My exp. w/ HAM, sat phone & cell phone
I wheel (alone) and race sail boats so I've thought a lot about communication in a pinch. I've considered both ham and sat phone. The issues as I see them are as follows.
I've used both radio and sat phone (on the ocean - when someone else is paying) and I have to say the sat phone is easier - just like using a cell phone. We had the sat phone because as per our medic's request so do yer own figurn there. Sat phones can be had for a few hundred bucks, and you can buy all different types of plans including "emergency use" only.
On the other hand, you need a plan, there's relatively few providers, and well, if the s___ really hit the fan, it's not a HAM radio.
On the HAM side, there's a bit of work to getting and maintaining a HAM license and to antenna set-up before you can use it. As I figure it, there's only a few places on a few roads where I like to go that would be good to HAM home so I'm pretty sure I'd need to move the radio from the get go. On the other hand, there are now a few rf signal propagation apps that seem like they'd tell you (before you get there) exactly where you won't get a signal so that's in favour of HAM.
I've also noticed that I get a cell signal in a lot of areas across the western states as long as I'm near a high point. For me that erodes a lot of the benefit of HAM.
From the little I know about SPOT (~$99/yr), that seems fair for one way communication. ~$49/month gets you 2 way, on demand voice over sat phone but that's only for ~40 minutes.
To me this argues in favour of the sat phone for very back country use. I like the fact that it is stand alone gear. I like the fact that everything needed goes in a small Pelican case. And I like the fact that anyone can use it.
Your needs may be different.
Chewy