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The Adventurer’s Health Insurance Conundrum

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BASE jumper Jill Kuzeman in Moab, Utah; Photograph courtesy of Jill Kuzeman

Throw yourself off a cliff and you only have yourself to blame for what happens next. The consequences of adventure sports are brought most clearly into focus when you think about what could go wrong in a pastime as dangerous as BASE jumping. Defined as a parachute leap from a building, antenna, span (bridge) or the earth (cliff), it’s among the most life threatening of all human endeavors. Though preparation, training, and skill can mitigate many of the incredible risks involved, there’s always the possibility of severe injury or even death. Despite meticulous planning any number of things can go wrong. Complete safety is impossible to assure.

On November 19, 2012 professional BASE jumper Jill Kuzman experienced the full impact of sudden unforeseen circumstances. It was a beautiful day in late fall on the high sandstone cliffs near Moab, Utah. No wind, 60 degrees, conditions were perfect for BASE Jumping.

“I was doing an unpacked jump that we call a TARD over. TARD = totally awesome rapid deployment,” Kuzman said in an exchange on Facebook. “I had a 180 (opened backwards) on inflation. I tried to stop it from flying towards the cliff, but because it was already open it was already flying.”

A parachute that opens backwards is never a good thing. She hit the cliff face twice before attempting a hard left turn to escape. But that just made matters worse. At such a sharp angle out of control she dove the canopy straight for the desert floor.

“I broke my femur when I impacted the ground,” she said. “I had three military medics and a doctor on the jump with me. They got to me fast, hit their spot for rescue, and had me in traction from a splint they had in the car within 20 mins. Those guys are my heroes, big time.”

Kuzman was very lucky. This was actually her fourth jump of the day after three safe and successful landings. If not for her expertise in handling a jump gone wrong and the emergency medical training of her partners she might not have survived the crash. But after a long hospital stay and extensive surgery she made a miraculous recovery. A little more than a month after the accident she was able to spend Christmas back home in Philadelphia with her family. In the weeks that followed she was able to walk without crutches. As her health improves she looks forward to one day BASE jumping again. But it will still be a while before Kuzman is fully recovered from her fall. Without health insurance to cover her treatment and time in the hospital she’s now on the hook for $120,000 in medical bills.

Though many might suggest BASE jumping without insurance is a foolish thing to do, there are many extreme sports athletes that don’t have even basic medical coverage. Personally from the time I was 26 right up to the day my wife and I got married at the age of 35 I had no health insurance what so ever. For that nine-year period I paddled, rock climbed, and skied with reckless abandon, keeping my fingers crossed for luck all the while knowing that I was one emergency room visit away from bankruptcy. Healthy as a horse, with no pre-existing conditions and gainfully self-employed, I made the reckless decision to go without. Only much later would I realize what a grave mistake that was.

So when Kuzman reached out via Facebook for financial help I was more than willing to make a contribution to her cause with a donation that could buy groceries and help pay down a growing pile of medical bills. A website was set up to take in donations on her behalf. It was easy to imagine myself in a similar position if I were more bold or less lucky 15 years ago. Dropping a couple of bucks online was the least I could do to help out.

Several of her friends felt the same way. To date 130 donors have chipped in almost $10,000 to literally help Kuzman get back on her feet.
“When I was in the hospital, I would check the donation site every day,” she said. “The amount of people who selflessly gave, all the kind words that were written to me, the stories of injuries that people shared, all those things helped me through the pain more than you could know.”

But with this positive upwelling of support there is also a vocal cadre of those who object to Kuzman’s alternative to health insurance and her having publicly reached out for support. An anonymous writer to the blog who goes by the handle Grown_Up says in a post riddled with sarcasm that engaging in risky activities without medical coverage is blatantly irresponsible. He suggests, tongue in cheek, that going without insurance as a BASE jumper, for which he pays $239 a month, could have been a great way to save money.

“All I had to do, was to always jump unpacked, regardless of the technicality of the jump or the winds, and if I would ever get hurt (highly unlikely) I would just put some sad pictures up on the Internet, have a friend set up a donation page for me and have all my friends (and their friends) chip in for my hospital and rescue bills (I would make sure to promote the donation page myself as much as I can),” wrote Grown_Up. “I wouldn’t even feel bad about doing it, since everyone can afford a $5 donation (price of a cup of coffee, for god’s sake). Luckily, I have 1500 ‘friends’!”

Although Kuzman is never mentioned specifically in the post several of those who replied to the thread indicated they believe she is the uninsured BASE jumper that Grown_Up is referring to. In a subsequent post the anonymous writer denied that his or her comments were directed at Kuzman. Instead Grown_Up insists that there is a growing trend among action sports athletes without insurance to seek assistance online when they get injured.

“The original post was not about one single case, just prompted by a recent one,” Grown_Up wrote. “This past year, FB and some other sites have been flooded with the donation pages. Not just BASE, there are climbing, surfing, skiing, swimming (!!!) accidents. It seems like it was becoming a norm to have others bail you out.”

My attempt to reach Grown_Up via email through went unanswered. That person has chosen to remain unnamed for fear of personal attacks online. Snarky comments in the posts notwithstanding Grown_Up does make several important points though most readers might perceive the expression of his or her opinions as an indirect attack upon Kuzman. In light of the inherent dangers of BASE jumping, comprehensive medial insurance should be just as mission critical as a parachute. A cohort of charitable well-meaning friends is no substitute.

