Category Archives: Europe

Disgusted!

I want to take a break from writing about medical travel, health care and workers’ comp, and address my comments to my many readers around the world from Africa, Asia, Europe, and Latin America and the Caribbean.

As a second-generation American, whose paternal grandparents arrived here from Russia more than a century ago, and whose maternal grandparents also arrived from Russia (they both held Polish passports when they emigrated) almost a hundred years ago, 1921 and 1923, respectively, I am disgusted, angry, and outraged that the Chief Executive of my country is an outright racist and bigot.

I am only glad that my parents, the children of my aforementioned grandparents did not live to see this asshole either become President, or was unable to understand that he was President due to suffering from Alzheimer’s.

I, like this moron, was born and grew up in New York City, having been born in Brooklyn, and lived in two different neighborhoods that had diverse populations. I also lived on NY’s Long Island, and while my town was less diverse than my previous residences; nevertheless, the proximity of New York City to where I lived, went to school and worked meant that I was never too far away from people of different cultures, ethnicities, racial makeups, and religions. When I had the chance, I always visited the United Nations and felt a great deal of joy knowing that such an organization, as flawed as the world is, existed and that my hometown was its headquarters.

On September 11, 2001, I was more than a thousand miles from NY when the planes struck the two towers, places I had spent time in during my early working life. In point of fact, I was driving to work in Houston, Texas when the first plane struck, and was listening to the local classical radio station on my car’s radio, The news came on at 8 am, local time, and the announcer said a plane had struck the World Trade Center. My first thought was terrorism, but I soon realized that many small planes fly up and down the Hudson, and that perhaps this is what happened.

When I arrived at my office, because we had very little work to do, and because we were all new, I took a brief nap, and when I went out into the hallway of my floor, I was told to go upstairs to the break room and watch the newscast on television. When I arrived in the break room, the first tower collapsed, and this boy from New York City saw my hometown under attack.

I never lashed out at an entire group of people, but knew immediately and from what the reporters were saying, that this was the work of Al Qaeda and Osama bin Laden. But I will tell you what I did see on television. I saw people in the West Bank cheering the attacks, not people in Jersey City, like the current occupant of the Oval Office has claimed he saw.

In fact, one of my high school alumna was interviewed on television, and has been on American television and written of in the New York Times many times. She came to the US from India and is a Muslim woman, married to the Iman who wanted to build a cultural center near the WTC. Our yearbook pictures are diagonally opposite each other in our school’s yearbook, and she was very friendly with a neighbor, whose brother was responsible for the biggest financial disaster of the last decade.

There have been American presidents of this person’s party who I did not vote for, or agree with, but at no time in my life, or that of my parents and grandparents, did they have to feel ashamed, disgusted, and incensed at the blatant racism, sexism, homophobia, crudeness, and Antisemitism of any of them, including FDR, who many have accused as not doing enough to save the six million Jews who perished in the Holocaust, including my maternal grandfather’s older brother, his wife and six children.

So I say to you, my dear and devoted readers around this wonderful world of ours, I am sorry if this idiot offends you, your country, your race, ethnicity, religion or culture. He does not speak for me, nor does he speak with the vast number of Americans who feel like I do. We, the American people, apologize. It is our fault, and our fault alone.

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An Open Letter to the Medical Tourism Industry

Dear Medical Tourism Industry,

I am writing you all to address some issues I am having with the industry on the occasion of my having past my five year anniversary writing this blog, and nearing another milestone, that of publishing 400 articles. At present, I am at 396.

For the past few weeks, I have noticed on the social media site, LinkedIn that some of my connections in the industry have been attending conferences around the world, and more recently, I have replied that I wished I was there and posted a recent post with the message to advertise my willingness to collaborate, or attend such conferences.

With the exception of one person this evening, not one person has responded positively, nor in the past five years has anyone other than one person invited me to speak at a conference, and that was three years ago in Mexico. The other two conferences I attended were here in Florida; one in Miami Beach, the other in Hollywood, Florida. The first in 2014, the second in 2012, and was the reason why I started writing my blog three days after it ended.

