Category Archives: Immigrant Workers

Immigrants in construction — key facts « Working Immigrants

Peter Rousmaniere posted the following fact sheet about immigrants working in construction. While this has no bearing on health care at present, it does have some bearing on workers’ comp, especially in light of the current regime’s draconian policy towards immigrants from Central America.

As this “crisis” progresses, it may be harder for construction companies to find workers to employ on construction sites.

This, in turn would mean that they may be less construction work, and for the insurance industry, less risk and less profit to be made from insuring these projects.

In workers’ comp, that would translate into less frequency of losses, but it would also cut off revenue from carriers covering such risks.

And he promised to create jobs? Hardly.

Source: Immigrants in construction — key facts « Working Immigrants

Advertisements

Number of Foreign Doctors Coming to US Dropping

As reported this morning in the weblog, Working Immigrants, the number of foreign born doctors wanting to come to the US is dropping, which may have a significant impact on the availability of doctors in certain parts of the country and in many hospitals and clinics, especially those that serve underserved and lower-income communities.

According to Working Immigrants, there are more than 247,000 doctors with medical degrees from foreign countries practicing in the US.

They make up slightly more than one-quarter of all doctors, and most are not US citizens, and are foreign-born as well.

One of the channels of immigration of foreign-born and foreign trained doctors is through graduate medical study. This year, just over 7,000 international medical graduates applied to study in the US, representing a downturn of 217 from last year, and nearly 400 from 2016.

Nearly 25% of residents across all medical fields were born outside the US in 2015, and in subspecialty residency programs, foreign medical graduates accounted for more than one-third of residents.

As I indicated above, foreign-trained doctors are more likely to practice in lower-income and disadvantaged communities than their American counterparts,

Where more than 30% of the population lives below the poverty rate, nearly one-third of the doctors are foreign-trained. And where per-capita income is below $15,000 per year, 42.5% of all doctors are foreign-trained. Finally, where 75% or more of the population is non-white, 36.2% of the doctors are foreign-trained.

This trend will most likely impact the predicted physician shortage that has been previously reported in this blog. In addition, it will add to the burden hospitals are facing in providing care as many of these immigrants work in hospitals to augment the staff shortages they already have.

If this trend continues thanks to current administration policy and xenophobia, the problem will only get worse. The reader should be aware that to even get into the US to practice medicine is a long and difficult process and many physicians do not get in to the country.

Instead of turning away good doctors from foreign countries, we should welcome them and keep them working in the areas of the country where they are practicing and providing care to those who otherwise would not have a doctor to go to.

Foreign-born Workers on the Rise: What it Means for Work Comp and Medical Travel

Working Immigrants.com posted a report this weekend that indicated that the percentage of foreign-born workers in the US will rise from 16% to 20% of the workforce over the next 26 years.

It will grow for the next 15 years, then the pace will slow considerably. Citing a Census Bureau publication from March 2015, Working Immigrants said that the total population of the US is expected to grow from about 319 million in 2014, to 359 million in 2030, and 380 million in 2040, which is an increase of 19% over the next 26 years.

According to the report, the working age population will grow by 12%.

There is a higher rate of employment among foreign-born, due to the fact that they mainly come here to work, and they are more concentrated in working age brackets ― 80% between 18 and 64, vs 62% among native born.

Modest increases in the foreign-born population will result in higher shares of employment for these workers.

By 2040, foreign-born workers will be one fifth of the workforce.

It is a given that not many of these workers will have a great command of English, and the most likely foreign-born workers will be Hispanics and Asians.

A workforce that does not have a command of English, is mainly from Central and South America and Asia, will no doubt put a strain on an already strained social welfare system, especially workers’ comp, since they are more likely to be injured on the job.

So those of you in the medical travel industry looking for patients and trying to entice well-off Americans down to Latin America for dental work, cosmetic surgery, plastic surgery, and other treatments not available in the US or that are too expensive, should consider expanding your offerings to your fellow Latino immigrants, or change direction and consider doing so by offering to facilitate less expensive surgeries for common injuries found in the workers’ comp space.

