Immigration and Workers’ Compensation: Round Two

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Now that the summer is almost over, and we have had a brief, educational interlude, thanks to my recent quiz and the article about the 1798 mandated health care law for merchant sailors, let’s turn back to more serious and more immediate subjects that are relevant to our times.

One such subject is immigration, and thanks to both Joe Paduda and Peter Rousmaniere, today’s post will build upon that subject, as I have previously written about it in my earlier posts, The Stars Aligned: Mexico as a medical tourism destination for Mexican-born, US workers under Workers’ Compensation, Immigration Reform on the Horizon: What it means for Medical Tourism and Workers’ Compensation, as well as my post, Survey says most immigrant workers unaware of Workers’ Compensation: What this means to Workers’ Compensation and Medical Tourism.

Joe’s post today, Immigrants in the workforce – and implications thereof, mentions that one of every seven workers in the US is foreign-born, and that about half are Hispanic and a quarter Asian.  About a third of the foreign born workers are undocumented.

Peter’s post, Foreign Born Workers Take Center Stage, in WorkCompWire.com, reiterates some of the statistics I mentioned in my posts on the subject, that foreign workers are skewed toward above average injury risk jobs, and sustain a large share of the nation’s annual three million work injuries.

He goes on to add that in 2012, there were 25 million foreign-born persons in the U.S. labor force, comprising 16% of the total workforce. Hispanics accounted for 48% of the foreign-born labor force in 2012, and Asians accounted for 24%. (Recently Asians have been entering the U.S. at higher levels than Hispanics.) Undocumented workers account overall for about 5% of the nation’s total workforce and roughly one third of foreign-born workers.

There are three key takeaways for those in the workers’ compensation arena to be aware of:

      • A foreign born worker poses higher injury risk due to language barriers, cultural miscues and poor health literacy.
      • The growing presence of immigrant workers is not temporary and reversible. It is part of global economic forces. Some 150 million workers globally are estimated to be working outside their country of origin.
      • Private sector employment growth has been and will continue be in fields with relatively high immigrant participation, ranging from software engineers to personal health aides.

Peter also details which industries are more likely to have high percentages of foreign-born workers and what that entails for future workers’ compensation injuries, something I also mentioned in an earlier piece. A key passage in his article states the following:

When you estimate the number of future work injuries, taking into account the injury rates of the individual jobs and their expected growth of openings, you find that immigrant workers will likely sustain 20% — one of every five – of work injuries.

The implications of this are clear as Joe points, out in his blog post today, and that I have already touched upon in the Survey piece, namely that:

Given these facts, it might be worth the workers’ compensation industry’s while to explore and seriously consider medical tourism as an alternative, but as much of the industry is focused on the issues of opioid abuse and the physician dispensing of drugs, which are certainly important issues, they nevertheless cannot blind the industry to other issues such as the impact of immigration on workers’ compensation, and to the alternatives that are out there to deal with them.

As I have been saying for some time, the implementation of medical tourism into the American workers’ compensation system is not just some fanciful dream or exercise in seeing myself in print. It is a rational, thoughtful and reasoned alternative to the high cost of medical care, not only within the general health care system of the US, but within the niche market that is the US Workers’ Compensation system.

As Joe and Peter so skillfully point out, and as I have done so in the past, the future American workforce will be made up of men and women who either were born in, or whose families came from countries in the Latin American and Caribbean region.

Sending injured workers to these and other countries in the region for medical treatment is a logical idea because of language and cultural barriers, access to quality medical care in the best facilities in their native countries or similar countries, and the ability of friends and relatives living there to visit the injured worker while recuperating from surgery, and therefore making recovery faster and more likely to have better outcomes.

If Peter’s 20% figure is correct, then it is safe to assume that a percentage of those injuries will require surgery at some point in the treatment process.

And if they will require surgery, what guarantees do we have that negotiations and fee schedules will bring down the cost of these future surgeries here at home, when a cheaper, better quality alternative is just a short flight away from the US mainland?

I have tried to get data on costs of certain surgeries common to workers’ compensation from a facility in the Caribbean and from hospitals in Latin America, and while I have also written about how difficult it is in getting such information, it nevertheless is imperative that the workers’ compensation industry gets behind this idea, and pushes for transparency from these facilities so that comparisons can be made between costs here and costs there, as well as quality.

