price of admission; we had a fantastic time. And it was Mother’s Day.
That evening, towards the end of our meal at a nearby brewery, a family of four took a table near ours. I had the tickets in my pocket, two days remaining. They were excited to get them. I gathered they were planning a trip there the following day anyway and hadn’t already bought tickets.
--MR

Cool, huh? It was pretty impressive to see what the artists at
Legoland had done. These heads were each roughly three feet tall.

These buildings were about four feet tall.
Even the cars, buses, and trucks you see
were made of Legos. This Manhattan skyline
was one of several iconic views reproduced
throughout the park. The Washington, D.C.
mall and surrounding monuments was
especially interesting to us.


This is the real Windy, not yet reproduced in Legos.
We are all eager to pick her up at the airport
in a couple days.

Sunday, May 27, 2012

Hopefully Healthy
By Michael

Frances and I dressed up (yeah, this is
as good as it gets) for a fancy dinner
out while we are alone. This was good
because except for this occasion, it has
been mostly cereal, cold pizza, and beer
since Windy and Eleanor left.
Back in La Paz a couple months ago, Frances woke one morning with slight swelling in one eye. We figured it was a sty that would clear up on its own. It got worse.

We don’t have a phone and we don’t have a car. We don’t have a primary care physician. We don’t have health insurance coverage in the way we used to. We didn’t have an appointment. I walked Frances down the dock and to a clinic we’d seen in town. She and I sat in chairs with other patients waiting to see a doctor. We didn’t check in with a receptionist or even take a number. The folks in chairs when we got there knew they would see the doctor before us, and folks who arrived after us knew their place in the queue.
When our turn came, we entered the doctor’s office down the hall, a scale behind us and in front of us a small woman sitting behind a small, basic wood desk. I began describing Frances’s problem when she stopped me to ask whether I would rather speak English; she went to medical school in the U.S.

She listened carefully, asked a couple questions, examined Frances and gave me a diagnosis and a prescription for antibiotic eye drops and cream. The doctor gave us her full attention and I felt I was free to spend another 15 minutes in there asking her questions if I liked.
I knew from the sign on the wall outside where we waited that the consultation fee is 40 pesos (about $3.07).
This is how health care
looks to the average Mexican:
signs advertising low
costs for standard procedures.
Want an ultrasound? Try 200
pesos ($15.30 U.S.). Are you
an athlete? Try 284 pesos
($21.75 U.S.) for blood work
and an electrocardiogram.

“Do I pay you?”
“You pay me.”

I found a fifty peso note in my pocket and handed it to her. She opened a drawer on her little wood desk, dropped the bill in, and fished out a 10-peso coin. We thanked her and left.
We filled the prescription at a local pharmacy (about $7.00 for both medications) and that day Frances jetted off to San Francisco, California with Windy.

Within 24 hours, the problem in Frances’s eyes had worsened, considerably.
After weighing limited options, Windy took Frances to a walk-in clinic for California’s uninsured. For the first fifteen minutes, Frances waited patiently while Windy completed the forms on her clipboard. She dutifully checked off that Frances is not pregnant, has never had syphilis, and doesn’t suffer migraines. The receptionist photocopied her driver’s license and they waited forty more minutes before a nurse called Frances to an examining room (they seemed efficient, but busy).

The nurse weighed and measured Frances. “The doctor will be right with you.” She said before closing the door and dropping Frances’s clean new file into a bin on the wall outside.

After examining Frances and seeing the medicines she was prescribed in Mexico, the doctor surmised that the antibiotic Frances was using was incorrect and she prescribed another. Cost: $200 (visit) + $35 (prescription)
Frances’s eyes did not improve.

Windy returned to the same clinic. This time the doctor referred Frances to a private practice ophthalmologist. The clinic called ahead and got Frances an appointment for the same day. Cost: $200

The ophthalmologist examined Frances and determined that she suffered from a viral condition that simply needed to run its course, one that was exacerbated by antibiotics. Cost: $275




