DIVING OVER 50 YEARS OLD

[scubadada]

....Getting back on topic, IF the OP's underlying premise is correct that older divers are more at risk of heart attack or other severe medical events during diving, then I would not dismiss his idea out of hand as ridiculous or horrible. Sure, as a potential customer over 50 years old, the idea doesn't appeal to me. But he would be no more "wrong" to discriminate based on age than an insurer or various others who have long made distinctions based on age.

Correct, we would all vote with our wallet, obtain medical clearance to dive with Dolphin Dive on Little Corn, or pick one of many, many other locations on our bucket list.

 

[uncfnp]

Not to get too off topic, but yeah. Old people cost insurers more, simple as that. So why shouldn't insurers charge higher premiums? Simply because it's "discriminatory"? Our society hasn't traditionally considered ALL practices that make distinctions based on age to be wrong, either under the law or what you might call morally wrong. Most age discrimination laws make exceptions for the kinds of distinctions based on age that actually make some logical sense. Constitutionally speaking, if there is some "rational basis" for discriminating based on age, the law passes muster. Police can have mandatory retirement ages, for example. Gender discrimination is less tolerated under the law than age discrimination, so it makes sense to me that Obamacare eliminated that practice. Maybe the relationship between gender and healthcare costs is more tenuous--less proven--than the relationship between age and healthcare costs. From what I understand, it's beyond dispute that healthcare needs and therefore costs increase with age. So it makes sense to me that Obamacare did not un-do the longstanding practice of insurers charging people for health insurance based on their age.

Getting back on topic, IF the OP's underlying premise is correct that older divers are more at risk of heart attack or other severe medical events during diving, then I would not dismiss his idea out of hand as ridiculous or horrible. Sure, as a potential customer over 50 years old, the idea doesn't appeal to me. But he would be no more "wrong" to discriminate based on age than an insurer or various others who have long made distinctions based on age.

The difference is that the added medical clearence requirement is based on the op's stated desire to keep us safe. It is not cost driven. Its apples and oranges.

Off topic. I have no dog in the Obamacare fight. I see too much abuse and misuse of the healthcare system itself to think that anything less then a complete overhaul will make any difference and we Americans will never accept the needed changes. Healthcare, among many other financial and social institutions, will eventually implode.

 

[agilis]

The fundamental concept informing medical insurance (not life insurance) is the concept of shared risk spread over the entire population of the insured. Unlike life insurance, group medical insurance should not charge different rates based on age.This defeats the entire purpose of medical insurance.

The Affordable Care Act is a complex document, and like most legislation of this kind was written largely by lobbyists for the insurance companies. It is, after all, nearly identical to a state plan initially proposed and approved by a Republican governor. Despite Obama's claims Obamacare's primary beneficiaries are the insurance companies which, along with a a few other entities like the financial industry and big pharma, control much of the political process in this country.

A government run single payer health care system would have been infinitely preferable to Obamacare. Obama acknowledged this when he began seeking the kind of universal health care system that every other first world country enjoys. He also acknowledged that such a plan would never be approved by Congress. That the Affordable Care Act was passed by a Congress hostile to Obama's very existence reflects the power of the insurance companies, not Obama's political skills.

Before I would submit to any dive operator's intrusive rules I would give up diving requiring their facilities. If that means solo diving from my own small boat or from shore, or only snorkeling on my own at a remote destination like Little Corn Island, so be it.

 

[Lorenzoid]

The difference is that the added medical clearence requirement is based on the op's stated desire to keep us safe. It is not cost driven. Its apples and oranges. . . .

I see it as both altruistic and "cost driven." If a diver needs evacuation, somebody has to pay for it. Even if the dive operator doesn't have to pay the cost of the helicopter or boat ride, a bad incident in which someone didn't get sufficient medical care in time could cost the dive operator's reputation, not to mention the dive operator having to divert time from regular business to assisting with the evacuation. Reducing the likelihood of hosting a diver who needs evacuation reduces somebody's costs. I think we've beaten this tangent to death.

So Craig posted this from the OP's website:

* INSURANCE - . . . We recommend that divers carry adequate travel insurance and have confirmation from their insurance company that the cover extends to Little Corn Island, and that the provider is able to arrange treatment, transport etc as recommended by medical staff. We require all divers over 50 to provide insurance details before diving.

If I were in the OP's position, I would just tighten up the wording and require divers over 50 (or all divers if he prefers, though he can kiss the backpacker clientele goodbye) to provide proof of medical evacuation insurance. It can be a bit expensive, but plenty of companies offer single-trip insurance that includes medical evacuation.

 

[tarponchik]

We've had a couple of minor incidents recently with people in that age bracket who have had medical issues following a dive, even though the dives were well within safe limits e.g. 45 minute dive at less than 40 feet, and the customer had self signed NO to all the medical questions required for a PADI DSD.

So, all this fuss over a COUPLE of MINOR incidents? "A couple" does not make statistics solid enough to make any decisions. You are likely to lose part of your customers w/o gaining much. However, "45 minute dive at less than 40 feet" policy already sounds like an overkill to me. I seriously doubt that any medical issues your divers had were diving-related under such restrictions. Probably, just a coincidence. People over 50 are more likely to have medical issues whether they are diving, driving or just sleeping peacefully in bed.

 

[uncfnp]

I see it as both altruistic and "cost driven." If a diver needs evacuation, somebody has to pay for it. Even if the dive operator doesn't have to pay the cost of the helicopter or boat ride, a bad incident in which someone didn't get sufficient medical care in time could cost the dive operator's reputation, not to mention the dive operator having to divert time from regular business to assisting with the evacuation. Reducing the likelihood of hosting a diver who needs evacuation reduces somebody's costs. I think we've beaten this tangent to death.

