Monthly Archives: December 2014

2014: That Was the Year That Was

As we approach the end of another full calendar year here at the Transforming Workers’ Comp blog, I want to take a look back at what kind of year it was, and what was accomplished, as well as what may lie ahead in the coming new year, a year that may be the beginning of a new dawn in Medical Tourism.

It was a year that saw me attend two medical tourism summits, and it was a year in which I finally met some of the people I have connected with since I began my interest in medical tourism, but had either never talk to, or met before. And it was a year that saw the passing of my father, who never thought I would go to the second summit, and did not live long enough to see me go. And it was a year of tremendous mental strain dealing with my mother’s illness as well

The year began with my article, NAFTA, Work Comp and Cross-Border Medical Care: A Legal View, which discussed a case that may have considerable impact on the expansion of cross-border health care under workers’ comp in the other border states between the US and Mexico.

Next, came a wonderful new year’s surprise some four weeks into the new year, when I was invited to attend and speak at a Medical Tourism summit to be held later that year in Reynosa, Mexico (more on that later).

The year got even better when my fellow blogger, Joe Paduda mentioned my name in one of his posts, which I reposted in my article, There Are No Words. It was very exciting to finally be recognized for my hard work and writing.

But there were the usual articles that went after the problems inherent in the workers’ comp system in the US that either had been discussed in previous years, or were new like the following articles:

Of ‘Aged Statutes and Old Case Law’ — Why Workers’ Comp Must Change

The Stench of Fraud: Why Workers’ Comp Can No Longer Be a Closed System

The Stench of Fraud, Continued

The Fiefdoms of Fools

And then there were some new avenues to explore, such as the demand for bundling of workers’ comp and health insurance, as well as a monkey-wrench that was thrown into the works when a Florida judge ruled the state’s workers’ comp system to be unconstitutional, and the update to that.

In early May, I attended the Costa Rican medical tourism summit that was held in Miami Beach. It was there that I met two people who I hope to be working with in the New Year, along with one of their employees on bringing the idea behind this blog to reality.

And lastly, as I mentioned above, I spoke and attended a medical tourism summit in Reynosa, Mexico, where I finally met the grand dame of medical tourism, Maria Todd, and many others, including another individual with whom I hope to work with in the near future. So in all, 2014 was a great year for me business-wise, not so good personally, for obvious reasons. But it ends on a hopeful note, so I wish you all a very Happy New Year.

Obamacare, American medicine, medical tourism and what it means for me

Here is a medical industry professional’s perspective of what I’ve been writing about, albeit from a general health care angle.

Guide to Surgery in Latin America

I haven’t written in a while because I have been looking for a way to describe what’s been going on in healthcare.

the American healthcare system the American healthcare system

As a provider

There has been a weird unhappy vibe in the  American hospitals these days.. It’s like nothing I’ve ever felt before in the last 15 years.  There has always been a collective feeling of frustration among providers; but it’s usually sat somewhat untended, like a slow cooker slowly simmering away..  These frustrations were related to our inability to provide the best for all of our patients, our frustration with the broken-ness of a health care system so rife with waste, yet with so little help for our vulnerable populations, and those in dire need.

It was manifested by occasion individual grumbling; during case management meetings, during conversations with faceless insurance companies as we explained yet again, why our patient:

a. really needed…

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Large Employers in Texas Opting Out of Work Comp

In two separate articles on Tuesday, David De Paolo and Stephanie Goldberg, mentioned a biennial report by the Texas Division of Workers’ Compensation that stated that even with some of the most favorable rates in the country, Texas employers still have issues with work comp.

According to De Paolo, about 2/3, or 67% as reported by Ms. Goldberg, of Texas employers carry workers’ comp coverage, which means an estimated 80% of the state’s workers are covered by the Texas system.  In 2004, 62% of employers were covered, according to Goldberg.

About 75% of the employers, De Paolo said who don’t subscribe have some alternative plan. This means, that 95% of private-sector employers have some form of work injury protection.

The remaining 5% of private-sector employees who are not covered total about 470,000 workers, or 30,000 fewer than in the last report in 2012. The percentage is the same in both reports.

Stephanie Goldberg reported that this is due to lower insurance premiums and an increased availability of workers’ comp health networks, as stated in the report.

Yet, as both De Paolo and Goldberg state, larger employers are choosing to opt-out of the state system.

Quoting from the report itself, De Paolo writes, “Despite lower workers’ compensation insurance rates in recent years, it appears that an increasing number of the largest employers in Texas have begun to opt out of the workers’ compensation system since 2010, while an increasing number of small and mid-sized employers have increased their workers’ compensation coverage rates.

TX Non-Subscribers Pct

In the prior report from 2012, the non-subscribing rate among the largest employers also increased from the 2010 report. The rate, De Paolo says went from 15% in 2010 to 17% in 2012.

The 19% figure in the table above, is still significantly lower, De Paolo said, than what was reported in 2008, when 26% of employers with 500 or more workers were non-subscribers.

The odd thing, De Paolo said, was that there was a slight decrease in non-subscription for employers with 5 to 9 employees, from 29% in 2012 to 27% in 2014, and for employers with 50 to 99 employees, 19% in 2012 and 18% in 2014.

So what does this mean for the implementation of medical travel, i.e., medical tourism into workers’ comp for expensive surgeries?

It means that as more states follow Texas’ and Oklahoma’s lead in expanding opt-out programs, as I mentioned in my article, Options for Workers’ Comp Getting National Attention, the focus of the medical tourism industry in going after this market is to target large employers, as far as Texas is concerned, and to research the non-subscription rates of all employers in those states that will follow Texas and Oklahoma’s example.

But it does not mean that as far as Texas is concerned, you should not try to go after smaller employers as well. Steven Bent, the executive director of the Texas Association of Responsible Nonsubscribers, and another connection of mine on LinkedIn, said that “…workers’ comp rates have been somewhat cyclical historically, and if rates were to go up again in the future, we would hope that the ability to provide benefits outside of workers’ comp exists as a check valve or as a pressure valve for higher workers’ comp rates.

And it does mean that there is a market to go after, with large, small, and mid-size employers. The best way to do so is to approach insurance brokers who have experience with international travel insurance and workers’ comp, and even health care. And you should go directly to the employers themselves by finding out who opts out and who does not.

You don’t need thousands of client employers, a few dozen or so large employers will do for a start. Texas is pointing the way.