At 30,000 feet over the Pacific Ocean, Michael Raymond felt the dreadful, familiar early signs of a heart attack — the shortness of breath, the pain in the center of his chest, the tightness that felt like an eagle's talon was squeezing his heart.
A flight attendant called for a doctor over the plane's intercom. Soon, Raymond was receiving medical attention in business class as the United airliner hurtled toward Tokyo.
"I was in a lot of pain," said Raymond, 62, while sitting in his southwest Windsor home. "I was popping nitro(glycerin) like it was going out of style."
Raymond's ailing heart was the whole reason he and his wife, Christina, last month joined the millions of other medical tourists around the world who venture to distant lands in search of affordable health care.
But nine hours into a 12-hour flight to Asia, it looked like Raymond might not make it to the Bangkok Heart Hospital and the life-saving treatment that wouldn't cost him his house.
When Raymond lost his job as center manager with the Marin Art and Garden Center in Ross five years ago, he also lost his health care. Two years after that, his continuing coverage ended. A badly blocked heart meant that he could not get coverage on the individual market. No one would insure him.
Raymond's first heart attack was in 1998 when he was living in Kona, Hawaii and working as a landscaper breaking lava rocks in the hot sun. He spent a week in the hospital and received a stent — a device that widens constricted arteries — in the right side of his heart.
In 2003, after moving to Windsor to be closer to his wife's family, he was playing a round at the Chardonnay Golf Club in Napa when he felt that tell-tale tightening in the chest. He was swinging so well that he refused to get off the course. He finished with a score of 72 and two more stents in his heart.
"When I'm shooting like that, there's no way I'm getting off the course. I'd rather die shooting par," he joked.
Raymond knew that he needed a long-term solution to his heart problems. But without insurance, his only option was to hope for good health.
Raymond, who is too wealthy to qualify for Medi-Cal, too young for Medicare and too sick for individual insurance, is in one of the groups set to benefit from the Affordable Care Act.
In January, he will be covered by a $581 per month plan. Under the new health care law known as Obamacare, insurers cannot deny coverage due to pre-existing conditions.
But in September, he started feeling that tightening in the chest again, so he saw a doctor at Russian River Health Center, a walk-in clinic in Guerneville. The clinic recommended that he see a cardiologist. Two weeks and $1,000 later, the cardiologist recommended cleaning out the blockages in his heart with a tube inserted through an artery in his leg, a procedure called an angioplasty.
Raymond asked for a quote on the procedure. Four days later, Christina Raymond heard from the hospital: $36,000, and that was just for the operating room. It did not include the doctors, anesthesiologists, medical equipment or recovery room.
"At that point, I said 'We're out of here,'" recalled Raymond, who is bald on top with a silver goatee. "I can't afford this. We're going to Bangkok."