Category Archives: Congress

Disaster Averted

Yesterday’s crushing defeat of the so-called “American Health Care Act” or AHCA, signals the end of the seven-year long attempt by the Republican Party to legislatively kill the Affordable Care Act (ACA).

Yet, as was pointed out on one cable news network last night, it won’t stop the health insurance industry from getting the Republicans in Congress to kill parts of the law slowly by eliminating the taxes that go to pay for the coverage.

Call it “genocide by stealth”, since millions of Americans will die, as per the Congressional Budget Office (CBO’s) scoring of AHCA. If they can’t kill the law outright, the so-called “Freedom Caucus”, actually the Congressional version of the Tea Party, will kill it slowly.

Why do you think they keep saying it is a disaster and it is crumbling? It’s because they are dead set against anyone getting health care unless someone else can make a profit from selling a policy.

Then there is the other question, the one usually raised by liberals and progressives, especially those who supported Vermont Senator Bernie Sanders last year in the primaries, as to why we are the only Western country without universal coverage.

The answer is complex, but not complicated (“who knew health care was so complicated?). First, everything the government of the US has ever implemented for the benefit of people has had to pass muster with the Constitution. It either has to be covered by the Constitution directly, or implied through the taxing mechanism.

Second, the Founding Fathers never mentioned or promoted the right to health care, as the prevailing political and social philosophy of the day was concerned with freedom, liberty, and private property. It has been unclear what, if anything, was meant by the phrase, “life, liberty, and the pursuit of happiness”, let alone, the phrase, “promote the general welfare.”

Why they never mentioned health care and why other nations have it, is due to the fact that the US was founded during the first half of the period historians call, “the Enlightenment”, when the right to private property, liberty, and freedom were the topics of discussion on both sides of the Atlantic. Basically, the difference between Classical Liberalism (Conservatism) and Modern Liberalism (Liberalism) is between negative rights (the right not to be killed) versus positive rights (the right to a job, education, housing, health care, etc.)

Canada gained its limited independence from Britain nearly a hundred years after we did, and therefore was influenced by the philosophy of the second half of the Enlightenment, which stressed involvement by government in the economy.

The only time the Founders cared about providing some kind of health care plan was directed towards a particular group of citizens in the late eighteenth century, as I wrote about in this post.

What is now called the Public Health Service began as a government-sponsored, health plan for merchant sailors on ships entering and leaving US ports and on inland waterways. It was never challenged in the Supreme Court as unconstitutional, nor was it ever attacked by members of the opposition party. In fact, it was supported by both Federalists and Anti-Federalist politicians of the day.

The third reason why we don’t have universal, single-payer is because the government allowed employers to provide coverage during WWII to attract women into the workplace when the men went overseas. The UK is often cited as an example for single-payer, but what most supporters of this type of plan do not realize is that because of the devastation the UK suffered at the hands of German bombs, their health care system needed to be re-built from scratch, so the government stepped in with the NHS. Even Churchill supported it.

Fourth, we have always provided health care to certain at risk groups like the poor (Medicaid), the elderly (Medicare), and to children (CHIP), as well as to former service persons and their families (Tricare), etc. Perhaps the way to begin to get universal coverage is to merge all of these programs into one, then expand it to cover everyone else.

But for the time being, a major disaster was averted, but we should not think this is the end of the debate, nor is there victory. The battle lines are drawn, and the enemy is not surrendering. This is not a time for congratulation, but for vigilance and resolve.

 

All Quiet on the Medical Tourism Front

It’s been a while since I posted anything on medical travel, so you will forgive me for taking liberties with the title of Erich Maria Remarque’s novel about the First World War.

I guess the lull can be attributed to the shock of realizing that the current occupant of the White House is totally unfit and may be reckless, so the world is holding its collective breath to see what happens.

Or, it could be that you are waiting for the other shoe to drop, and by that, I mean, what will happen to the Affordable Care Act now that he has signed an executive order to dismantle it.

This much we do know. What we don’t know is will the Republicans in Congress repeal it completely, or will they replace parts of it. And what does you-know-who want? Canadian-style health care, as some have suggested he favors? And we also know that his nominee for Health and Human Services is against the ACA, and the Speaker of the House wants to kill Medicare and Medicaid.

