Category Archives: complexity

Damned If You Do, Damned If You Don’t

“You can always count on Americans to do the right thing – after they’ve tried everything else.”

Winston Churchill

“Our policy is to create a national health service in order to ensure that everybody in the country irrespective of means, age, sex or occupation shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.

Winston Churchill

 

Veering away from the usual topics covered in this blog, I thought about some recent articles I saw about the attempt to repeal and replace, or to simply repeal the Affordable Care Act (ACA), which the current political regime wants to do.

The first article, in yesterday’s [failing] New York Times, warned that repealing the ACA would make it harder for people to retire early. Those who retire early, before reaching 65, can get retiree coverage from their former employers, but not many companies offer that coverage.

Those early retirees poor enough could turn to Medicaid, and everyone else would have to go to the individual market. Without the ACA, health care coverage would be more difficult to get, cost consumers more where available, and provide fewer benefits.

According to the article, if the ACA is repealed, retiring early would become less feasible for many Americans. This is called job-lock, or the need to maintain a job to get health insurance.

This is one of the concerns the ACA was supposed to address, in that it would reduce or eliminate job lock. Repealing the law could, according to the article, affect employment and retirement decisions.

The second article, from Joe Paduda, also from yesterday, reported that improving healthcare will hurt the economy, and Joe lays out the arguments for doing something or doing nothing to improve health care and what effect they would have on economic growth.

For example, Joe states that healthcare employs 15.5 million full time workers, or 1 out of every 9 job. In two years, this will surpass retail employment. As Joe rightly points out, those jobs are funded by employers and taxpayers. He suggests that some experts argue that healthcare is “crowding out” economic expansion in other sectors, thereby hurting growth overall.

But Joe also points out that by controlling health care costs, employment will be cut, and stock prices for pharmaceutical companies, margins for medical device firms, and bonuses at health plans will also be affected.

So, if cost control and increasing efficiency works, these lost jobs, reduced profits, and lower margins, Joe says, will hurt the economy. The economy will suffer if the health care sector is more efficient, and since healthcare is also a huge employment generator and an inefficient industry, fixing that inefficiency will reduce employment and growth.

Thus, the title of this article, “Damned if you do, damned if you don’t.”

But wait, there’s more.

Yesterday, a certain quote has been making the rounds through the media. It was uttered by Number 45. “Nobody knew health care could be so complicated.”

Yes, it is complicated and complex, but does it have to be so? If we consider the second Churchill quote above, and realize that the UK, France, Germany, Canada, and many other Western countries have some form of single payer, then one must conclude that it is only the US that has complicated and made too complex, the providing of health care to all of its citizens.

There are many reasons for this, which is beyond the scope of this article or blog, but there is one overriding reason for this complexity…GREED. Not the greed of wanting more of one thing, but the greed of profit, as one executive from an insurance company stated recently.

This brings me to the last of the articles I ran across yesterday. It was posted on LinkedIn by Dave Chase, founder of the Health Rosetta Institute. He cited a segment on the Fox News Channel’s Tucker Carlson program, in which Carlson interviewed a former hospital president who said that pricing was the main problem with the US healthcare system.

Mr. Chase does not solely rely on Carlson’s guest in his article, but cites other experts in the field as evidence that pricing failure is to blame.

If we are to except this as true, then it buttresses my point that the overriding problem is greed, for what else is the failure to control prices but a symptom of greed inherent in the American health care system, and something that does not exist elsewhere in the Western world.

Which brings me to Churchill’s first quote above. Since we Americans have tried the free market system of health care wanting, and have tried a reformed free market system, perhaps it is time to go all the way to a government-sponsored, Medicare for All, single payer system.

The bottom line is: we’re damned if we do, damned if we don’t. The question is, which is the lesser of two evils.

UPDATE: Here is Joe’s take on what will happen to the ACA in the next two years. I agree with his assessment.

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Models, Models, Have We Got Models!

FierceHealthcare.com today reported that CMS (those lovely folks with all them rules), launched three new policies Tuesday that continue the push toward value-based care, rewarding hospitals that work with physicians and other providers to avoid complications, prevent readmissions and speed recovery.

The newly finalized policies are meant to improve cardiac and orthopedic care, and also create an accountable care organization (ACO) track for small practices, according to the report.

There will be three new cardiac care payment models for hospitals and clinicians who treat patients  for heart attacks, heart surgery to bypass blocked coronary arteries, or cardiac rehabilitation following a heart attack or heart surgery.

Federal officials said that the cost of their care…varied by 50% across hospitals and the share of patients readmitted to the hospital within 30 days also varied by 50%. Medicare, the article points out, spent more than $6 billion in 2014 for care provided to 200,000 Medicare patients who were hospitalized for heart attack treatment or underwent bypass surgery.

