Monthly Archives: June 2016

Cut the C**P!

For my 300th article, I want to address the medical travel industry and its failure to rid itself of the crooks, liars, shysters, and phonies who prey upon the desperate.

Case in point, the article last Wednesday in the New York Times by Gail Kolata about one man’s experience getting stem cell therapy through medical travel.

This case is endemic of the industry’s impotence to police itself and get rid of those medical providers and hucksters who use slick promotional material to sell useless and often dangerous treatments or dubious procedures.

But what do you expect from an industry whose major organization is merely a conduit for funneling money into the pockets of the organization’s founders and their friends?

What do you expect from an industry that emphasizes attending conferences and not on standardizing the laws and processes for the provision of medical care across national borders.

When I started this blog over three years ago, I had high hopes that the industry would listen to what I had to say, and to at least consider offering medical travel to injured workers in the US. But as happened with the workers’ comp industry, no one has stepped up and offered to work with me.

I’m not mad at everyone in the industry. Many of you are very nice people and work very hard, but your focus is on such medical care as dentistry, cancer, cosmetic/plastic surgery, and other treatments not available in the US, or too expensive.

But helping those who are injured on the job, and many of whom are from many of the countries in this hemisphere who offer medical travel services, should be something some of you might want to do.

It was my hope that this industry would offer me a chance to change direction, but that has not happened, and now I am not sure if it ever will.  There does not seem to be any financial or employment opportunities here, just a lot of conferences and hyperbole.

Prove me wrong.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

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Deaf, Dumb and Blind

It’s time once again for a rant. This rant is courtesy of my fellow blogger, Joe Paduda, who wrote an article today that criticizes members of the workers’ comp industry for not publicizing the positive things they do, but complain about all the negative press they have been getting.

As Joe writes, “Yep, it’s your fault that the popular press smacks you around, citing a few examples of alleged insurer screw-ups as proof that you’re all a bunch of cold-hearted, nasty, lazy incompetents motivated only by profit.

Joe was referring to reports from ProPublica, NPR, plaintiff lawyers, muckraking journalists and bloggers (including yours truly, as well as two women I have previously written about, and who are injured workers themselves), and calls for the industry to stop their bitching.

Most industry professionals may not realize that workers’ comp came into existence due to the writing of early twentieth century muckrakers as Upton Sinclair (The Jungle), Ida Tarbell, Lincoln Steffens, and many others.

He takes them to task for not publishing a case of the month, sending out a press release honoring an employee for going above-and-beyond in helping out an injured worker.

Joe says it is their fault because the reasons they don’t promote their good works are short-sighted, ignorant, and indefensible; in short, you are deaf, dumb and blind to reality.

From the day Edward Lloyd opened his coffee house in London in the 17th century, the insurance industry, and specifically, the workers’ comp industry has been dominated by Lloyd’s fellow countrymen and co-religionists.

The same holds true here in the US, but American pluralism (of a kind) has allowed some minorities to make it in the industry, but it is still mostly a white male, majority religion club (certain exceptions such as Saul Steinberg and Maurice Greenberg notwithstanding).

I know people in my family and in our extended social circle who have worked for insurance companies, and the highest level they have attained has been below that of the top executives. My first job in workers’ comp was with a company whose executives were not members of that club, but my boss was, and that was a reason some of us claims people were mistreated by him. Sheer resentment that he was not a member of the tribe and thus the board of directors. Let’s not pretend it does not exist. Why do you think some companies are called, “white shoe” companies?

Here is my take on this:

  1. You are resistant to change unless the change comes slowly, and from sources you trust and can control or dominate.
  2. As evidenced by Joe’s writing, you are unwilling to accept criticism from anyone who is not a member of the club or is from the lower ranks, or even someone who is on the outside looking in, as I am.
  3. You refuse to offer those with a passion for making workers’ comp better and opportunity to do so, and have laid off the best, brightest and hardest working people to save money on employee benefits, to cut payroll, costs, or because everyone else is laying people off, so why should you be any different. One of my LinkedIn connects writes a lot about millennials going into insurance, and many of you have complained online that you can’t find talented people. That’s because they are out looking for work.
  4. You refuse to accept any new idea, no matter who gives it, no matter what it is, and even have the nerve to criticize the idea and the person who promotes it. You continue to do the same things over and over again, and expect different results.
  5. You have elevated the laws, regulations, rules and statutes to the level of sacrosanctity, and that has frozen the industry in time, if not in place.
  6. Not one of my LinkedIn connections in the industry or in the insurance and risk management arena, who are hiring managers or executives have ever complimented me personally, save Joe, on my knowledge, my writing, or my passion for improving workers’ compensation. Crickets…
  7. You must dump the adversarial attitude pervasive among carriers, TPA’s, service providers, physicians, and employers. Not all injured workers are crooks. Treat them accordingly, and help those who really need help. Get emotional when you hear a sad story and work to fix it.
  8. STOP USING MEDICAL PROVIDERS WHO DELIBERATELY INJURE WORKERS, BOTH MEDICALLY AND EMOTIONALLY BY LYING TO THEM, DENYING THEM TREATMENT, OR JUST BEING GREEDY. Punish them by refusing to pay them or turning them into the legal authorities.
  9. Lastly, listen to the outsiders, even though they don’t have a job title, or are publishing anecdotal evidence of how bad some workers have been treated. Resist the snake-oil salesmen of opt-out like ARAWC and ALEC, whose agenda is both political and economic. They believe in an economy much like that when Edward Lloyd opened the coffee house. Ever wonder why Texas, and now Oklahoma are the only two states with opt-out? Because they are both states whose leaders in business and politics believe in laissez-faire, free market (free to the capitalist) capitalism. Don’t believe me? Here’s what Dwight Eisenhower said to his brother in a letter in 1954:

“Should any political party attempt to abolish social security, unemployment insurance, and eliminate labor laws and farm programs, you would not hear of that party again in our political history. There is a tiny splinter group, of course, that believes you can do these things. Among them are H. L. Hunt (you possibly know his background), a few other Texas oil millionaires, and an occasional politician or business man from other areas. Their number is negligible and they are stupid.”

The Koch Brothers are just like the Hunts were back then, so be careful about opt-out expansion. It is a ploy to abolish the progressive reforms the muckrakers helped to create.

That’s all I have to say. It’s up to you to change course and make things better, but know this, we are not your enemies. We want to help, and I want to help you now.  Don’t be deaf, dumb an blind to us.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

RIP GLOBALIZATION?

From all the commentary this weekend and on Friday about the referendum to leave the European Union (EU) in the UK, it would seem that the dream of a handful of international bankers, multinational corporation heads and politicians of both the left and the right since the end of the Second World War have made a terrible and unforeseen error in pushing for a globalized world economy.

How did we get to this place? Simple, as a result of the economic policies of the 1920’s and 1930’s, Europe and her allies in North America, were plunged into a second global conflict. Near the end of the conflict, the economic leaders of the Allied nations gathered in Bretton Woods, NH to carve out the Bretton Woods Agreement, which established the World Bank and the International Monetary Fund.

Along with this, came the United Nations to deal with the political and military crises that would arise in the second half of the twentieth century. To provide greater perspective, we must go back to the First World War and recognize that here in the US, many Americans were woefully ignorant not only about world affairs, but of geography as well. In 1914, I doubt many Americans could point out just where Sarajevo or Serbia was, or where any of the other nations drawn up into that war were located.

Following on the heels of an earlier organization, the National Civic Federation, several prominent business, political, academic, labor and other leaders formed the Council on Foreign Relations. The Council promoted the study of geography and political science in colleges and universities, as well as promoting social studies in high schools and junior high schools.

The Council also published Foreign Affairs magazine, which became a forum for the discussion of world events and dissemination of political theories and policies from leading academics and business leaders. But there was one other thing that the Council did. It provided the US government with its future Secretaries of State, War, Treasury, and later Defense, among other lesser administration positions from the 1920’s onward.

My first major in college was political science, and more specifically, international relations and foreign policy. I also had a graduate course in American Foreign Policy at NYU as part of my History Masters degree.

After WWII, the Cold War forced many of the Western countries to realize that in order to defend against Communism, as they had against Fascism, they needed to have greater cooperation. So the North Atlantic Treaty Organization, or NATO was born, and within Western Europe, the idea of European cooperation led to the formation of the Common Market, of which the UK was a member.

In the 1950’s and 60’s, the European Coal and Steel Community (ECSC) and  was created, followed by the European Economic Community (EEC). These developments were spelled out in the Brussels Treaty of 1948, the Paris Treaty of 1951, the Modified Brussels Treaty of 1954, and the Rome Treaty of 1957.

In the 1960’s, the Merger Treaty of 1965 created the European Communities, made up of the European Atomic Energy Community (EURATOM), as well as the  ECSC and EEC.

The Maastrict Treaty of 1992 created the European Union, and its membership has grown steadily, especially after the fall of Communism in Eastern Europe and the breakup of the Soviet Union and Warsaw Pact.