Your guess is as good as mine. But whatever happens, it is certain that the industry needs to be prepared, because once people lose their coverage, they will need alternatives to high cost medical care here.

A total repeal would be catastrophic for health care in this country. Replacing it with something worse will also be bad for the health care industry, but may offer a way for medical travel to finally get a hearing with the American people, at least those who can afford to go abroad after losing their ACA coverage.

Those covered under Medicaid when their states expanded coverage will be the ones to lose the most, since they are the poorest and sickest. Those who purchased coverage through the exchanges and paid lower premiums than those who paid higher premiums, may be right for medical travel, if the industry goes after them.

Predictions are that should the ACA be repealed, premiums for everyone will go up. So, it is imperative that the industry be ready, willing, and able to handle the influx of new patients, and not just for boutique procedures and expensive treatments.

I said this once before, and I will say it again, the market will not come to you; you must go to the market. You must show Americans that there is an alternative to high cost care in the US, and for obvious reasons, only those locations within a three-hour flight will be possible.

BTW, if any of you need someone to work on a project for medical travel between the US and your country, let me know. You know me by now, so don’t be a stranger.

I’m Back

To quote Michael Corleone, in the Godfather, Part III, “just when I thought I was out…they pull me back in.” To blogging again, that is; not joining the Mob.

There is so much to catch up on in my absence, that I decided to apprise you, my loyal readers, of a subject I discussed earlier this year, the proposed Amendment 69 in the state of Colorado.

To refresh your memories, Amendment 69 (couldn’t they come up with another number?), also called “ColoradoCare”, was an attempt to create a single-payer system in the Rockies.

My previous three posts, “Colorado Gets Real on Workers’ Comp and Health Care”, “Colorado “Single Payer” in Health Care Industry’s Sights”, and “A Little Disruption is a Good Thing” outlined the plan for single-payer, the opposition to single-payer from the health care industry, and how it would be a good thing to have some disruption, especially in workers’ comp.

My writing on the subject also got the notice of a fellow writer, Katie Kuehner-Hebert, of Workers Comp Forum, a sister publication of Risk & Insurance magazine. Her article discussed whether the proposed amendment would be helpful or harmful for workers’ comp payers.

Last month, the voters in Colorado defeated the measure by a wide margin. On election night, at 8:30 p.m., with nearly 1.8 million votes counted across the state, the amendment was trailing 79.6% to 20.4%. Vote totals at 7 a.m., the next morning, with 86 percent of the vote counted, the measure continued trailing at roughly the same percentage or 1,833,879 to 467,424.

As reported in the Denver Post by John Ingold, throughout the campaign, the measure had polled better with Democrats than Republicans, and even in left-leaning Denver, the amendment lost by 2-to-1.

What does the defeat of the single-payer measure mean for the future of health care and possibly workers’ comp?

It means that until there is a nation-wide push for single-payer, state-specific measures such as Amendment 69 will either go down to defeat, or be scraped altogether, as happened in Bernie Sanders’ home state of Vermont. Amendment 69 was an attempt to get there, but as I followed up some weeks later, it was targeted by the health care industry, and never had a chance.

That brings me to my next topic. The recent political campaign that witnessed a misogynistic, egomaniacal, sexist, racist, Corporatist/Fascist bully and demagogue elected president, and a Congress of like-minded semi-demagogues.

Now this capitalist clown is appointing men to his cabinet who stand in opposition to many things the American people believe in, and one man, Representative Tom Price, R-GA , an ardent opponent of the ACA, is to be Secretary of the Department of Health and Human Services, the department which oversees the Centers for Medicare and Medicaid Services (CMS), who makes the rules for the health care law and the other medical insurance programs of the government.

Folks, that’s like putting the fox in charge of the hen house. Sooner or later, the chickens are going to be devoured, except it won’t be dead chickens lying around, but millions of Americans who will lose their health care newly won, and who may die because of it.

