There are some people in the workers’ comp world whose mission it is to keep the status quo going for the benefit of plaintiff lawyers, defense lawyers, doctors, hospitals and workers’ comp services providers, as well as for the state legislators and regulators of workers’ comp systems in all fifty states who write the laws and oversee that the rules and regulations are adhered to.
They like to argue that the claimant’s lawyers would object, but it is the very lawyers, both plaintiff and defense, that have made workers’ comp claims so expensive and so dysfunctional. Then there are the myriad service providers who claim to be able to lower costs, but only add more expenses to the claims. Add to that what the physicians charge, what hospitals charge and by the end of the claim, the medical costs have outstripped the indemnity payments to the claimant. There is something wrong with that.
And because these people are invested with keeping the status quo, they feel it is their right to shoot down any idea that would change the status quo. One such individual has called my idea to implement medical tourism into workers’ compensation a “ridiculous idea” and “a non-starter”.
Yet, I have been published in several medical tourism blogs and newsletters published in this country and elsewhere, and have been singled out as one of the “many smart, loud, and committed folks talking and writing about what needs to happen [to improve workers’ comp] and why.” by a well-respected fellow blogger in the managed care/workers’ comp arena. This blogger also told me that I am “far in front of the crowd” on this issue, and I wrote a post with that very title.
And, I have been invited to speak at a medical tourism summit in Mexico in November because of my writing on the subject of medical tourism and workers’ comp. So obviously, my idea is not as far-fetched or ridiculous as some would have you believe.
What most of these individuals do not know is that cross-border health care is already happening. And it’s been happening for years, as I’ve written in my post, Cross-border Workers’ Compensation a Reality in California, and I also wrote about a company in North Carolina that is paying for their employees to go to India or Costa Rica, mainly for work-related back injuries.
They are under the delusion that workers’ compensation, unlike other industries, is somehow immune to the forces of globalization, and that by doing the same things over and over again, to lower costs, and to get better quality outcomes, they are going to get different results. You know what that is called, right?
What most of these people are afraid of is that these innovative and new ideas will actually work to help bring down costs and provide better quality outcomes for workers’ comp claims. They know that if employers and insurers actually save money by sending injured workers to places like Costa Rica, Mexico and other Latin American countries where they speak the same language as the claimant and have the same or nearly the same culture as the one the injured worker came from originally, that other injured workers will do the same.
And that would mean that the American surgeons and hospitals that charge thousands of dollars for surgeries common to workers comp could lose market share. Well, isn’t that what capitalism is all about? Getting the same good or service at the same or better quality, but at a lower price? Why should workers’ comp be any different than buying a car in another state where the price of the car is lower than what is available at a nearby dealer?
But there is another reason why these people do not like the idea of medical tourism in workers’ compensation. It’s called “American exceptionalism”. It is a meme carried over from our colonial past whereby the original settlers believed that America was a shining city on a hill, and therefore anything Americans do is the best. Well if that is true, then why is America’s health care system so bad? I wrote an article not that long ago called “We’re No. 1!”, NOT! — Why the US Health Care System is Not the Best in the World and Why Implementing Medical Tourism into Workers’ Comp Could Improve Outcomes that proves that we don’t have the best health care system in the world.
But what’s more, these people actually believe that non-Americans cannot be as good as Americans, as if being from another country somehow means that they are less qualified or less skilled, even when the physicians are trained in the US or in Western Europe. Have any of these people ever seen how many foreign-born doctors are working in our hospitals? Where do you think they go once they stop working in this country?
Yet again, these people believe that it is okay to subject injured workers to this broken, dysfunctional system, and insist that if we only do this, or do that, or try something else that has no chance of lowering costs to a reasonable level, they will get different outcomes. Saying that you can negotiate lower costs or use a fee schedule to bring down costs, when even that negotiated cost or fee schedule cost is higher than what is available outside the US, is not a real solution to high-cost medical care. It only makes matters worse. What good is getting surgical costs down to $25,000 from $30,000, when the same surgery can be less than $20,000, with airfare and accommodations for two people in a first-class medical tourism facility?
I know there are barriers and obstacles to implementing medical tourism into workers’ comp. I wrote a White Paper on it, and have written many times that it won’t be easy, nor is it a “pipe dream”. They even say that it can’t happen under the current workers’ comp statutes. I know, that is why I said they have to change the statutes to do so. And they also said that no judge would order medical tourism. No judge has to order this, it has to be done before it goes before a judge, but since they mentioned it, I will say that the District Court of Appeal in Florida has ruled that a worker can return to their home country for care under Florida law (see AMS Staff Leasing v Arreola).
But somehow, medical tourism for workers’ compensation is harder to do than flying in the air, or going into space and walking on the moon. Tell that to the millions of people around the world who fly in airplanes every single day. Tell that to the men and women, from many countries, not just our American astronauts and Russian cosmonauts who have flown in space, and tell that to the men who have walked on the moon. Is medical tourism in workers’ comp harder and more difficult than those achievements? Hardly. The only thing that stops us is our lack of imagination and lack of will.
I leave it to others to figure out how to get employers, insurers, lawyers, doctors, and most of all, employees to choose medical tourism as an option for medical care. It’s not for everyone, but for those who do chose it, it could be better than the sub-standard care they are getting now in our broken and dysfunctional health care system. And they just might find that the world is really truly getting smaller and that borders are no longer the barriers they once were for all kinds of goods and services.
The world is globalizing. Health care is globalizing, and workers’ comp medical care must and will globalize. If not, it will fail as a system to provide the best care possible at the lowest cost possible. There is nothing anyone in the workers’ comp industry can do to stop globalization, so you might as well get on-board with it and stop fighting it. You’ll feel better when you do.