Category Archives: Fear

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I have addressed the legal barriers in comp in my White Paper, and found that there were outdated federal and state laws and regulations, intended to protect consumers, actually increase costs and reduce convenience, restrict public providers from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.

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Paralysis by Analysis: Or the Only Thing We Have to Fear Is, Fear Itself

Having now written this blog for more than two and a half years, I find that when I discuss the issue of medical travel, either for workers’ comp or for general health care, that there are dozens of reasons (or maybe they are excuses) given by various individuals I have conversations with, as to why medical travel is not feasible or even profitable.

Being an intelligent, well-educated person, I know that this country has put men and women into orbit, landed on the Moon, and have sent unmanned space crafts to every single planet and planetoid in our system, as well as sent two probes out of the solar system and into deep space.

And yet, as complicated as these space missions were, no one ever said it was impossible, no one ever said it would never work, no one ever said it was not profitable, and no one ever said there was no incentive in it for this one or that one, etc., ad infinitum.

However, that is not the case with medical travel. There always seems to be some kind of reason, some kind of caveat, and some kind of negative excuse given against this idea. And mostly, it concerns what some lawyer would do to an employer, or other entity that puts the fear of a lawsuit or economic ruin if this were to be attempted.

But it is not just lawyers who are at fault here for the fear that I am sensing. Laws and regulations designed to deal with all aspects of the health care and benefits fields, not to mention the statutes and regs in workers’ comp, are to blame for what a career counselor I knew years ago here in Florida, used to tell unemployed people at the weekly workshop.

He was a retired engineer, and in his field, they talked a lot about “paralysis by analysis”, and how we stop doing things once we analyze it to death. This was true in the engineering field, and is true in doing a job search, and even implementing medical travel into either health care or work comp.

We are so used to being afraid of doing new things, we are so afraid of doing something different and out of the norm, that one has to wonder why any of us get out of bed in the morning, or leave the house for that matter, fearing that something terrible is going to happen.

As pertains to medical care, of course bad things can happen. They can happen in the hospital across town, or on the way to the hospital, but we don’t avoid it because of what might happen. The same is true for medical travel. The same complications and negative outcomes can occur here that they are afraid of might happen over there.

Then there is the legal liability excuse. Damn, if I had to worry about legal liability, I would not take my car out of the garage.

And here again, we come back to the issue of lawyers and lawsuits, etc. As many of you may know, my father died last September, and since then, and earlier that year, we had to deal with lawyers to handle family matters in the event one or both of my parents passed away.

The first lawyer we used is the best friend of my first cousin, and was the person who drew up several legal documents for my parents in the past. The second lawyer was referred to me by the first lawyer after my father died, and I was using him up until April, when my brother decided to go with someone who was referred to him by a fourth lawyer he sat next to on the plane to Miami when my brother came for a short visit.

I have known many lawyers in my life, as no doubt many of you have, and on the whole, they are not a bad lot. But some of them are just out for the money and to prevent progress on a whole range of fronts, including health care and workers’ comp.

I have worked for and under two lawyers in my career in claims. Both of them did not leave me with a good feeling for insurance lawyers, so when I hear that employers are afraid to consider medical travel to save money on expensive surgeries, or that some large organization in the labor world might sue an employer or a union, because benefits are negotiated in collective bargaining agreements, then it tells me that people are afraid that it might work.

Instead, the lawyers force employers and insurers to spend more money because it is in a contract, or they want to use American medical providers, etc.; when it has been clearly proven that ours is the most expensive health care system in the world.

FDR said in his first inaugural address that the only thing we have to fear is, fear itself. It would seem that in the case of medical travel, it is not fear itself we fear. We fear lawyers and lawsuits, we fear what others might say or do, we fear that employees will like to go abroad because the care is better, we fear that employers will save money which rightfully belongs to those who are profiting from the status quo, and most importantly, we fear that we aren’t the best in everything, except in self-delusion and in paralysis by analysis.

We can do better.

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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.

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. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.