Meanwhile, in other regions of the world, similar ideas were taking shape. In Asia, the Association of Southeast Asian Nations (ASEAN) was formed to do for Southeast Asia what NATO and the European Communities were doing for Europe.

To foster greater cooperation between North America, Western Europe and Japan, the three industrial regions of the world, David Rockefeller, Chairman of Chase Manhattan Bank and Zbigniew Brzezinski created the Trilateral Commission. In the next two decades, membership in the Commission was expanded to every other region of the world.

Like the Council on Foreign Relations, members of the Commission could be involved in politics in their respective countries, but once they achieved national office of any kind, they resigned from the Commission. Membership was recommended by current members, and the incoming Jimmy Carter Administration of 1977-1981 saw the following members leave the Commission: Jimmy Carter, Walter Mondale, Harold Brown, Zbigniew Brzezinski, Cyrus Vance, among many others.

It was in college that I studied global politics, or what would become known as Globalization, and with the expansion of the Commission’s member countries, and the fall of Communism, it seemed that globalization would continue.

Yet, they made one big mistake. Neglecting to replace the jobs lost to globalization from the 70’s to the present and thinking that “free trade” conducted through treaties such as NAFTA, CAFTA, TPP, and under the approval of the WTO would benefit both the developed and underdeveloped worlds. Hardly, as the Brexit vote and the rise of Trump in the US, as well as Bernie Sanders on the left can testify to.

Globalization has been mostly a one-way street out of the developed countries and into the undeveloped or developing countries. It has had the unintended consequences of stirring up racism, bigotry and resentment, as well as distrust in institutions and government. It has also favored the wealthy and those international players already in the game, but locks out those who are attempting to benefit from it, as many in the medical travel industry have tried and failed to do.

With other European nations threatening to leave the EU, and opposition here to TPP, and other trade deals (“I’m going to make better deals”), it would seem that globalization, far from dead yet, may at least be stopped in its tracks for the foreseeable future. That may happen if the US does the stupid too, and elects a moron.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

Where No One Has Gone Before: Or Will Captain Kirk Save Work Comp?

Tom Lynch, of LynchRyan published an excellent piece today about the bumpy ride workers’ comp has had since 1972, when a commission established by Richard Nixon made 19 recommendations for the improvement and uniformity of state workers’ comp standards.

As the Chairman of the Commission, John Burton suggested, “if we continue to advance at this rate, the 19 essential recommendations will be law throughout the land sometime in the 23rd century.”

“Hailing frequencies, open Captain.”

Tom is not the only one who wrote recently about the vested interests holding back progress and change. David De Paolo last week said the same when he wrote,

“Insurance companies are as much a vendor in either scenario as physicians, bill review companies, utilization review companies, attorneys, vocational counselors, etc. Each and every single one makes a buck off work comp, and each and every one has an interest in maintaining the status quo.”

Do we really have to wait until warp engines and transporters carry us off to far distant planets to have meaningful and substantial reform of workers’ comp that benefits the injured worker and minimizes the abuse by vested interests?

Or do we continue to illogically believe that nothing can change, and that new ideas are stupid and ridiculous and a non-starter? Or do we ignore those in the industry who blog about workers’ comp, but are impeding change by denying the credibility of the individuals presenting new ideas, or the ideas themselves?

These 19 recommendations should be looked at again and implemented, along any other ideas, outside of opt-out to bring injured workers better and less expensive medical care. To do otherwise is illogical.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

ERISA, Stop Loss and Unintended Consequences

“The problems of the world cannot possibly be solved by skeptics or cynics whose horizons are limited by the obvious realities. We need men who can dream of things that never were.”

John F. Kennedy

“Some men see things as they are and say why. I dream things that never were and say why not.”

Robert F. Kennedy

“It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult.”

Seneca

Those quotes were included at the top of my June 19, 2013 post, “Clearing the Air: My Defense of Implementing Medical Tourism into Workers’ Compensation” where I defended myself against the charge that I was offering “simplistic solutions” to medical travel and workers’ comp. In that post, and in “The Faith of My Conviction: Integrating Medical Tourism into Workers’ Compensation is Possible and is not a Pipe Dream” I acknowledge that is won’t be easy, but there are ways to do it.

In my last post, “Self-Insured Employers Fail To Adopt Medical Travel“, I discussed the reasons given by Irving Stackpole for why US employers have failed to adopt medical travel into their corporate health plans.