Frances's eyes improved quickly and she was soon back to normal.
I think the disparities in the cost of care and approach to care in the two countries are intertwined. In other words, the cost is higher because the approach is different. So what accounts for the difference in approach?
Another poster advertising a-la-carte
services. In this case, EKG for under $10,
 an ultrasound for $15.30, complete
blood work for $8, urinalysis for $3.25,
and a pregnancy test for $8.50.
Because of the way the Mexican civil courts are structured, litigation there is rare*. It follows that Mexican doctors are not strangled by exorbitant premiums for malpractice insurance and every bit of CYA that goes with it, such as unnecessary interventions and overzealous, superfluous documentation. Too, there is a definite cultural distinction regarding how doctors are perceived. As in the U.S., doctors are at the high end of the income scale, but that income band is not as wide. The average doctor in Mexico can live very comfortably, but will earn less than a quarter of the income of her U.S. counterpart. The profession in Mexico is respected, but not exalted. When my mom was in a private hospital in Puerto Vallarta for surgery to repair her broken femur, I was caught off guard several times at the intimate, casual nature of the care. The white coat is not de rigueur; her surgeon often did his rounds in street clothes and the first time we met her anesthesiologist, the woman walked into the room looking no different than a woman in the grocery store, with her purse hanging from her arm. And like other small businesses in Mexico, a doctor’s practice is as likely to be run out of their home as any other location. For all of these reasons, Mexican health care systems can be easily pared down and adapted to meet the needs of even the very poor. I think these same factors are at play in other countries to varying extents.
Mexico has a nationalized health insurance program and some government-run hospitals, but the doctor Frances saw in Mexico is an employee of a private company. Had Frances not traveled when she did, we would have eventually wound up in the office of a private-practice ophthalmologist in La Paz to get the same viral diagnosis—at a cost likely ten or twenty times what we paid at the walk-in Mexican clinic, and still dirt cheap by U.S. standards.

Another cruiser wrote recently about his experience with Mexico's medical care system. He got a colonoscopy ($300 for a state-of-the-art procedure, and a DVD to boot). Two observations he made highlight how disparate the two countries approaches are. “We left the Dr office with a bag containing two plastic bottles filled with my colon biopsy samples. So into a Taxi we went to drop them off at the lab. We will pick up our own lab results when they are ready and if everything looks good, we are done, no need to see the Dr again just for him to tell us what we can clearly read on the lab report…[and] it sure was a lot cheaper than using the Medical Currier lab service!” Then he wrote, “The test results won't be kept in the office in case of a law suit for 20yrsor summarized and sent on to some masterminds at a Government run health care review board, but remain with ME, the paying patient.” (bold emphasis is mine)
For a family out cruising, or trying to make the leap, health care considerations can be one of the biggest obstacles to overcome—especially if there is an existing, ongoing condition for which treatment is expensive and currently covered by an employer-based health insurance plan. But it is important to remember that care outside of the U.S. is significantly more affordable and readily attainable. This fact is highlighted by a restriction attached to our international, high-deductible, catastrophic health insurance plan: we are prohibited from spending longer than six months in the U.S.--and the U.S. is the only country in the world for which there is a restriction--during any policy period.

--MR
* In Mexican civil courts, the pressure is on to reach an agreement because both sides know that for civil trials, they must pay their own court costs and no special or punitive damages can be awarded. Mexican civil trials are not held before a jury, but judges alone review arguments in writing and render decisions. In Mexico, lawyers on both sides cannot be present when either party or witnesses are called in to make statements. Pretty radical and I’m not advocating this as a model for U.S. tort reform, but as an example of the way medical needs can be met affordably (as they are in much of the world) when legal impediments are absent.

This is my dentist in La Paz, Dra. Elvia Patricia Navarro Trejo. She gave
me a crown, filling the hole left after I had a tooth removed in the U.S.
before we departed. And she has a sense of humor too; it was her idea
to hold the pliers for our picture.

And yet another such poster--Saturday is discount day.

Tuesday, May 22, 2012

Fail!
By Michael

Eleanor left on a plane for D.C. this
morning, to visit friends and for the
experience. It was a surreal seeing
my child off as an unaccompanied
minor for the first time. Now it is just
Frances and I holding down the fort.
Lighting aboard Del Viento is poor. General lighting comes from the six original fluorescent fixtures on the cabin overhead, circa 1978. They emit a good amount of light, but it is fluorescent light. And while these bright overhead lights are great for cleaning, they are no longer appealing come dinner time—and they cannot be dimmed. And don’t get me started on the power draw, about two amps a piece. When we have just half of these guys burning, they consume more power than the refrigerator.
So I attacked the problem, sacrificing a forward light that stopped working last month.
At IKEA, I bought a nice looking, 120V, ceiling light fixture. Once home, I confirmed it’s aesthetic suitability and then headed back out again, this time to an electronics store. The resident LED expert happened to be working that day, so I learned what I could from him and bought what I needed.
Back aboard, I ripped the 120V socket and guts out of the IKEA light. Using mounting tape, I attached the three LEDs I bought, pig-tailed their wires in the back, and attached them to the hot 12-volt wires hanging from the ceiling. Wow, were these things bright!
I screwed the fixture into the ceiling, again temporarily connected the wires, and replaced the glass shade.
I hadn’t installed even the switch or the potentiometer for dimming this thing and already I could see it was all wrong. The quality of this light sucked: colder than ice. It made the output from the fluorescent lights resemble the little glowing cottage windows in a Thomas Kinkade painting.
I’ve lost the first round, but I am not finished. I’m hopeful that if I find a yellow tape or film, I can color the light so that it is incandescent-appearing. I am drawn by the promise of affordable, dimmable, bright, all-around ceiling lights that are pleasing and consume very little power.
Stay tuned.
Michael

Here is what we want to replace: 22W circular fluorescent
bulbs in a 10-inch-diameter, RV-styled fixture.

