Opt-out as a way in: An Update

In June of last year, I wrote an article entitled, “Opt-out as a way in: Implementing Medical Tourism into Workers’ Compensation“. In that article. I discussed how the state of Oklahoma has enacted an opt-out program for workers’ compensation. David De Paolo wrote last week that employers in Oklahoma are excited about policies being offered by three (soon to be four) insurance companies that meet the minimum standards the Oklahoma opt-out law requires. David said that this is a very exciting time in the evolution of workers’ compensation. We have a system that is over 100 years old and has been morphing, particularly in the last 20 years, to cope with changes in work and the economy, and many feel those changes have been negative. He goes on to add that the Oklahoma experiment is bold. Whether it is the beginning of a trend remains to be seen – but it is clear that the early sentiment reflects a sizable appetite for something new. As I concluded in my previous post on the subject:

What this means for medical tourism and workers’ comp is this, as more states enact opt-out programs for employers in their states, the likelihood that an employer would chose to send their employees abroad for medical treatment increases. Considering what I have already said in earlier posts about the changing demographics of the US labor force and the rise of medical tourism destinations in Latin America and the Caribbean, this possibility is closer to becoming a reality because more states will have given their employers a choice to stay in the statutory system with its complexity and its legal barriers to implementing medical tourism, or to allow them to add workers’ compensation medical care as another employee benefit which they control and for which they can offer medical tourism as an option since they would no longer be subjected to state rules and regulations concerning medical care for injured workers.

If employers are really looking for something even more bolder than opt-out programs, they might want to consider lobbying their legislators to change the statutes to allow them to offer medical tourism as an option to their employees. What they will get in return, is lower cost health care at the same or better quality, and if their workforce is increasingly Latino, they will benefit from receiving care in the best facilities in their home or similar countries. That would really be a bold move.

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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 “Opt-out as a way in: An Update

    1. Transforming Workers' Comp Post author

      Jo,

      A lot depends on how willing employers are to explore other alternatives beyond the opt-out program. If they get a handle on their comp costs, short of surgery, they may not care that they are paying more for surgery here, if that is offset by lower costs for all medical care up to the surgical procedure.

      Also, it depends on the legislators, the lobbyists for the state’s hospital and physician groups, and lawyers. But the medical tourism industry has a role to play in this too. If it wants to get into the game, it has to step up and play the lobbying game in OK and other states that adopt opt-out.

      But if enough employers recognize the value of medical tourism, and here again is where the industry needs to get moving on, then they can pressure politicians in their state to loosen the work comp regs to allow medical tourism.

      Transparency in cost and quality will go a long way to making medical tourism a viable option.

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      1. Jonena

        Thanks Richard, I understand that this blog is all about Worker’ Comp, but wouldn’t it be GREAT is the ACA allowed patients to get care abroad as well and pay for those services. Surely our government would save costs. Thoughts/Ideas?

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  1. Transforming Workers' Comp Post author

    Jo, that would be a great idea, and certainly the medical tourism industry would welcome that, but I don’t think the insurance companies that wrote the law want that to happen, but that could change if more people had access to care through Medicaid, or if we just did away with ACA and went to a Medicare for All program. The shortage of doctors, nurses, and hospital beds would certainly require a safety valve that medical tourism could provide. But as Shakespeare said, “…perchance to dream…”

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