But let me be clear, this is not going to be easy, and I have said it before, and it needs to be said again and again, it will be difficult to implement medical tourism into workers’ compensation, but can you really afford not to?

Recently, I had a conversation with the President and CEO of a surgery benefit management company, who also had the same idea, and in our conversation, he told me that he believed that the savings would have to be greater than $5,000, including surgery and airfare, for medical tourism to be a financially viable alternative to the high cost of surgery. His business model relied on getting the lowest cost domestically for his clients, which is still higher than what might be possible in Latin America or the Caribbean, but without reliable data, it is impossible to prove that claim.

What needs to happen is this, both the medical tourism industry and the workers’ compensation industry need to find each other and begin the process of determining how best they can help each other, and how best they can serve each other’s needs. One way for this to happen is for large, workers’ compensation services companies that already provide various services to the workers’ compensation industry such as medical care, translation services, and transportation services, through an in-house or contracted travel agency, so that their insurance carrier or employer clients can confidently and effectively secure better quality and lower cost care for their foreign and native born workforce in the event of serious work-related injuries.

The workers’ compensation industry needs to get focused on this issue, and the medical tourism industry needs to come clean with just how much it costs to perform surgery X, Y, or Z, and in which countries. Not being transparent and basing costs on multiple factors is like buying a car and being told that the price depends on the color, the time of day it is bought, the time of year, whether or not the salesman woke up on the right side of the bed that morning, and so on.

We cannot shut out the rest of the world, despite what the Tea Party wants, because like their Know-Nothing and Whig Party forefathers, they too will disappear from history if they continue to ignore the immigration issue. Let’s hope the medical tourism and workers’ compensation industries don’t either.

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This entry was posted in Immigrant Workers, Immigration, Immigration Reform, Legal Immigration, Medical Tourism, Undocumented, Workers' Compensation and tagged , , , on by .

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 “Immigration and Workers’ Compensation: Round Two

  1. Patrick Pine

    I administer a plan serving farmworkers, mostly in California, predominantly Mexican and Mexican American, predominantly Spanish speaking. We have long used providers of medical and dental services and some pharmacy services on the border in Mexico at negotiated rates well below US rates. One thing I noticed a couple of years ago – at a large travel convention in Los Angeles next to the meetings I attended there were two booths – one from Mexicali Tourism Board or Bureau and another from Tijuana. Both had several hotels – on both sides of the border promoting that they would provide transportation to and from various medical facilities – in other words, the medical providers and the lodging businesses were allied in promoting medical tourism to their respective areas. Later at a meeting in Palm Desert I ended up sitting next to a woman representing hotels in the Palm Springs area and suggested she may want to talk with the providers in her area about a similar marketing promotion. I agree that obtaining more transparent pricing from providers is critical – but it really is not that difficult to negotiate – at least with the Mexico based providers we have dealt with. My dominant population often prefers to travel to Mexico just for medical services – partly for the financial savings but also for “peace of mind” reasons – the providers speak the language, may have served them or family and/or friends in the past and there is a much greater sense of ease in such circumstances. I think US employers will find it worth the time to consider medical tourism options.

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    1. richardkrasner Post author

      Patrick,

      Thank you for your wonderful comment about Mexican medical tourism. I would like to see if we can do something together.

      One thing I do have a concern about, is security for patients in Mexico in light of cartel violence, but if that can be dealt with, then I see no reason that this should not continue.

      Again thank you for your comment. I will invite you to follow my blog.

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  2. property

    First off I want to say wonderful blog! I had a quick question that I’d like to ask if you do not mind.
    I was interested to find out how you center yourself and clear your head prior
    to writing. I have had difficulty clearing my thoughts in getting my thoughts out there.
    I do enjoy writing but it just seems like the first 10 to
    15 minutes are usually wasted just trying to figure out how to begin. Any ideas or
    tips? Appreciate it!

    Like

    Reply
    1. Transforming Workers' Comp Post author

      I generally shoot myself in the head to clear it. Just joking.

      It depends on the topic I am writing about. If it is straightforward and involves reporting on what others have said, it may not take me that long.

      But if it is something I have to think about, something that I am not sure about, or cannot figure out how to begin, I struggle with it until it comes out.

      I usually write free-flowing, top-of-my head, especially when I rant, but that is not very often.

      Just allow thoughts to come into your mind without thinking about it. Wait for the ether to send you the words.

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      Reply

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