My intention then, as now, was to transition into a new career path, so that I could be employed and enjoy the things other people enjoy, and see the world before I am unable to. But In the past five years, while I have connected with practically all the major players in the industry, defended the industry in numerous posts, and even been critical of the industry at times; no one, not here in the US, nor anyone in Latin America or the Caribbean has invited me to a conference or a fam tour, nor to any other part of the world that is not part of some current conflict.

Recently, an American filmmaker had the premier of her film on medical travel on American television, on what we call the “Public Broadcasting System”. or PBS. I missed most of it, but was able to see two names in the credits that I recognized. One person I met in Miami Beach in 2014,  the other I am connected with on LinkedIn, but have never met. I tried to contact the filmmaker, but when she did not respond, I contacted my connection, who told me she was leery about responding because I had had an association with an organization we all know, but do not like that purports to represent the industry. He had to tell her that I am legitimate.

Folks, after five years of writing, and six, almost seven, of researching the industry, and being viewed on every major continent, you would think that many of you would know that I am honest, sincere, and definitely a legitimate advocate for medical travel.

Last week, I discovered that there was a conference in Dusseldorf, Germany, and today, I learned that one of my other connections, who I did meet in Reynosa in 2014. was invited to a conference in China. What does it take to be taken seriously and given the respect and courtesy of being invited to attend these functions after all this time?

I began my work in 2011. This coming March will be seven years since I wrote my White Paper. The paper is on my blog. My articles, even those covering Workers’ Comp and Health Care have not generated many views on a daily basis, save for a few here and there. I admit, they all cannot be prize winners, but at least I am persistent. Yet, I am not making headway with the industry, nor am I getting any compensation for writing,

I don’t want to sound like I am complaining, but I feel that after all this time, it is wrong for me to be ignored. I have committed long hours of my time and my life to this industry, even as my health over the summer was an issue. I am not out of the woods yet, but I am doing ok, and with the proper treatment, and eventual surgery, I should be healthy in the future, and can travel until such time, as long as I have more than two weeks notice.

In the beginning of my blog writing, I added a section where I asked readers to tell me where they are from and who they were. No one responded, so I stopped the practice. I still would like to hear from you, but after reading this letter, I hope you will do more than just dropping me a note.

I am waiting to meet you and to participate in future conferences.

Sincerely,

Richard Krasner, MA, MHA

Map shows countries to date where my blog has been viewed.

The Economist Explains it All: What the U.S, Needs to Do With Health Care

Thursday’s The Economist had the following article.

It explains what the U.S. needs to do to fix health care.

Our leaders in Congress, both Democrats, and especially Republicans should listen to what it has to say.

Medicare for All is not socialism, socialized medicine, or communism. But the status quo is health care capitalism, and has been a disaster.

Top 10 Orthopedic Hospitals by Procedure

Last year, Christmas Eve, to be exact, I wrote a short post about the top ten hospitals for total knee replacement under $50,000.

This year, I’d like to expand on that and discuss the top ten orthopedic hospitals outside of the US for such procedures as Arthroscopy (knee or shoulder), Disc Replacement, and Rotator Cuff Repair.

The website I linked to in my post last year, Archimedicx.com, is the same website I used now to illustrate the difference between costs in the US and elsewhere in the world.

This website is by no means the definitive source of such information. There are other websites that provide similar prices and are only ballpark figures, not actual quotes, or firm prices. Archimedicx’s website will give you a quote once you have chosen from among a list of hospitals you searched for, depending on what procedure you want to have.

I have limited the discussion here to only the three I mentioned above, as arthroscopic procedures for both knees and shoulders, resulted in the same hospitals being displayed.

The price range column indicates those hospitals who charge the amount stated or less, as the website allows an individual to choose the price range they want.

In the table below, the quality score is the ranking algorithm that generates a unique quality score for each procedure in each analyzed hospital (on a scale of 1 to 5). For the sake of clarification, a certain hospital can have different quality scores, depending on the procedure or treatment in question.

 

Table – Top Ten Orthopedic Hospitals by Procedure

top-ten-ortho-hosp

For each procedure examined, there were at least a few hundred other hospitals that one could look at, but I only wanted the top ten, as you see, ranked by quality scores. There are no doubt other hospitals on the website that may score better on other websites, or can provide these procedures for far less than they do.

The idea here is to point out that the US is more expensive than others, and as the following chart shows, we are dead last in terms of care.

nhs-best-system

But it is sad that Americans do not realize this and do what the other countries in that chart have done, provide health care to all.