And those of you in workers’ comp who have shut your minds to new ideas and refuse to listen to what I am saying, either should learn Spanish or Chinese, or deal with the changing nature of health care globally, and stop worrying about stepping on the toes of the vested interests, and start thinking about the interests of all those new foreign-born workers who will be coming here in the next 26 years (24 now that it is 2016).

They may not feel comfortable going to a hospital for surgery if the staff there does not speak their language, or the food is unfamiliar, and they may even recover faster if they know they are surrounded by friends and family in their home country. That will lead to a more productive and happier employee.

And a happier employee will improve your bottom line.


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 300 articles and counting, many of them re-published in newsletters and other blogs.

Share this article, or leave a comment below.

Los inmigrantes latinos sufren lesiones más Construcción

Trabajadores latinos e inmigrantes frente a los riesgos mortales desproporcionados en la construcción, según un informe publicado ayer por el Comité de Nueva York para la Seguridad y Salud Ocupacional (NYCOSH), e informaron hoy en Immigrants.com Trabajo.

El informe, “El Precio de la Vida: 2015 Informe sobre la construcción muertes en Nueva York”, dijo que los latinos constituyen el 25% de los trabajadores de la construcción del estado de NY, pero representa el 38% de las víctimas mortales de la construcción en Nueva York en 2012.

A nivel nacional, las muertes de construcción latinos aumentaron de 182 en 2010 a 233 en 2013, según el informe.

Algunos de los otros resultados reportados por los inmigrantes que trabajan son las siguientes:

• Un estudio de los registros médicos de 7.000 estadounidenses trabajadores de la construcción Latino encontró que eran 30% más propensos que los blancos no latinos trabajadores que se lesionan en el trabajo. Varios estudios han demostrado que la falta de formación es una de las razones por las tasas de lesiones más elevadas de trabajadores de la construcción hispanos.
• Además, muchos trabajadores de la construcción de Nueva York son los no ciudadanos, de acuerdo con la Encuesta de la Comunidad Americana del Censo de Estados Unidos, incluyendo 40% de los 124.240 trabajadores de la construcción de Nueva York, el 36% de los 7.710 instaladores de paneles de yeso, 28% de los 10.405 techadores y el 25% de los 88.475 carpinteros. Ellos, también, tienen menos probabilidades de recibir formación en seguridad.
• Las personas de los trabajadores de color y de la construcción inmigrantes tienen más probabilidades de trabajar fuera de los libros, para ser clasificado erróneamente como contratistas independientes, para trabajar como jornaleros, o tener conocimientos limitados de Inglés que no suele incluir términos técnicos, y por lo tanto es menos probable que recibir capacitación en seguridad.
• El 80% de los trabajadores inmigrantes en la construcción son latinos. Un Centro para la Democracia Popular informe hallazgo mostró que el 60% de la caída de la construcción de Nueva York muertes OSHA investigó 2003-2011 eran latinos y o inmigrante. Además, los contratistas no sindicalizados tienen menos probabilidades de proporcionar condiciones de trabajo seguras, entrenamiento OSHA y equipos de seguridad.
• Los trabajadores indocumentados son menos propensos a negarse a trabajar en condiciones peligrosas o de hablar a favor de mejores condiciones de salud y seguridad por temor a ser despedidos o deportados. En profundidad es la información sobre todos los casos difíciles de conseguir, ya que muchas muertes se anuncian antes de los nombres de ser liberado, y no hay seguimiento de los informes de los medios de comunicación.

Esta no es la primera vez que hablé de la difícil situación de los trabajadores latinos en ciertas industrias de alto riesgo, que incluyen la construcción. Mi post, una alternativa a cirugías de alto costo para los reclamos de compensación laboral en virtud de los programas de recapitulación, discute este tema con más detalle, y señala al lector a los artículos anteriores he escrito, y para artículos de Joe Paduda y Peter Rousmaniere, que escribió hoy pieza.