So Craig posted this from the OP's website:

* INSURANCE - . . . We recommend that divers carry adequate travel insurance and have confirmation from their insurance company that the cover extends to Little Corn Island, and that the provider is able to arrange treatment, transport etc as recommended by medical staff. We require all divers over 50 to provide insurance details before diving.

If I were in the OP's position, I would just tighten up the wording and require divers over 50 (or all divers if he prefers, though he can kiss the backpacker clientele goodbye) to provide proof of medical evacuation insurance. It can be a bit expensive, but plenty of companies offer single-trip insurance that includes medical evacuation.

Hmmm. Interesting points but I don't think valid. Cost of evacuation is not placed on the dive op. He makes this clear. And I think we have all agreed that prior arrangements for evacuation plans and coverage may be reasonanble under the circumstances.

And as to the risk of someone not getting sufficient timely medical care, a medical release has no impact on this. This is where the emergency action plan comes in with adequate supplies and training of the staff. This is true for all age groups.

To me the bigger issue is healthcare period in a remote location, dive or medical or accident. Worth investigating and taking appropriate precautions no matter your age.

 

[agilis]

I've been a DAN member for decades. I've always automatically handed over my DAN Preferred card along with my C cards when signing up for dives while on holiday, assuming that the dive operator ought to have this information should an emergency evacuation become necessary. My perspective was that this was in my best interest.

Taking appropriate precautions, investigating emergency procedures, and familiarizing myself with the lay of the land wherever I've traveled is something I can't imagine not doing. I understand that there are a lot of morons out there, but it's always annoyed me when some officious dive operator assumed I was too stupid to take proper care of myself.

I'm beginning to realize that this is probably unreasonable on my part. I may have been overestimating the competence of the average person all these years.

 

[billbb]

Wont be headed your way.

 

[clarkey]

Hi Adam,

The information awap posted earlier contained information from your website for Dolphin Dive, Home The following is also posted on your website:

DIVERS AGED 50 OR OVER - Anyone wishing to undertake a PADI program or refresher with us will be required to bring written medical clearance from their doctor before starting any program (irrespective of whether they answer yes or no to the questions on the PADI Medical Statement below).

Certified divers aged 50 or over will be required to show proof of valid medical insurance covering their diving activities, including contact details for medical emergencies *

* INSURANCE - we are located in a remote location with very limited access to medical facilities. There is usually no doctor on the island, just a nurse. Big Corn has a basic hospital facility but medical emergencies will require boat evacuation to Bluefields or Managua. Dive emergencies will require evacuation to the re-compression chamber in Puerto Cabezas in the north of the country, a boat trip of 6-8 hours. We recommend that divers carry adequate travel insurance and have confirmation from their insurance company that the cover extends to Little Corn Island, and that the provider is able to arrange treatment, transport etc as recommended by medical staff. We require all divers over 50 to provide insurance details before diving.

So, you already require anyone 50 or older to submit medical clearance if they are taking any course from you, regardless of the answers to the screening questionare. You also, already require, anyone 50 or older to show proof of dive insurance. The new issue you brought up is whether all divers 50 or older should have to submit medical clearance to dive with you. Clearly, the sentiment from SB was against this measure.

If you really want your divers to be as safe as possible, I see two things you need to do. As uncnp pointed out, you need to develop your own high quality emergency plan. This would require education/training, personnel, and equipment. A good place to start might be the DAN education offerings Scuba Diving Safety & Training Courses - DAN| Divers Alert Network - DAN | Divers Alert Network I would suggest that, at a minimum, you should be able to supply adequate support to cover the period until emergency transport can be arranged, this might dictate a considerable oxygen supply. Assuming you meet the requirements of this emergency plan, you could inform potential visitors of this level of support. This may or may not differentiate you from your competitor(s)

That brings up the second, and perhaps the most difficult topic, emergency transport. I'm not sure you or we fully understand what kind of transport might be available and what DAN (or other carriers) might do to facilitate transport. In the DAN outline description of medical coverage, the following is listed:

Ambulance transportation by ground, air or marine ambulance services to the nearest Hospital or Hyperbaric Chamber where prescribed care or treatment can be given

Many of us have read of the extraordinary lengths DAN has gone to in order to evacuate divers from some remote areas, including seaplane. At the very least, it would seem that an injured diver could be evacuated by boat to Big Corn, and then by plane to Managua, or perhaps even directly to Puerto Cabezas. It would behoove you to work with DAN to devise an acceptable emergency transport plan. Given your statements to date in this thread, if I were considering a trip to Little Corn, I would contact DAN first, to make sure reasonable transport was available for me.

Best of luck,

Craig

Yes I amended our website a couple of days ago with a 'holding policy' for now. I'm still thinking through the best way to approach this. I've exchanged a number of emails with DAN who have no specific answers. They said that in the absence of proper medical facilities or transport here that they would need to talk someone through procedures over the phone, and then maybe wait until the next day to arrange transport. That's not something that reassures me! Neither ourselves or anyone else around here has an oxygen supply that can last that long. The reality though is that is the facilities don't exist, then not even DAN can use them!

I note however with some amusement the posts to this thread who just say they wouldn't come based on me starting a discussion..... I feel something positive then has been achieved by this!!

 

[Lorenzoid]

. . .
I note however with some amusement the posts to this thread who just say they wouldn't come based on me starting a discussion..... I feel something positive then has been achieved by this!!

I would be more wary of a dive operator who didn't give much thought to the issues. You seem to be weighing various options, some more palatable to us potential customers than others, but that's fine. I'm convinced safety is a top priority to you. Kudos.