I've never, as yet personally, done USART without MAX232...but if the rest of the experts(read:Nigel and Wilksey) vouch for it, then I guess it's doable. So far I've used MAX and it works like a charm.
Don't be so sceptical!
http://picprojects.org.uk/projects/simpleSIO/ssio.htm
It's a very old tried and tested technique - there's nothing really special about a max232, it just inverting and level shifting.