Unfortunately, it wasn't just the light that didn't work in this
experiment, but I couldn't mount the fixture close enough to
the overhead to make it attractive. Also, I don't know what
I was thinking, but the glass shade supported by dinky plastic
clips wasn't the best idea. I need to find something else.


The lighting thing is really just a distraction from the dozens
of other projects I am completing now. Among them is the
windlass gypsy. After emailing back and forth with the tech
folks at Imtra (Lofrans), we think the pockets on this
bronze gypsy are worn, the cause of our recurring
and dangerous chain jumping problem.




Saturday, May 19, 2012

Got Milk?
By Michael

Not ready to give up her Lala
Lots happened in the U.S.A. while we were sailing in Mexico.

Gas prices climbed.
I can no longer tell the difference between the high-end Hyundai sedan and a high-end Mercedes sedan.

Romney closed the field.

More States sensibly legalized same-sex marriage.
On the music front, Toby Keith released his song Made In America, pandering to jingos who associate patriotism and protectionism. The song booms at least every ten minutes from the ceiling speakers in the West Marine stores here in San Diego. But fortunately, they also play The Lumineers, who in our absence ascended to prominence with a roots music style that just makes me feel good and restores my hope in everything human.

Steve Jobs is gone.
Magnum ice cream bars became available in the U.S. We first became acquainted with these when we arrived in Mexico and assumed they were distinctly Mexican—turns out they are made by Unilever and have been selling all over the world (except the U.S.) since the 1980s.

Unfortunately, something that I hoped would change here in the U.S., did not. I hoped that while we were gone, U.S. grocery stores would have been reconfigured and shelf-stable milk would be the dominant offering in the milk aisle. It didn’t happen.

I think only UHT milk is
more expensive.
They don’t sell a lot of pasteurized milk in Mexico. In fact, you can only find it in the very large supermercados, and only a couple facings. Like 70-percent of Europeans, the Mexicans buy their milk in liter-sized boxes. It is ultra-high-temperature (UHT) processed and so requires no refrigeration until opened. It has all the nutritional value of pasteurized milk.
Living aboard and cruising, UHT milk is the next best thing since sliced bread (and especially if cereal is a major part of the diet for half your crew). We would buy and store aboard 36 liters (9.6 gallons) at a time in Mexico, rotating them into the fridge as needed. Their many-months shelf life is suited to our life in which a “quick trip to the store for milk” is rarely realistic. Their small, rectangular form factor is ideal both for dry storage and for small, awkward galley fridge spaces. There is no place in our fridge to put a gallon of milk and the half-gallons and quarts are too tall.

Now our situation is dire. The girls are eagerly consuming their favorite Trader Joes cereals and we are down to our last few liters of Lala milk. I found a Hershey’s-brand boxed UHT milk in a San Diego Ralphs grocery store, but it was $1.99 per quart, or almost $8.00 per gallon.
This was encouraging; I’d solved the supply issue, I now had only to solve the price issue.

I searched online. Suddenly, $1.99 per quart began to seem cheap. On Amazon.com prices ranged between $27.00 and $63.00 for 12-quart cases—shipping not included. Elsewhere I found more of the same. I searched suppliers and wholesalers to an avail. And then I stumbled on a post on a message board praising Dollar Tree and their great price on UHT boxed milk.
I rushed over to the site and found it! A 12-count case of Gossner Foods quart-sized, boxed UHT milk was listed for $12.00—not too far off the 90-cents-per-liter price point we enjoyed in Mexico. Yes!

No! The stuff is out of stock. Judging by the five reviews on the page, it’s been out for a while and isn’t coming back anytime soon. The people who wrote the comments were obviously dedicated UHT milk drinkers, their passion and despair evident: “We depend on you for this milk! We need 120qt NOW! Its such great value - who do I need to call to impress upon you how important this is to us...
So far I’ve kept the girls in the dark about the looming crisis. Neither is tall enough to peer down into the locker where the milk reserves are. But one day soon, there will be no more boxes to remove from that locker, our Mexico milk supply exhausted. I will suggest we give powdered milk a try; they will surely stage a milk mutiny. I just hope it doesn’t happen before Windy returns home.

