Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare?

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Two years ago, when I wrote my white paper, Legal Barriers to Implementing International Providers into Medical Provider Networks for Workers’ Compensation, I pointed out that medical tourism would relieve the critical shortages in medical staff for physicians, specialists and nurses. I cited data that said the demand for registered nurses in 2000, exceeded the supply by more than 100,000, and that by 2020, this would increase to more than 200%. In addition, I stated that the ACA would put considerable strain on an already strapped health care system, and to prove this, I only need to direct the reader to Joe Paduda’s latest blog post on this very subject.

Joe’s latest piece is the third in his series examining the impact the Affordable Care Act (ACA), also called “Obamacare” is expected to have on workers’ compensation. In this piece, Joe discusses access to care, as Obamacare will result in more people, and conversely, more workers covered by health insurance. To bolster his point, Joe cites data on the number of working-age Americans without health insurance.

21 percent of working-age Americans don’t have health insurance.  This varies widely by state, from 31% in Texas to 6 percent in Massachusetts, with several in the high twenties.  That’s more than 40 million people between 18-64.

Joe says, that adding 30 million to the rolls of the insured is going to lead to a lot of demand for primary and specialty care, and that…they will need check-ups, tests, drugs, evaluation and counseling.  Some will need major procedures; knee replacements, shoulder surgery, stents and cancer treatment.

As it is probably impractical and not cost-effective to have injured workers travel abroad for primary care, the most likely scenario in which the physician shortage can be addressed by medical tourism, post-ACA implementation, is in specialty care, especially surgery. According to Joe, Specialty care is where the big problems are going to be.

Orthopedic surgeons get paid to do orthopedic surgery, and there are going to be millions of newly insured patients with conditions that may justify/require surgery.  Stands to reason that specialty care – particularly for musculo-skeletal conditions – is going to be in high demand.  The “good news” here for workers comp payers is Medicare, and many private insurers, are doing their darndest to reduce utilization and reimbursement for specialty care.  And, as WCRI so ably reported just last month, workers’ comp pays a lot more for specialty care than most, if not all other payers.  While just paying more won’t guarantee priority access, it will certainly help.

The workers’ compensation industry will no doubt try many different solutions to try to address the problem of access to care short of implementing medical tourism into workers’ comp, but like so many other problems the industry is trying to deal with, it will only prolong the problem, not solve it. It can only bury its collective head in the sand for so long until it needs to come up for air. Why should they pay more to get better access to care, when they can get the same or better quality of care, for less money, not more, in medical tourism destinations?

Many of these destinations are right here in this hemisphere, not thousands of miles away in Asia. Hospitals and clinics in Latin America and the Caribbean say they offer better quality of health care at lower cost, but getting them to prove that has been difficult, as my post, “If You Have to Ask” discusses.

And why should the medical tourism industry turn its collective backs on a new and perhaps lucrative market by not coming forth with a clear business model to get that business and with a transparent pricing structure that will convince insurers, third party administrators and employers that they can provide better quality health care at lower cost, and back that up with real numbers, and not just hype?

It seems to me that once Obamacare insures millions more Americans, the medical tourism industry and the workers’ compensation industry may just pass up a golden opportunity to avail themselves of each other’s services and business opportunities. I had originally titled this piece, “Can Medical Tourism Relieve the Doctor Shortage Due to Obamacare?”, but on second thought, changed it to read, “Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare?” because while I know that it can, I am not so sure it will. A lot depends upon the medical tourism industry, and a lot depends on the workers’ compensation industry. I’d love to be proven wrong.

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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

3 thoughts on “Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare?

  1. Arun K. Potdar

    “Can Medical Tourism Relieve the Doctor Shortage Due to Obamacare?”, but on second thought, changed it to read, “Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare?

    Response:

    In the consumer markets, among all the other options in reducing cost of labor in the US, outsourcing seem to have played the most important and major role in keeping inflation down . The health care provider services industry, historically suffered lack of adequately trained professionals. There are many causes for that and this is a worldwide phenomenon. The third world countries have produced more and more physicians and nurses only to lose them to advanced economies of the world. Solution seems to be pointing at the most discussed and often maligned solution of outsourcing the work itself and that means patients must be sent to the locations with low wages and equally competent personnel available as EU has done. Spain and Portugal regions receive patients from Scandinavian and other areas of high inflations. Both the payers and patients are happy because of excellent climate and low costs. In the US there are two options: 1) open immigration and reduce length of retraining in the US licensing requirements for qualifying foreign medical/nursing school graduates to flood the market and 2) build an interactive relationships with foreign Medical Care Giver Communities and start transporting patients who can be transported without undue risks.
    The incoming health insurance policy holders under ACA, will without doubt increase the pressure on all segments of health care delivery systems and with supply and demand equation not being taken in consideration during the ACA designing phase, labor front is going to feel the stretch far more than it is currently set to handle. The Medical Tourism (MT) as the term implies to this trip overseas can be beneficial to economies of US and for example India the current favorite destination. The patient receiving institutions must meet or surpass the International Quality Standards and to do that technology transfer from the US or other advance countries and the communication protocol for two sides also provides additional opportunities. If this approach is taken the most benefits will go to the Sole Community Hospitals and CMS will also benefit immensely as Disproportionate Share Hospital (DISH ) or Sole Community Hospital adjustments will be eliminated. Most Community based hospitals do take huge losses in serving uninsured and Medicaid patients. Most patients for elective procedures from this lot then can be treated in the MT locations at half the cost of what reimbursement dollars come to hospitals. VA hospitals also will be able to reduce waiting periods for the urgently needed procedures at a much more lower costs. Only reservation I have is with the Workers’ Compensation (WC) area. I am unable to measure impact WC losses have on the health care as a whole and how MT will address that.
    My own experience of MT in W. Africa indicates that it has a very positive impact on the availability of health care services. It is felt much more in the African countries like the Republic of Ghana which is a fast emerging market with Gold, Oil and Coffee for export. The availability of Medical Care is not adequate in spite of abilities to pay being substantial among the population. In place of opening additional hospital before opening more medical and nursing schools to make trained labor force available, MT is the immediate solution for providing most acute care needed and not available at present. The MT services also can spawns other industries like specialized Travel Agents, Specialized Airlines for taking sick and bringing back post procedure patients. I believe MT is a necessity for managing health care globally and there is no other solution to address shortage of Physicians and Nurses worldwide.

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    1. richardkrasner Post author

      Arun,

      Thank you for that rather lengthy, but informative response to my post.

      I agree with most of what you said, but will tell you that as far as Workers’ Compensation is concerned, I have been told that it represents 2% of the total health care market of the US, so even though that is a very small percentage of the overall health care system, nevertheless, as the old saying goes, when one gets a cold, someone else gets a fever, so if the health care system as a whole cannot handle the increased number of insured people, as well as the higher costs, then it stands to reason that workers’ comp will too.

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  2. Pingback: Will Medical Tourism Relieve the Doctor Shortage Due to Obamacare? | Welcome to Medical- South East Asia, News Focusing on Medical Devices | Medical Tourism | Hospital Services and more

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