It is also sad that our system for treating on the job injuries also does not allow people to seek medical care outside of their states or the country. Only two states do that, Washington, and Oregon, but as I’ve said before, there have been exceptions.

Now with a new administration seeking to destroy the social safety net and the ACA, we may see more case shifting and more crowded ER’s and not enough medical personnel to treat them.

And for what?  The commodification of health care for those who can afford it, and for the profit of those who pay for it.

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.

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Colorado “Single Payer” in Health Care Industry’s Sights

Earlier this month, I wrote that Colorado was introducing a ballot initiative for single payer.

As reported today by Don McCanne of Physicians for a National Health Plan, and published on Friday in The Intercept, business interests in Colorado and many of the largest lobbying groups around the country and in the state are raising funds to defeat Amendment 69, the single-payer ballot question going before voters this November.

One organization leading the move to defeat this amendment is the Council of Insurance Agents & Brokers, a national trade group.

As quoted in the article by the author, Lee Fang, “The council urges Coloradans to protect employer-provided insurance and oppose Proposition 69.

The group has dispatched Steptoe & Johnson, a lobbying firm to analyze the bill.

Other lobbying groups that represent major for-profit health care interests in Colorado, including hospitals and insurance brokers, Fang writes, are similarly mobilizing against Amendment 69.

The Colorado Association of Commerce & Industry, a trade group led in part by HCA HealthOne, a subsidiary of HCA, one of the largest private hospital chains in the country is soliciting funds to defeat single payer. The business coalition to defeat the measure also includes the state’s largest association of health insurance brokers, Fang reported.

Dr. McCanne wrote in response to the Fang article that, “In the meantime, the opponents know that their task does not involve educating the public on the facts. They do not have to engage the other side in a information battle over the truth. They merely have to appeal to the passion of the voters. Simple rhetorical soundbites are usually enough to convince the voters that they do not have to waste their time studying some complicated government scheme in order to know how to vote on it. Just look at some of the rhetoric of the opposition group, Coloradans for Coloradans: “doubling the state budget,” “diminishing accessibility and quality,” and “creating an unaccountable, massive bureaucracy.” Who would support that? No need to try to find out the truth.”

What does this really mean?

It means this: that until the whole US health care system collapses of its own weight, inefficiencies, complexities, absurdities, bureaucracy, and stupidity, that no matter who runs for president promising free health care for all, it won’t happen.

Talking in generalities, wishing and hoping that a mass movement (or political revolution) will change things, is only magical thinking and pixie dust. Given the political polarization of the US electorate, and the lack of thinking on the part of those who are supporting the GOP candidates for president and for Congress, single payer nationwide or statewide will not happen until every single American cannot get any health care coverage.

How did the UK get single payer? Thank the Luftwaffe for destroying the British health care system before WWII. Don’t believe me? Just read what Winston Churchill said (Conservative Party – like our Republicans, only smarter):

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.”

How did Germany get a kind of single payer system? Otto von Bismarck. And sixty years later, when the most conservative government Germany ever had came to power, not even a paperhanging, SOB with a Charlie Chaplin moustache could undo it.

Why can’t we have single payer? Read Thomas Jefferson, John Locke, Adam Smith, Edmund Burke, the Constitution and the Declaration of Independence. Any mention of health care or health insurance? No, because they were more concerned with “life, liberty and the pursuit of happiness” however they defined that in the eighteenth century.

Freedom was another thing they were concerned with, such as the freedom to have what is yours remain yours, so that the government can’t take it to spend on such extravagant luxuries as health care and education for all.

But as I wrote back in 2013, the founders did create a tax-based health plan for merchant sailors because it was affecting our national economy and trade. But it was only for a select population group, as was Medicare and Medicaid and SHIP, and Tricare last century.

But the health plan for sailors was never challenged in the courts, nor was it ever a part of any political campaign for the Presidency to be repealed; however, that is not stopping the GOP and their allies from doing the same thing to the ACA, or to any proposal for single payer.

The US is, as that paperhanging SOB is quoted as saying before he took cyanide and shot himself, “the ultra-capitalists”, and therefore, the free market and the profit motive wins out.

You want single payer, Bernie? Start learning the words to “The Internationale”.