La gente sigue preguntándome donde la propuesta de valor es para el empleador y el empleado en tener la cirugía realizada en un país distinto de los EE.UU., y especialmente en el país de origen del trabajador lesionado, por lo que no existen barreras idiomáticas o culturales.

Bueno, esa es una propuesta de valor, ya que al ser capaz de entender el proceso de reclamaciones y el procedimiento quirúrgico en el lenguaje de la propia proporciona la confianza de que el paciente está recibiendo la mejor atención médica posible. No siempre tiene que ser un valor en dinero de por qué la cirugía en el extranjero es mejor que recibir en un hospital de Estados Unidos donde la lengua y la cultura son impedimentos.

La segunda propuesta de valor de tener el paciente ir al extranjero, especialmente a un trabajador latino, es que los amigos y familiares que siguen en el país de origen pueden visitar al paciente y hacerle sentir mejor acerca de su ser sin trabajo temporalmente.

Estas son las propuestas de valor intangible que no se puede poner un precio, pero que pueden dar lugar a una recuperación más rápida y un empleado más feliz cuando lo hace volver al trabajo. Eso por sí solo vale la pena la inversión.

Pero como para el empleador, si el costo de la cirugía y la factura total del hospital es miles de dólares menos en un centro médico del turismo extranjero de lo que pagarían en un hospital local, entonces el valor para el empleador es que él está ahorrando un mucho dinero, especialmente si la mayor parte de su fuerza de trabajo es latina.

He hablado con varias personas acerca de esta idea, y, sin embargo, algunos de ellos no ven el valor en el ahorro de dinero en cirugías costosas. Sólo puedo suponer que les gusta pagar por la nariz para la cirugía en una rodilla, cadera, hombro o muñeca.

O tal vez, sienten que está bien para un trabajador para ir al extranjero en virtud de salud de grupo (como una compañía en Carolina del Norte ha hecho), pero no en un borrador de los trabajadores. ¿Eso no golpear de sesgo de clase?

He escrito mucho sobre el alto costo de sistema de compensación de nuestros trabajadores, sus fracasos y deficiencias, pero sin embargo, nadie está dispuesto a admitir a sí mismos, y mucho menos este escritor, que tal alternativa es realista.

Para ser justos, he tenido algunas conversaciones con algunas personas que lo consiguen, pero por desgracia, no hay segundo partido dispuesto a explorar esto. A medida que la fuerza de trabajo se vuelve más latino, y como un borrador de trabajo está bajo asalto en muchos frentes, puede haber algunos empleadores, intermediarios, transportistas por ahí que lo escuche.

Mientras tanto, voy a seguir escribiendo, a pesar de que me estoy haciendo nada para hacerlo. Prefiero ser ganar honorarios de consultoría o incluso un cheque de pago, pero hasta entonces, voy a seguir creyendo que el turismo médico no es sólo para la gente blanca con grandes bolsillos de seguros y profundos, o para grandes empresas con planes de salud de grupo, o para aquellos la búsqueda de la cirugía estética o plástica, etc., pero para todas las personas, ricos y pobres.

Latino Immigrants Incur Most Construction Injuries

Latino and immigrant workers deal with disproportionate deadly risks in construction, according a report issued yesterday by the New York Committee for Occupational Safety and Health (NYCOSH), and reported today on Working Immigrants.com.

The report, ”The Price of Life: 2015 Report on Construction Fatalities in NYC”, said that Latinos make up 25 % of NYS construction workers, but represented 38% of construction fatalities in New York in 2012.

Nationally, Latino construction fatalities increased from 182 in 2010 to 233 in 2013, according to the report.