As for orthopedic care, the new payment model is for physicians and hospitals that provide care to patients who receive surgery after a hip fracture, other than hip replacement.

They also finalized updates to the Comprehensive Care for Joint Replacement Model, which began earlier this year.

So far, that’s three models. But wait, there are more where those came from.

There’s the new Medicare ACO Track 1+ Model, that has a more limited downside risk than other tracks in the Medicare Shared Savings Program (another model I discussed a while back in the post, “Shared Savings ACO Program reaps the most for Primary-care Physicians“).

These new five-year models provide clinicians with other ways to qualify for a 5% incentive payment through the Advanced Alternative Payment Model (APM) path under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Quality Payment Program. (three more models — so many, in fact, I am losing count)

Why am I pointing out the problem with the release of new payment models?

I’ll tell you why. When I began my MHA (Masters in Health Administration) degree program, I took an online elective on Healthcare Quality. The textbook we read discussed how CMS over a period of several decades, created and instituted so many models and programs, that it made me wonder why our health care system was so complex, expensive and so out of whack compared to health care systems of other industrialized countries.

The answer was simple. Too many models, programs, rules, and so on that only gum up the works and make real reform not only impossible, but even more remote a possibility as more of these inane models are added to what is already a broken system.

Winston Churchill said that you can always count on Americans to do the right thing, after all the other things were tried. We are still on the trying part, and I am afraid we will never get to where Sir Winston said we would.

 

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.

Healthcare CEO’s Reject Single-Payer

There are many reasons why the US is the only industrialized nation that does not have a single payer health care system.

One deep seated reason has to do with the foundational value system of the US, from the time of the early settlers whose religious convictions lined up with the rising middle class of 17th century England’s economic values (i.e., the Protestant Ethic).

But another reason — at least for the foreseeable future — as my fellow blogger, Joe Paduda wrote a while back when talking about Bernie Sanders’ plan, is that the health insurance industry will not blow up their businesses and start all over from scratch.

To prove Joe’s point, Modern Healthcare.com published an article last week that explored the opinions of healthcare CEO’s on the ACA and the subject of single-payer health care.

Here are the key takeaways from the article:

  • the nation’s top healthcare leaders overwhelmingly back the ACA
  • support its goal of pushing providers away from fee-for-service medicine and toward delivering value-based care
  • while the Republican Party and its presumptive nominee continue to stand by their “repeal and replace” slogan, the sector’s CEOs overwhelmingly reject that idea, in large part because they are unimpressed with the GOP’s attempts to articulate what it would replace it with.
  • only a small group supports moving to a single-payer system, which has been a central theme of Democratic presidential candidate Bernie Sanders
  • The overwhelming message from the survey, was that the next president and Congress should stay the course set by President Barack Obama and the ACA.
  • But healthcare leaders are also looking for the nation’s political leadership to reject complacency and look for ways to improve what they see as a far-from-perfect piece of legislation.

Here are the survey results, as published today by Don McCanne of PNHP:

The CEO Power Panel includes 110 top leaders of hospitals, insurance companies, physician groups, trade associations and other not-for-profit advocacy groups. The second-quarter survey on policy options that the next president and Congress might address attracted 86 respondents, a 78% response rate.

Future of ACA

Do you support Congress and the next president in:

Repealing and replacing the Affordable Care Act?

2.3% – Yes

67.4% – No

29.1% – It depends on the details

1.2% – No opinion

Expanding the ACA’s subsidized private insurance plan system to achieve universal coverage?

34.9% – Yes

15.1% – No

48.8% – It depends on the details

1.2% – No opinion

Scrapping private insurance in favor of expanding an enhanced Medicare to cover the entire population (single payer)?

9.3% – Yes

61.6% – No

29.1% – It depends on the details

Other insurance issues

Allowing private insurers to sell individual and family policies across state lines under national rules that preempt state rules?

52.3% – Yes

20.9% – No

24.4% – It depends on the details

2.3% – No opinion

Expanding the use of health savings accounts to pay premiums and meet costs under high-deductible plans?

74.4% – Yes

11.6% – No

12.8% – It depends on the details

1.2% – No opinion

Creating subsidized high-risk pools to cover people with preexisting conditions?

43.0% – Yes

16.3% – No

36.1% – It depends on the details

4.7% – No opinion

Medicare

Raising Medicare eligibility to age 67?

54.7% – Yes

23.3% – No

22.1% – It depends on the details

Expanding means testing within Medicare, such as higher co-pays or reduced benefits for high-income seniors?