--MR
The Catanzaros (kids not pictured) are friends and former Washington, DC
neighbors who spent part of their California vacation visiting us. We
enjoyed a nice day sail in San Diego's harbor. They have a house and
regular house refrigerator and easy access to a grocery store; they are
refrigerated, pasteurized milk people like we once were.
Windy is now in Thailand, pictured here with Oliver, one of our nephews.
I think UHT milk is predominant in Thailand, I will ask. UPDATE: It is
and Thailand is also one of the first places to recycle the TetraPak
boxes they come in, to address the waste. And the waste the boxes
make is also an issue on Del Viento, but at least they can be compacted. 

Sunday, May 13, 2012

Consumer Fatigue
By Michael

Looking aft, motorsailing north to San Diego
We’re back in the U.S. and we’re spending money like drunken sailors…well, we’ve spent very little on booze and none in brothels, but we’re spending lots. Neither of us enjoys it.  This is really the last big spending/work spree until we transition to a more sustainable maintenance mode.

The first thing to address was fiberglass work. I foamed in and glassed over the area around the rudder post. Where it enters the hull, the vertical reinforcements were molded in the same shape as a Davis radar reflector, mounted in the rain catcher position. This configuration allowed water to pool and remain trapped against the inside of the hull until it evaporated. No more.
Of course, the source of this water was the lazarette hatch. For some reason, it is a tall hatch, but with coamings that are too shallow, about only a half-inch tall. These coamings were insufficient for preventing water that found its way onto the aft deck (including heavy tropical rains) from spilling into the lazarette. I cut foam strips into the shape I wanted and then glassed over them.

The easiest, but most significant piece of glass work will be to cover the holes that remain after I removed the radar pole and to patch the hole that said pole support made in the transom after it broke free. We are shopping for a new radar; we’ll mount the radome on the front of the mast. I need to rig a lighter-duty stainless pole to re-mount the SSB antennae, wi-fi antennae, cockpit light, and stern running light that shared the old pole with the old radome.
We are also having a new mainsail cover made. We are having a new v-berth mattress made for Windy and me. Our ancient Datamarine Link 5000 instrument cluster is dying a slow death and has already been to the shop once, so we are buying new wind, speed, and depth instruments. I had the alternator bearings and pulley replaced.

This coming week our new dinghy will arrive and I will write about that in a separate post. Our new outboard is here. I have twenty other small jobs on my list.

In her excellent reference, The Voyager's Handbook, Beth Leonard wrote that folks buying a boat that is ten years or older, should budget about 50% of the purchase price to outfit that boat for offshore voyaging. I thought that was a gross generalization when I first read it years ago. I knew that any boat Windy and I bought, would never require that much for a refit. After all, we are do-it-yourself folks, not boat yard check writers. In fact, even after we decided on our Fuji 40 and got to know her, I would have estimated our refit cost to be about 30% of the purchase price, or about $20,000. I was wrong. Keeping in mind that many of the improvements to Del Viento we are making now fall under the discretionary column instead of the necessity column, we are going to exceed the 50% mark. I will know more when I update The Cost tab of this blog for the past quarter.
And then there is the travel this month.

Windy is flying to Bangkok on Tuesday to help her sister-in-law travel with our very young nephews. She’ll be gone 17 days. While she is doing that, we decided to fly Eleanor to Washington, D.C. For a long time she’s wanted to fly on her own. She’s repeatedly asked us questions about making such a journey alone, unrelenting in the way that Frances was about helping the stray dogs in La Paz. I think she is most excited about the prospect of ordering an unlimited amount of Sprite from the flight attendant. We think Eleanor is ready for the trip and hope it will be a positive growing experience for her. She’ll be staying with and visiting people in D.C. who are like family to us, so that will be good.
So, the mostly sober sailors of  Del Viento hit port, exhausted a chunk of their cruising kitty, and are scattering about the planet through the end of this month. Shortly after we are all back together, the refit of Del Viento should be complete and we can dramatically slow the flow of money into the old girl. And head north. Whew.

--MR
Standing in the lazarette and wetting a piece of fiberglass tape
to build up the hatch coaming










These wood blocks formed the base of the 12-foot aluminum radar tower aft.
They were glassed to the intersection of the transom and hull, and they were
rotten. This was the point of failure, resulting in the shearing of two of the
bolts that mated the collar to the deck where the pole passed through (right
side of picture). Once everything was loose, even after I tied it down, the
slack in the pole was enough to saw a hole through the transom over 500
miles. We didn't notice that aspect until San Diego.

Just days before Mother's Day, the girls played mothers-to-be, though
it appears Frances already has one in tow.

The girls were excited to see Uncle Ken who dropped in for the day.