Some of the other findings reported by Working Immigrants are as follows:

  • A study of the medical records of 7,000 U.S. Latino construction workers found that they were 30% more likely than white non-Latino workers to be injured on the job. Several studies have shown that lack of training is one reason for the higher injury rates of Latino construction workers.
  • In addition, many New York construction workers are non-citizens, according to the U.S. Census’s American Community Survey, including 40% of New York’s 124,240 construction laborers, 36% of the 7,710 drywall installers, 28% of the 10,405 roofers and 25% of the 88,475 carpenters. They, too, are less likely to receive safety training.
  • People of color and immigrant construction workers are more likely to work off the books, to be misclassified as independent contractors, to work as day laborers, or to have limited English proficiency that does not often include technical terms, and therefore are less likely to receive safety training.
  • 80% of immigrant workers in construction are Latino. A Center for Popular Democracy report finding showed that 60% of New York construction fall fatalities OSHA investigated from 2003 to 2011 were Latino and or immigrant. In addition, non-unionized contractors are less likely to provide safe work conditions, OSHA training and safety equipment.
  • Undocumented workers are less likely to refuse to work in hazardous conditions or speak up for better health and safety conditions for fear they will be fired or deported. In-depth information on all cases is difficult to come by, as many fatalities are announced prior to names being released, and there are no follow-up media reports.

This is not the first time that I discussed the plight of Latino workers in certain high-risk industries, which include construction. My post, An Alternative to High Cost Surgeries for Workers’ Compensation Claims under Wrap-Up Programs, discusses this issue in greater detail, and points the reader to earlier articles I wrote, and to articles by Joe Paduda and Peter Rousmaniere, who wrote today’s piece.

People keep asking me where the value proposition is for the employer and the employee in having surgery performed in a country other than the US, and especially in the home country of the injured worker, so that there are no language or cultural barriers.

Well, that is one value proposition, since being able to understand the claims process and the surgical procedure in one’s own language provides confidence that the patient is receiving the best possible medical care. There doesn’t always have to be a money value to why surgery abroad is better than getting it in a US hospital where language and culture are impediments.

The second value proposition from having the patient go abroad, especially a Latino worker, is that friends and family still in the home country can visit the patient, and make him feel better about his being out of work temporarily.

These are intangible value propositions that you can’t put a price on, but that may result in a faster recovery and a happier employee when he does return to work. That alone is worth the investment.

But as for the employer, if the cost of surgery and the total hospital bill is thousands of dollars less in a medical tourism facility abroad than what they would be paying at a local hospital, then the value to the employer is that he is saving a lot of money, especially if the majority of his workforce is Latino.

I have spoken to a number of people about this idea, and yet, some of them fail to see the value in saving money on expensive surgeries. I can only surmise that they like paying through the nose for surgery on a knee, hip, shoulder or wrist.

Or perhaps, they feel that it is okay for a worker to go abroad under group health (as one company in NC has done), but not under workers’ comp. Does that not smack of class bias?

I have written extensively about the expensive cost of our workers’ comp system, its failures and deficiencies, but yet no one is willing to admit to themselves, let alone this writer, that such an alternative is realistic.

To be fair, I have had some conversations with a few people who get it, but alas, there is no second party willing to explore this. As the workforce becomes more Latino, and as work comp comes under assault on many fronts, there may be some employers, brokers, carriers out there who will listen.

In the meantime, I will continue to write, even though I am getting bupkis for doing so. I’d rather be earning consulting fees or even a paycheck, but until then, I will continue to believe that medical tourism is not just for white people with great insurance and deep pockets, or for big companies with group health plans, or for those seeking cosmetic or plastic surgery, etc., but for ALL people, rich and poor.

————————————————————————————————————————————–

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.

Some Late Afternoon Reading Before the Weekend

Here are a few links to articles found today on Twitter:

http://www.businessinsurance.com/article/20150508/NEWS08/150509850/young-hispanics-at-small-construction-firms-at-highest-safety-risk?tags=|338|308|92|304

http://www.jdsupra.com/legalnews/the-oklahoma-option-benefit-plan-follows-84596/

Have a good weekend!