50.0% – Yes

18.6% – No

30.2% – It depends on the details

1.2% – No opinion

Moving to a universal Medicare Advantage system with a means-tested defined contribution (premium support) for seniors?

28.2% – Yes

20.0% – No

48.2% – It depends on the details

3.5% – No opinion

Gradually expanding Medicare to cover everyone over age 55 who doesn’t have private insurance?

21.4% – Yes

48.8% – No

28.6% – It depends on the details

1.2% – No opinion

Delivery system reform

Taking aggressive measures to curb rising prescription drug prices such as allowing imports and authorizing the CMS to negotiate prices?

70.6& – Yes

9.4% – No

20.0% – It depends on the details

Repealing delivery system reforms such as value-based payment, accountable care organizations and the use of quality measures included in the Affordable Care Act?

03.5% – Yes

83.5% – No

11.8% – It depends on the details

01.2% – No opinion

So, it is apparent that as long as the health care industry continues to profit from the status quo, and supports the ACA, the likelihood of single payer will be remote at best, despite what the Sanders’ campaign seeks.

Things will only change when the entire system collapses of its own weight from complexity, waste, fraud, abuse, and excessive cost so that no CEO’s opinion will matter. People will demand a single payer system because no one will be able to afford having insurance.

The ancient Greeks, among other people, discovered the science of dialectics, or the study of change. Dialectics says that the seeds of change come from within, and that change does not happen until certain conditions are met, and change becomes inevitable. We are not yet at that point, but it is slowly moving in that direction.


 

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.

The Technological Revolution and Health Care: On the Same Track?

Yesterday, I ran across an interview on Truthout.com by Mark Karlin. Mr. Karlin was interviewing the two authors of a new book, People Get Ready, by Robert W. Mc Chesney and John Nichols.

Mr. Karlin’s first question, answered by Mr. Mc Chesney, intrigued me and got me thinking of what is happening in workers’ comp, as well as what is happening in health care.

As I mentioned briefly in my last post, automation and artificial intelligence will have a significant impact on the future of workers’ comp, and this is emphasized in Mc Chesney and Nichols’ book. There have been other books and articles recently on the subject, so this is nothing new.

But what got me thinking is that Mr. Karlin addressed the main question the book raises — namely that the conventional wisdom has always been that the more advanced technology becomes, the more beneficial it will be for humans.

Mr. Mc Chesney responded that convention wisdom said that new technologies will disrupt and eliminate many jobs and industries, and that they would be replaced by newer industries and better jobs.

Mc Chesney also said that they argue the idea that technology will create a new job to replace an old one is no longer operative; nor that the new job will be better than the old one.

According to Mr. Mc Chesney:

Capitalism is in a period of prolonged and arguably indefinite stagnation. There is immense unemployment and underemployment of workers, which we document in the book, taken from entirely uncontroversial data sources. There is downward pressure on wages and working conditions, which results is growing and grotesque inequality. Workers have less security and are far more precarious today than they were a generation ago; for workers under the age of 30, it is a nightmare compared to what I experienced in the 1970s.”

Likewise, Mr. Mc Chesney, continued:

there is an immense amount of “unemployed” capital; i.e. wealthy individuals and US corporations are holding around $2 trillion in cash for which they cannot find attractive investments. There is simply insufficient consumer demand for firms to risk additional capital investment. The only place that demand can come from is by shifting money from the rich to the poor and/or by aggressively increasing government spending, and those options are politically off-limits, except to jack up military spending, which is already absurdly and obscenely high.

Contemporary capitalism is increasingly seeing profits generated, he adds, not by its fairy tales of entrepreneurs creating new jobs satisfying consumer needs, (remember Mitt Romney’s ‘job creator’ line of bs?) — but by monopolies, corruption and by privatizing public services.

Finally, Mr. Mc Chesney states that:

Capitalism as we know it is a very bad fit for the technological revolution we are beginning to experience. We desperately need a new economy, one that is not capitalistic — based on the mindless and endless pursuit of maximum profit — or one where capitalism has been radically reformed, more than ever before in its history. It is the central political challenge of our times.

They are not the only ones arguing for such reform or revolution, Senator Sanders notwithstanding. In previous posts, I have mentioned the biopsychosocial theory, Spiral Dynamics, and the book by Said W. Dawlabani, MEMEnomics The Next-Generation Economic System.

Other authors such as Richard Wolff, and Robert Reich have written books about this subject, and like Mc Chesney and Nichols have reached similar conclusions. Yet, Dawlabani, accessing the Spiral Dynamics model, goes much deeper into why we got here and what we need to do to get out of it.