In conversations with a noted ERISA and medical travel expert, I have been making the case that laws and regulations such as ERISA, Stop Loss, and other “barriers” erected decades ago, in order to address specific problems such as tort claims, aggregate claim losses, etc., have the unintended consequence of holding back the globalization of health care, which includes workers’ comp.

I have addressed the legal barriers in comp in my White Paper, and found that there were outdated federal and state laws and regulations, intended to protect consumers, actually increase costs and reduce convenience, restrict public providers from outsourcing certain expensive medical procedures, and that federal laws inhibit collaboration, while state licensing laws prevent certain medical tasks being performed by providers in other countries.

Let me state here that I, in no way, am advocating the removal of these laws and regulations. My chief argument is this: our best minds have split atoms, launched satellites and men into space, discovered cures for diseases plaguing humans for centuries, but to send patients to other countries for medical care is impossible, and not worth pursuing, smacks of cowardice or fear that it actually might save money and provide better care. Do we not have the best minds to figure out how to deal with these “barriers”, or are we too fearful and litiginous a society that we have given up accepting new ideas?

Every industry is being affected by two powerful forces today: globalization and automation. With globalization, jobs, plants and other forms of capital are moving across borders. With automation, jobs that were once held by humans and considered very dangerous, are being done by robots, and soon other jobs will be done by artificial intelligence.

Neither force can be stopped, and how we address the consequences of these forces is what many minds are working on right now. But to say that one industry is going to draw a line in the sand and say, “NO” and stop globalization from happening is either insanity or a deliberate attempt to profit from the maintenance of the status quo that many along the supply chain of medical care services, both within the general health care space and workers’ comp have carved out for themselves.

When I was in college, I studied International Relations, and back then, globalization was a word very few outside of academia ever heard. There was an organization created in 1973 by David Rockefeller and Zbigniew Brzezinski called the Trilateral Commission. Its purpose was to foster better cooperation between the countries in North America, Western Europe and Japan (the Trilateral countries) and their multinational corporations. In the ensuing decades, the Commission expanded the membership to the rest of the world, and globalization became a household word.

Coincidence? I think not, since the heads of major US, Western European, and Japanese companies were members, and so were many politicians, including a former peanut farmer from Georgia and most of his top administration personnel. Other politicians after him also have been members, from both sides of the political spectrum.

Their chief goal is to allow capital, goods and jobs to cross national borders, or to eliminate them altogether, and I doubt they expected the health care industry to stand in their way. These are men who generally get what they want, and damn the consequences. We see this in the breakup of the European Union, which many of them advocated for years, just like they advocated for NAFTA, CAFTA, the TPP, and other trade deals, and don’t give a fig about the impact they have.

So, it is important to realize that the only real thing preventing medical travel is what unintended consequences have on the growth and development of the industry. This is where the industry needs to focus its attention, not on slick advertising, but on hard work and cooperation to overcome these “barriers”.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

Self-Insured Employers Fail To Adopt Medical Travel

When I began my writing, one of the ways I saw medical travel could be implemented into workers’ comp was through employers who self-insure.

There are not that many companies who do self-insure for several reasons, one of which is the administrative costs and extra hoops they would have to go through just to get approval from state regulators to be self-insured. This is something most small employers will not do. More on what I think about this later.

Today, Irving Stackpole, President of Stackpole & Associates (a LinkedIn connection of mine), wrote an article in the International Medical Tourism Journal (IMTJ) about why US employers have failed to adopt medical travel benefits.

For the sake of transparency and honesty, I have never met Irving, but have had discussions with him a few times on LinkedIn in some of the groups we have in common. I have met his co-host of his radio show, Elizabeth Ziemba, when we both attended the 5th Medical Tourism and Wellness Business Summit in Reynosa, Mexico in November 2014.

In his article, Irving mentions that while some small employers such as HSM (who I have written about in earlier posts), Hannaford Supermarkets, the Casino and Hotel of the Blue Lake Rancheria Tribe in Northern California, and IDMI Systems have added medical travel to their health plans, he does not know of any large employers who have.

When I attended the 5th World Medical Tourism & Global Healthcare Congress in 2012, large employers such as Disney Institute, American Express, and Google sent representatives to speak at the Congress. If they attended, then surely their companies must be involved in some degree with medical travel? What did they discuss? Certainly not the weather (Hurricane Sandy was right outside the hotel).

But I digress, yet again.

According to Irving, six percent of firms offering fully-insured plans reported that they intend to self-insure because of the ACA. So, he is correct in that not many companies are self-insured.

However, Irving also states that it is estimated that the average self-funded plan covers between 300-400 employees, and that 59% of them in the US self-fund as part of their health plan.