To her credit Kuzman made a good faith effort to acquire health insurance. Unfortunately as a single payer with three pre-existing conditions, including seasonal allergies, the cost was prohibitively expensive. Without coverage she found herself, as many do at the prime of life with a passion for adventure, facing a very difficult choice.

“I’m not saying it was the smartest decision I’ve made. I didn’t not get insurance because I wanted to be a financial burden on my friends,” she said. “It’s just a crappy situation that I, among many people these days, found myself in. Do I let that one thing be the magnetic pull in my life or do I keep following my passion? In retrospect, I’d do it all over again.”

When you’re young, healthy, and unattached with the rest of your life ahead of you it’s hard not to feel indestructible. I know I did. After 20 years of hard falls and close calls I never once spent a night in a hospital bed. But all that wear and tear takes a toll. As the years go by you’ll start to slow down with little aches and pains that just might indicate something more serious. In my case an untreated low-back injury from a fall off a chinning bar in an Iowa City hotel room in 1992 resulted in a relatively minor dislocation of my left hip that was never corrected. I “walked off” the injury, but without medical care it grew progressively worse. My activity level began a steady decline over several years until I finally walked with a persistent limp. In late December 2012 I was diagnosed with advanced osteo-arthritis in both my left hip and my right. Now at the age of 46 I write this story from an orthopedic recovery room after the first of two complete hip replacements.

On the bright side, thanks to group health insurance through my wife’s employer, I’ll have my operations with very little out of pocket expense. At an estimated average cost of $30,000 for each of two surgeries there’s no way I could pay for treatment without assistance. Though I might have launched a fund-raising campaign online I’m grateful that I won’t have to ask of my friends and family for anything other than gifts of home-cooked meals and get well cards while I’m in recovery.

Had I been a bit more prudent in my youth I might have purchased health insurance. Then when I was originally injured I might have been more inclined to see a doctor and keep the soreness in my hip from becoming the agonizing pain in the ass it is today. At current rates though often with high deductibles the cost of health insurance is infinitely more affordable than the alternative. Even with high risk activities like BASE jumping there are policies available that will cover virtually all the expenses related to a medical emergency or catastrophic injury.

In the post to Grown_Up offers some good advice for adventure athletes shopping for health insurance. It’s suggested that anyone looking for a worthwhile policy ask at least these four basic questions:
“1- Is any parachute activity (such as skydiving, paragliding or BASE jumping) covered by the plan I want to get?
2- Is any parachute activity (such as skydiving, paragliding or BASE jumping) mentioned in any way in the exclusions?
3 – If I get injured (short or long term) while participating in any parachute activity (such as ….) will I be covered?
4 – Just for good measure, I also asked if a helicopter ride to a hospital would be covered.”

Some insurance policies have very specific exclusions for injuries sustained in high risk activities. Sports with inherent hazards that may include skiing, mountain biking, or surfing could be exempt from claims. It’s important that every insured person is well aware of their levels of coverage. And it’s important to ask what might appear to be silly questions.

“I’d rather sound like a moron, than fall through a loophole,” Grown_Up wrote.

Starting in 2014 the Affordable Health Care Act signed into law by President Obama will go into full effect. At that time everyone in the United States, with the exception of those in poverty and some with religious objections, will be required to have health insurance or face a fine of $695 per year. With a much deeper pool of potential policy holders the understanding is that premium costs will go down as market competition rises. But it remains to be seen. Even when health insurance is more accessible will those of us involved in adventure sports and prone to risky behavior decide to buy an affordable policy or simply pay the fine?

At the heart of the matter is the safety and well being of the adventure sports community as a whole. In the balance are those at risk of injury and those who aim to push the limits of their abilities for an ecstatic experience that can only come from an adrenaline-charged sport like BASE jumping. What happens when too many athletes are injured or even killed because their safety plan failed to include adequate medical coverage.

“The bottom line isn’t so much about the problems with health care, and insurance in the USA,” wrote StealthyB on “The problem is that every incident in Moab that gets attention is one more black mark against BASE no matter how little difference you think it makes. If you burn sites like Moab… you are going to run out of playgrounds.”

There are only so many places in the world where BASE jumping off natural features is possible or even legal. Concerns over the personal safety of athletes eager to throw caution and themselves to the winds have resulted in the prohibition of the sport at areas across the U.S. in places with high cliffs like Yosemite. Moab, one of the last lawful BASE jumping sites in the country, could be next.

Without advocating for massive regulation of the sport it stands to reason that an affordable insurance policy with mandatory eligibility requirements for safety could help to reduce the number injuries like Kuzman’s. Certainly she survived and with the help of her friends and family she’ll eventually dig out from under that mountain of debt. The adventure community is supportive that way. But even though she did everything right at the time of her accident shouldn’t the final check of her BASE rig have been up to date medical coverage? Or should a broken and dysfunctional healthcare system be allowed to stifle the creative expression of flight and freedom at the core of the sport? For now it’s up to each individual to decide for themselves.

The Joy Trip Project is made possible with the support of sponsors Patagonia, Rayovac and the New Belgium Brewing Company.