Clearing the Air: My Defense of Implementing Medical Tourism into Workers’ Compensation

“The problems of the world cannot possibly be solved by skeptics or cynics whose horizons are limited by the obvious realities. We need men who can dream of things that never were.”

John F. Kennedy

“Some men see things as they are and say why. I dream things that never were and say why not.”

Robert F. Kennedy

“It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult.”

Seneca

In the past few weeks, I have received some criticism of the ideas I have expressed in this blog in regards to implementing medical tourism into workers’ compensation. Simply stated, I have been accused of offering “simplistic solutions” to medical tourism and workers’ compensation by inferring that all it takes is a plane ticket. I have also been accused of “throwing pixie dust” on the issue and have been made to feel that I don’t understand the complexity of the issues involved, and therefore should not even bother to tackle the subject.

Well, if that was the case, no one would ever attempt to explore new areas of knowledge or publish new ideas because they were not fully knowledgeable about a particular subject. That is what writing and expressing one’s ideas are all about, learning what you did not know before you started to write. I have also been accused of making it sound easy to get injured workers to go abroad for treatment, and that the ones who would be making that difficult and arduous decision are clerical persons in HR departments. Nothing could be further from the truth.

At no time in the seven months of blogging have I ever said that implementing medical tourism into workers’ compensation was going to be easy. As those of you who have read my white paper, “Legal Barriers to Implementing International Medical Providers into Medical Provider Networks for Workers’ Compensation”, a copy of which can be seen here,  have learned, I lay out a number of legal barriers to implementation of medical tourism into workers’ compensation, some related to workers’ compensation, and some related to only medical tourism and health care.

Because the original paper was written for a class in Health Law, and not for a class in medicine, I did not focus on the medical barriers to such an implementation. And by not doing so, that does not mean that I believe that there are no such barriers or difficulties associated with traveling abroad for medical care. No, I don’t believe that. In fact, I believe that the same barriers or difficulties that exist for private insurance patients also exist for patients covered under workers’ compensation insurance. Is there something different about patients who can afford to pay for medical treatment abroad or who have private health plans that do, from those who get injured on the job and have their treatment paid for by an employer or insurance carrier under workers’ comp?

I have been getting the sense that those who advocate medical tourism for those who can pay or who have private insurance are engaging in class warfare against the working class by somehow painting the treatment of workers injured on the job as somehow different from patients seeking such surgeries as hip or knee replacement, or back surgery, for example. As I have stated before in a few of my blog posts, what difference is there if a person injures their hip or knee by engaging in some sort of physical activity outside of their employment, or if the person gets hurt on the job? Are the surgical procedures for these types of surgeries different for a working person than those for a middle-class or upper-middle-class person? Or is this just bourgeois nonsense of the kind heard on Fox News?

Are the risks and complications of long-distance travel different for a construction worker who goes to a country where he or his family originally came from for medical treatment for an on-the-job injury, or do white, middle-class people have some immunity from risks and complications from surgery for such procedures as getting one’s face lifted, breasts enlarged or reduced, or other medical tourism procedures? I know full well that if one person has complications, so too can others. Economic status and employment status are not risk factors.

What I have been advocating for the past seven months of blogging, is that medical tourism should get over its class bias, and treat all patients, rich or poor equally. As the three gentlemen above have said so eloquently, we need people of vision, we need people who are willing to dare and to ask the tough questions, “Can this be done?”, “Can we provide all patients cheaper, better quality health care, no matter what their bank account, or economic resources are?”, “Can we provide the best health care available to injured workers and save their employers or insurance carriers money, even if they, the patient does not pay for the treatment directly?”

In my lifetime, and many of yours as well, we have seen the dreamers and idealists murdered in cold blood, only to be replaced by people whose vision looks backwards, not forwards, whose motivations are designed around making those with money richer, while making those without a lot of money, even poorer. Our elections have pitted rich men against the people, as the last presidential election showed, and some of the men who have occupied that high office since 1980, have been men who lacked the vision of two of the modern men cited above, but who have convinced us that we don’t need or can’t afford “that vision thing”.