And he goes on to say that many small companies are looking to self-fund to reduce their share of the cost burden, but that because small employers are not able to assume the same risk levels, stop loss rates are rising. This pressure, he adds will serve as a limitation on the expansion of self-funded health insurance into the smaller market.

Irving concludes that there are four reason why large self-insured companies would add an additional medical travel benefit to their insurance plans:

  • Current implementation of the ACA has distracted or absorbed attention of insurance markets, including self-insured companies. Many companies are wrestling with far issues of how many employees will be included/excluded, potential penalties, and avoiding fines under the ACA;
  • Self-insured plans are exempt from many of the more costly and burdensome requirements of the ACA as long as they don’t make significant changes, therefore they are careful about keeping their plans unchanged;
  • Reinsurance, or stop loss coverage may be limited for plans offering a medical travel benefit, and;
  • There is no history of outcomes , evidence or actuarial models to support the case among employers for a disruptive change such as international medical travel. Reports suggesting cost savings and quality outcomes are not yet supported by evidence.

One other factor Irving suggests as to why many employers have avoided medical travel is because many find it necessary to contract with a third party administrator (TPA) to collect premiums, manage membership enrollment, claims adjudication and payment. These TPA’s are sometimes referred to as providing “Administrative Services Only” contracts or “ASO” contracts, where they provide typical third party administration services, but assume no risk for claims payment.

Because of these contracts, Irving says that while economic logic suggests that self-funded employers should be interested in high quality, lower cost destinations, it is necessary to convince both the benefits manager and the TPA/ASO  of the value of being a destination provider, and the low risk associated with accessing international medical travel.

Okay, now it’s my turn.

“Impossible is just a big word thrown around by small men who find it easier to live in the world they’ve been given than to explore the power they have to change it. Impossible is not a fact. It’s an opinion. Impossible is not a declaration. It’s a dare. Impossible is potential. Impossible is temporary. Impossible is nothing.”

Muhammad Ali

While everything Irving wrote about appears to be factually true at the moment, and I cannot dispute what he says, the fact that employers have been unwilling to pursue medical travel is more complicated than the reasons he gives above.

True, the ACA has many things in it that may or may not seriously impact health care and the health insurance industry, but what he does not mention is that many of the things holding employers back pre-date the enactment of the ACA, and are more concerned with keeping health care the purview of those along the supply chain who profit the most from the system we have created, and not concerned with providing people either under health insurance or workers’ comp, with the best medical care possible, at the lowest cost, no matter where it comes from.

TPA’s and ASO’s and ERISA, and many other mechanisms such as stop loss insurance, and risk avoidance, etc., are mere barriers to the implementation of medical travel into both health care and workers’ comp.

Using my oft-time quoted analogy of going to the Moon, imagine if the baby steps we took to get there such as the Mercury, Gemini and early Apollo programs were not baby steps to the Moon, but actually barriers set up so that we are thwarted every step of the way to getting there or to go even further, such as landing humans on Mars. Don’t you think there would be people just like Irving who would say that it cannot happen?

That is why I quoted the late Muhammad Ali. For a poor black kid from Louisville, he sure had a better understanding of what can be than most folks who did not grow up like he did.

But this does not let the medical travel industry off the hook. I said so in my post, “Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is“.

But it is not just the industry itself that needs to come clean. Foreign governments and their travel ministries, the medical travel facilities, the providers, and the facilitators must present hard evidence that better quality and lower cost is possible, and so that when some of the dire predictions of the impact of the ACA are fully realized, or the US health care system collapses of its own weight (see my post, “Colorado “Single Payer” in Health Care Industry’s Sights“), medical travel as an alternative will become more acceptable to US employers, large and small, and not just for health care, but for workers’ comp as well.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

How Employers (and Medical Travel Facilitators) Can Deal With Zika

Teresa Bartlett, wrote last Friday in Insurance Thought Leadership.com about the precautions employers can take to avoid the Zika virus, and how to think about it.

She raises the following questions, and gives insightful answers:

  •  Where Is Zika Spreading?
  • What Are the Symptoms?
  • How Is Zika Treated?
  • What Special Precautions Should Be Taken by Pregnant Women?
  • What Should Employers Do?

The entire article can be read here.

Now that summer is almost upon us in the US, employers and those in other industries, like health care and medical travel, as well as the travel industry itself, should be fully aware of these facts.

Only time will tell before we have native cases of Zika here. You must be prepared.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Comp Blog is now viewed all over the world in over 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

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