———————————————————————————————————————————–

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.

 

 

Immigration Reform Revisted

Tomorrow evening President Obama is to unveil his plan to grant millions of undocumented immigrants a form of legal status by executive action.

As reported in two articles today, one in Health Affairs blog, and the other in The New York Times, access to health care will not be a part of the President’s plan.

In “The Case For Advancing Access to Health Coverage And Care For Immigrant Women and Families”, Kinsey Hasstedt said that a web of policy barriers to public and private insurance options effectively keeps millions of immigrant women and their families from affordable coverage and the basic health care, including sexual and reproductive health services that coverage makes possible.

Of course, this sounds all too familiar to anyone who has read my articles in the past about immigration reform, medical tourism/travel, and its implementation into workers’ comp.

Ms. Hasstedt also said that many lawful immigrants are ineligible for coverage through Medicaid and CHIP (Children’s Health Insurance Program) during their first five years of legal residency. And as reported in today’s New York Times, undocumented immigrants are barred from public coverage, and the ACA prohibits them from purchasing any coverage, subsidized or not, through the exchanges.

In The New York Times article, Obama’s Executive Order on Immigration Is Unlikely to Include Health Benefits, the president will use his executive authority to provide work permits for up to five million people who are in the US illegally, and shield them from deportation. But his order will not allow them to be eligible for subsidized, low-cost plans from the government’s health insurance marketplace.

Ms. Hasstedt noted in her article that past immigration policy reforms, both executive (something the GOP forgot about because it was Saint Ronnie who did it) and congressional have failed to address the health care needs of immigrants.

I know there are many in the immigrant community, and among their supporters in the rest of the country who applaud the President for taking this long-overdue action due to the inaction of a Congress more in tune with the sentiments of those who like wearing white sheets, than a party whose last occupant of the White House preached “Compassionate Conservatism”.

And there are many within the Insurance and Risk Management and Workers’ Comp industry who downplay the impact immigration reform and the granting legal status to undocumented workers will have on the number of claims filed under workers’ comp.

But as I said in many previous posts, there is no way that workers’ comp can handle all of the claims that will be filed not only by legal residents, but by immigrants and those who are granted legal work status, as the President will do tomorrow night.

The medical tourism/travel industry is not perfect. Name me one industry that is. But the reality is that I have found, having attended three different conferences in the span of two years , that there are highly professional and dedicated people out there, physicians, hospitals and clinics who not only are seeking patients for private pay or group health insurance, but would probably consider taking on patients under workers’ comp, especially in the areas of orthopedic surgeries from work-related accidents, repetitive motion injuries such as Carpal Tunnel, and even weight-loss surgery, as I mentioned in my last post.

So while many in the industry are gambling in Las Vegas this week, which as the commercial says is where their money is going to stay, and where many Hispanics once called home before we showed up, it is high time to seriously consider medical tourism/travel as an option.

The influx of immigrants, and the soon-to-be announced legal status of the undocumented will put a terrible strain on an already strained health care system. It’s time to open the safety valve and let injured workers, many of them Latino, receive care in their home countries and in neighboring countries so that there are no language or cultural barriers to contend with.

Opening up a safety valve and immigration is nothing new. It’s how millions of Europeans came to America in the 19th and 20th centuries. I would not be here writing this today if my grandparents could not use the safety valve of immigration to escape what would have been a terrible fate. Thousands of Irish would have starved if they could not immigrate to the US and other countries. And millions of Chinese would have died in labor camps, famines and revolutions in the early 20th century.

But so long as the US workers’ comp system is locked away in a “padded cell”, the increased number of legal and undocumented workers with legal work status will add more demand on an already overburdened health care system.

The choice is yours. You can go with the flow of history, or stay in Las Vegas and party your way to irrelevance.