Category Archives: Immigration Reform

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

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The Cry of the Children

Taking a break from writing about health care, workers’ comp, and medical travel, I want to talk about something I saw, or rather heard yesterday afternoon on MSNBC.

It was an audio (furnished by ProPublica) of children crying at a detention center (more like Concentration Camp) that broke my heart. I was in tears, and very seldom do so. But those cries went right to me.

If they did to you, then you are a good human being. If not, then you have no soul. And please, don’t quote me that that’s the law, or it is in the Bible, or they are illegal and have no rights.

EVERY HUMAN BEING HAS RIGHTS.

And as for whether or not they are “illegal”, I guess you forgot that when your ancestors arrived on the Mayflower or whatever ship they sailed on, the landlords here for thousands of years knew you were “illegal” too.

The ancestors of all of these people now streaming to our border came to this hemisphere some 20,000 years ago, so by those standards, you, me, and all the rest of us are undocumented aliens. But no one tells us to leave. Or yanks our kids from our arms.

That we do this and many other things to minorities is a symptom of our greed, ignorance, and stupidity that never seems to die out. Take for example, our Confederate-era Attorney General, Jeff “Foghorn Leghorn” Sessions. That refugee from the set of “Gone With the Wind” is not only a religious zealot, but a full-out bigot and racist from a region of the nation that still has not given up its racism and hatred of non-whites, and non-Christians. In this case, non-Protestants from Catholic Latin America.

Too many of our fellow Americans have been poisoned by talk radio, Fox News, and local politicians to see that we are all immigrants and that at times in the long history of the human species, we were migrants too. Our prehistoric ancestors migrated, as did many more recent peoples. But none ever subjected to such cruelty, except during the 1930’s and 1940’s.

We were all taught in school to believe in the ideals of America as a shining city on a hill (incidentally, an idea the Puritans created), and was more about a religious view than a secular one. We were all taught about why we fought a revolution, why we have a Declaration of Independence, and why we have a Constitution that secures our rights and liberties.

And now we are throwing all that away because of a clique of neo-fascist, racist bullies and bigots, headed by a pathological liar and con man, who has conned a large segment of the American people (by which I mean White people) that he can make America great again, all the while cozying up to dictators and dissing our friends.

Folks, this is how Hitler and the Nazis began. And it ended with 6 million dead (my maternal great-uncle, aunt and their six children among them), so don’t tell me it is legal or biblical. You know where you can put that.

And those of you who say they have stolen our jobs or they are criminals and rapists, I have news for you…next time you are in a restaurant, or a family member is in a hospital, bus your own table, and clean up your family member’s dirty linen. Because if Herr Miller (Stephen) gets his way, there won’t be any bus boys, nurses’ aides, home health aides, janitors, and other occupations Americans won’t be filling begging for workers. Oh, and you can come to Florida and pick your own fruits and vegetables, because there won’t be anyone to do it for you.

AMERICA IS A NATION OF IMMIGRANTS, SO WE NEED THESE PEOPLE.

 

In-bound Medical Travel and Immigration

U.S. Domestic Medical Travel.com published the following article this morning that discusses the impact of in-bound medical travel on an individual’s immigration status.

http://medicaltraveltoday.com/spotlight-renata-castro-founder-of-castro-legal-group/

Russian Anchor Babies: Has Putin Already Begun the Invasion?

As loathe as I am to address anything from the MTA, this item caught my attention just now, as I am an hour north of Miami, and with all the talk about Dreamers and immigration from so-called “s**thole” countries, why is it not on the GOP’s radar that Putin is sending us his women to give birth so that they can claim American citizenship for the children born here?

Not that I am opposed to legal immigration and a path towards legalization for those who came here undocumented, either willingly or because their parents brought them here as children.

What impact this will have on the health care system cannot be determined just yet, but with all the problems we have, this will add to it in greater numbers.

Here is the article.

Let’s hope that Special Counsel Robert Mueller finishes his investigation into Russian interference into the 2016 election. Then he can turn his attention to Russian anchor babies.

 

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.

Primary Language-Speaking Physician Ruled Not Medically Necessary

I came across an interesting article today from David DePaolo on his blog, DePaolo’s Work Comp World. The article, Comunicación No Es Médicamente Necesario, discussed a recent workers’ compensation case in Florida that involved the right to bilingual treatment.

A roofer in 2012, suffered a head injury when he fell 30 to 40 feet off of a ladder. His employer accepted the compensability of the injury and authorized treatment from several doctors, including a neurologist, Dr. Angelo Alves.

Dr. Alves recommended that the claimant undergo a neuropsychological evaluation for his memory, cognition and emotional state. The employer then arranged an appointment with Dr. Arthur J. Forman. Because Dr. Forman did not speak Spanish and the claimant only spoke limited English, his employer arranged for an interpreter for the claimant’s office visits

The claimant objected to the interpreter, and filed a petition for benefits, seeking authorization for an evaluation by a Spanish-speaking neuropsychologist. His reasoning was that he did not want to do it through an interpreter and talk about the intimate details of his life through another person.

Dr. Alves supported the claimant’s claim and testified that the claimant needed to have a neuropsychological evaluation performed by a Spanish-speaking psychologist. It was Dr. Alves’ position that having the evaluation through an interpreter was not the same as with a Spanish-speaking doctor, because the doctor could get the wrong information.

However, the Judge of Compensation Claims was not persuaded by that argument. The claimant appealed, but a split panel of the First District Court of Appeals agreed with the JCC.