More than the life of a man was taken on November 22, 1963, April 4, 1968, and on June 6, 1968, our vision of the future was taken away, our dreams were taken away, and our hopes for a better future for all human beings were taken away, only to be replaced by greed, avarice, ignorance, stupidity, hatred, fear, and a sense that nothing can be done, so why do anything. The future of medical tourism must include workers’ compensation, or else it is just another means to getting rich from tourism and making the wealthy feel better about being wealthy.

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About Transforming Workers' Comp

Have worked in the Insurance and Risk Management industry for more than thirty years in New York, Florida and Texas in the Claims and Risk Management spheres, primarily in Workers’ Compensation Claims, Auto No-Fault and Property & Casualty Claims Administration and Claims Management. Have experience in Risk and Insurance Business Analysis, Risk Management Information Systems, and Insurance Data Processing and Data Management. Received my Master’s in Health Administration (MHA) degree from Florida Atlantic University in Boca Raton, Florida in December 2011. Received my Master of Arts (MA) degree in American History from New York University, and received my Bachelor of Arts (BA) degree in Liberal Arts (Political Science/History/Social Sciences) from SUNY Brockport. I have studied World History, Global Politics, and have a strong interest in the future of human civilization in all aspects; economic, political and social. I am looking for new opportunities that will utilize my previous experience and MHA degree. I am available for speaking engagements and am willing to travel. LinkedIn Profile: http://www.linkedin.com/in/richardkrasner Resume: https://www.box.com/s/z8rxcks6ix41m3ocvvep

4 thoughts on “Clearing the Air: My Defense of Implementing Medical Tourism into Workers’ Compensation

  1. Scott Doherty

    Richard…so sorry that you feel the need to defend yourself. From my experience, Medical Toursim makes sense for many if not most medical encounters in one way or another……..meaning medically when there is an international alternative that offers better outcomes, financially when this treatment is available at a significant discount (travel expense included) to comparable or even inferior care in the US (especially post-operative care during recovery), and of course there is the intangible tourism aspect which allows for obtaining care at a global level and intereacting with and experiencing different cultures.

    I have toured dozens of hospitals in different parts of the world, and have firsthand experience regarding bad outcomes domestically ( at an internationally recognized Center of Excellence) which included a life threatening hospital acquired infection in addition to complications of unidentified origin resulting in brain damage during open heart surgery (teenage daughter). We lived inpatient for four months …..never leaving our daughters side……and thus have learned a thing or two.

    Stay the course……it’s the right one.

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    1. richardkrasner Post author

      Scott…thank you for your comment. I am defending myself because I am not being taken seriously by certain individuals and by both the medical tourism and work comp industry. One just wants to provide tourism in a medical setting, the other is so focused on saving money by attacking a drug problem, a physician dispensing problem (which is connected to the first problem), and half-measures that are not bringing down the medical claim cost for lost-time claims, only slowing the percentage of increase in costs.

      Just because I don’t spell out every single issue or problem related to medical care abroad, the complications and risks, as you so ably described with your daughter, does not mean that I am treating the subject lightly. After all, I am writing a blog, not a medical textbook or dissertation. So I can be forgiven if I go lightly into the subject, but make a strong case for implementation, knowing full well that there are barriers, risks, complications, concerns medical personnel have, and that the regulatory and legal challenges are formidable. But given the three quotes above the text, anything that is difficult or hard to do is worth doing.

      I also think that some people are threatened by new ideas, and some so-called “clients” of medical tourism experts have been led to believe that there are simple solutions, when there is not, and so they ask their service provider if such a thing as medical tourism for workers’ comp is easy. It isn’t and my white paper says so.

      Thanks for the encouragement. I needed that.

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  2. Kimberley Carlton-Healy

    Kudos to you Richard for speaking out and expressing your opinion. While the “experts” may have knowledge to pass on, we shouldn’t overlook what insight there is to be gained from listening to the opinions of those considered “non-experts”. From knowledge and imagination successful ideas are made.

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    1. richardkrasner Post author

      Kimberley,

      Thank you for your comment. That is much appreciated. It seems that if you do not have medical experience, you cannot or should not discuss issues related to medical care, lest others think what you are saying is possible, when the experts say it isn’t. And I realize that there are medical issues involved, and that those issues are not minor, but if you accept those issues and risks when dealing with private or insurance-paid patients for medical tourism, why not do the same for workers’ comp patients?

      Your last sentence is what the three quotes are all about.

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