We still don’t know what will happen to the ACA after January 20th, because that man refuses to release his tax returns, refuses to commit to anything and goes off on tirades on Twitter to anyone who gets in his way. But I believe that this idiot and Congress will take away not only health care for millions, but eliminate Medicare and Medicaid, which is what Speaker Paul Ryan wants to do, but may be forced to back down once opposition gets wind of it.

Either way, health care in this country will get worse, not better.

That moron soon to occupy the White House has even nominated the CEO of a fast food chain to be Secretary of Labor. This guy, Andy Pudzer (or is it Putzer?, or just plain Putz?) wants to replace fast food workers with robots. Methinks he is one.

True, by 2025, it is predicted that 50% of all occupations will be replaced by automation, but the reason Pudzer wants to replace fast food workers with robots is so that the companies won’t have to pay living wages of $15 an hour to their workers.

I guess this putz would like to see workers thrown out into the street, especially younger minority workers who generally take these jobs to give themselves some work experience, and older workers left out of the changing economy.

You know what 50% less workers mean for workers’ comp? 50% less claims adjusters, physical therapists, durable medical equipment companies, pharmacy benefit management personnel, etc.

It also means that there will be more unease, anger, and maybe even violence. The kind of violence that has been avoided for decades, and that was predicted more than one hundred and fifty years ago by a certain German writer. And what if that 50% goes to 75%? What then?

One idea is to give these permanently unemployed a universal basic income (UBI), but with this Congress, that too will not happen.

There is an old Chinese curse that is appropriate now: “May you live in interesting times.” Interesting, possibly; dangerous, most definitely.

Tracking Poll Highlights Americans Views on Health Care Issues

The Kaiser Family Foundation released its Health Tracking Poll for August 2016.

The issues polled ranged from the ACA to Medicare and to Zika funding, as well as travelling to areas of Florida where Zika was found (would that I could leave this overdeveloped, bug infested, alligator crawling and now disease-ridden swamp).

Sorry, Rick Scott…Florida is not in a good place right now, thanks to your lousy leadership.

Here are the findings from the poll:

  • Two-thirds of voters say the future of Medicare and access and affordability of health care are top priorities for the candidates to be talking about during the 2016 presidential campaign.
  • More voters trust Hillary Clinton to do a better job dealing with health care issues than trust Donald Trump, although few believe their own ability to access affordable health care would get better regardless of which candidate is elected. Voters, age 65 and older, are split between which candidate they trust to do a better job dealing with the future of Medicare with a similar share saying they trust Trump (44 percent) as say they trust Clinton (47 percent).
  • Almost all Americans have heard or read about the Zika virus (92 percent), and one-third (36 percent) say that passing new funding to deal with the outbreak in the U.S. should be a top priority for Congress, with an additional 40 percent saying it should be an important but not a top priority. A large majority of all partisans say that new Congressional funding should be at least an important priority for Congress.
  • About half of the public says they would not feel comfortable traveling to places like parts of Florida where people have been infected with the Zika virus by mosquitoes. In addition, three-fourths (77 percent) say these places are generally unsafe for pregnant women. The Kaiser Family Foundation has been tracking public opinion on Zika since February 2016; for more poll results, visit the up-to-date Zika slideshow.
  • About half of Americans are concerned that an unauthorized person might get access to their confidential records and information; despite this, 80 percent say it is important that their doctors use online medical records.
  • Americans’ opinion of the health care law remains split, with 40 percent saying they have a favorable view and 42 percent saying they have an unfavorable view.

More Info on Zika – Puerto Rico

From Elizabeth Ziemba, here is a link to a report on CNBC.COM about Zika and Puerto Rico:

http://www.cnbc.com/2016/04/29/first-us-zika-death-reported-in-puerto-rico.html?__source=xfinity%7Cheadline&par=xfinity

And our wonderful morons in Congress are holding on to the money to fight this disease like a sphincter muscle trying to hold it in.

My one wish is that the Aedes mosquito would get past the security at the Capitol and bite every GOP politician, House or Senate on the behind. And since they have small brains already, it would only mean we would have to use an electron microscope to find theirs once infected with Zika.

They don’t want to bail out Puerto Rico, and now they want them to die of a horrible disease along with those who already are infected. Way to go!


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.

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