Such a future version of capitalism has been called by many different names that I have come across in the past decade or so. Natural Capitalism, conscious capitalism, and so on, to name a few. But the main point is as Mc Chesney and Nichols points out in their book, the technological revolution, rather than liberating humans and making our lives better, as Mc Chesney says in the interview, may have the perverse effect of reinforcing its stagnating tendency.

An issue related to automation and artificial intelligence and its impact on the future of work, is if we are all replaced by machines and software, how will people be able to live? How will the goods and services produced by automation be sold, and to whom? Only those who are fortunate to have employment in jobs that machines cannot do? Or will we have to go back to a time when money was only the purview of those who had it?

The answer to these questions have also been raised by those in the tech world, and one suggestion they have come up with is a national basic income (NBI), and naturally has already been shot down as a bad idea by those on the Right. I guess they really want people to be poor.

But this idea should be kept on the back burner for now, as given the political climate in this country, that idea will be dead on arrival. Yet, while many have acknowledged what Mc Chesney, Nichols and others have said is happening, the other side — namely the current Speaker of the House and others in his party, have doubled down on their stubborn adherence to the rantings of a two-bit novelist, Ayn Rand and Ayn Randism.

Which brings me to the other point I wish to discuss, and that bears on what happens in the overall economy at large.

If automation and artificial intelligence will lead to elimination of many, if not all jobs, and if that will require a new economy as Mc Chesney and Nichols, and others have argued, what does that mean for the health care industry that seems to be going in the opposite direction?

Even before the enactment of the ACA, health care has become more centralized, bureaucratic, consolidated and more profit-driven than ever. The ACA in many ways has accelerated this process, and the direction it is headed is towards a more consumer-driven form of health care, and one where large hospital systems have integrated physicians and insurance services into their business plan.

The move among some physicians and physician practices towards concierge medicine, also is a sign that health care is moving towards a more capitalistic health care, in that it creates two classes — those who can afford concierge medicine, and those who cannot.

The transition to a new economy will not happen overnight, and may not happen for some time, especially if the forces aligned against it remain strongly opposed to reform. But if the health care system collapses, as I mentioned previously in articles last week, then along with the stagnation of capitalism generally, there will be an opportunity to move in that direction in health care as well.

Calling for ‘Medicare for All’ now with firm opposition to anything that spends government money or has a social benefit other than producing profit for a few, is only a waste of time and a con job.

There are only two ways an economic system and its attendant political system changes; by revolution or evolution. One is violent and bloody, the other happens because the old is replaced by the new so seamlessly that no one gets too emotional when it happens. An election does not do that, especially when the opposition is headed toward fascism.

That issue is for another time and place, and the rest of Mc Chesney and Nichols’ book discusses the current presidential campaign. I wanted to discuss the dichotomy between where capitalism is headed and where health care is headed, and at some point, health care will have to fall in line with the new capitalism.


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’ Blog is now viewed all over the world in 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.

Fourteen Hundred Plus Pages – For One Rule???

Health Affairs blog author, Sara Rosenbaum wrote an article today about the final rule for Medicaid that was released back on April 25th.

What immediately jumped out at me was the length of the rule — 1,452 pages. That’s right, fourteen hundred and fifty-two pages for one lousy rule.

Those of you who read my post from last Friday, “A Simple Friday Morning Health Care Philippic – (With Apologies to Simon & Garfunkle)”, will remember that I called our health care system, “more complex, confusing, bureaucratic, wasteful, idiotic, and expensive.”

I also said that it “is so top-heavy, so convoluted, and so complex that the sheer weight of its rules, regulations, laws, programs and models will cause it to collapse.”

At fourteen hundred and fifty-two pages, that is a lot of weight. Added to all the other rules, regulations, models, programs and whatnot, you’d need a forklift just to put it into a law library, or at best, have it craned in before the roof goes on.

I know War and Peace is a big slog through, but we are talking about health care here, not a fictionalized account of the Napoleonic Wars.

DOES ANYBODY ELSE THINK THAT 1,425 PAGES FOR ONE RULE IS OVERKILL? AND WHY IS THAT NECESSARY? CAN’T WE HAVE A SIMPLE, SHORT FINAL RULE THAT DOES NOT QUALIFY AS ‘GYM EQUIPMENT’?

If you don’t know why our health care system is so bad, one look at this bound rule will convince you that we have gotten out of hand with something that should be basic and simple…providing every American access to health care, and not lining the pockets of paper makers, ink makers, book printers, binders and the poor schlub who has to carry these rules to wherever these things are held.

And we are also lining the pockets of physicians, lawyers and other stakeholders whose grubby little hands (must be relatives of Trump) are in every nook and cranny of the system.


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’ Blog is now viewed all over the world in 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.