The finding of the court was that while a Spanish-speaking provider was preferable, the evidence did not establish medical necessity.

Judge Scott Makar, an appointee to the First District Court of Appeals by current Tea Party-backed Florida governor, Rick Scott, in a concurring opinion, addressed the challenges of meeting health care expectations within the limited resources of any health care delivery system.

According the Judge Makar, “In an ideal world with unlimited resources patients would have health care information published in their own primary languages, and their health care service providers would speak their primary languages.” He went on to add, that since this ideal is “unattainable”, “the trajectory of the language access movement in the United States currently has gravitated to the use of translators (for written communication) and interpreters.”

The dissenting opinion, by Judge Bradford Thomas, an appointee of former governor Jeb Bush (who by the way speaks Spanish and is married to a Hispanic woman), argued “that no medical testimony supported the JCC’s view that the Spanish-speaking psychiatric evaluation was not medical necessary, and that the JCC had failed to give a “reason” for rejecting Dr. Alves’ opinion.”

David pointed out that Judge Thomas had the burden of proof backwards and ignored the substantial evidence standard. But, he also pointed out that the majority opinion seemed to take the position that Spanish is a “minority” language, which David points out in the rest of his article, it isn’t.

Before I tackle that issue, I would like to explain why I mentioned who appointed the concurring and dissenting judges, and what struck me as I read the court’s ruling in this case. Had Judge Makar been appointed by any other governor besides Rick Scott, I would have been puzzled as to why they would go out of their way to annoy a growing segment of Florida’s population such as Latinos, especially since they are sensitive to any form of discrimination against their community, such as restricting their right to vote.  This is especially true of non-Cuban Latinos who generally vote for Democrats.

That Rick Scott is a Tea Party-backed politician, and knowing that the Tea Party has elements in it that despises immigrants, both legal and illegal, who are usually Hispanic, Judge Makar’s opinion shows obvious Tea Party bias towards Spanish-speaking people in the state.

His characterization of Spanish as a “minority” language is certainly not true to this former New Yorker who had gone through several areas of Miami, Fort Lauderdale and many other cities in South Florida and felt like I was in the minority. Also, his statement about an ideal world is typical of right-wing conservatives who are opposed to any accommodations to non-English speaking people.

I say this as the grandson of four immigrants who had to learn English and had to speak their native language, Yiddish, at home amongst themselves and other family members and friends, so that the “kinder” would not know what they were talking about. And since my family also came from what was once the Russian Empire, they had to know a smattering of Russian and maybe Polish to converse with neighbors and officials of the government.

But that was a different time in the US, when the National Civic Federation sponsored night classes in English to newly arrived immigrants so that they can assimilate. But it is different now with Latinos, and as has been pointed out before, the younger generation of Latinos already here, speak English and Spanish. I have had classmates in my MHA classes, and have met many others in all areas of South Florida who do.

On the other hand, Judge Thomas’s appointment by Jeb Bush did not surprise me, given his dissenting opinion. It recognizes the reality of life in Florida, and in other states, with regard to Hispanics, and does not, like the Tea Party often does, seek to turn the clock back to a time in the US when only one language was spoken.

Going back to David’s article, demographic research he points out, shows that the Hispanic population has outgrown that of the white population in David’s home state of California and New Mexico, as well as a few other states, according to a Pew Research Center study. The projections, David cites, are that these demographics will be reflected in the overall US population by 2040.

California has about 14 million Hispanics out of an overall population of 33 million. 47% of New Mexico’s population is Hispanic, and while the white population of Texas is still the majority that is projected to change soon, as the Hispanic population growth represents nearly 64% of all population growth since 2000.

Florida, by contrast, David states, has 4.5 million Hispanics, which represents 23% of the population. He notes that because workers’ compensation is state specific, relative to the overall population of the state, the decision by the First District Court of Appeals makes sense. However, that he says can change.

I have discussed the issue of immigration reform and its impact on workers’ compensation and medical tourism in earlier posts, and have cited statistics about the Hispanic population growth in such articles as Immigration Reform on the Horizon: What it means for Medical Tourism and Workers’ Compensation, Immigration and Workers’ Compensation: Round Two, and E PLURIBUS UNUM: Latin American and Caribbean Immigration, Workers’ Compensation and Medical Tourism.

It also occurred to me that the court that decided this recent case was the same court that decided an earlier case that I mentioned in Legal Barriers to Implementing International Providers into Medical Provider Networks for Workers’ Compensation: A White Paper.

In that case, AMS Staff Leasing, Inc. v. Arreola, FL 1st DCA, 2008, the First District Court of Appeals ruled that Arreola, who had been injured loading a truck, was entitled to get treatment in his hometown in Mexico.

The court ruled that “that state law did not preclude the foreign physician’s treatment of the claimant in Mexico. They stated that Florida workers’ compensation law contemplates coverage for non-citizens, and they cited an earlier case in which the court held that undocumented workers were entitled to workers’ compensation coverage in Florida…”

The court “also stated that Florida law indicates that an injured worker is not prohibited from moving from his pre-injury residence in the state, and receiving treatment outside of the state.”

This would appear to indicate that the court in 2008, before Rick Scott became governor, was willing to have workers’ compensation claimants get treated by physicians in their home country who could speak their language, but the court in 2014, with an appointee of Tea Party-backed, Rick Scott, ruled that the claimant in this case had no right to a physician who could speak his language, even if the claimant was seen here in Florida and not in his home country.

It would appear that judges appointed by Tea Party-backed governors, especially in a state like Florida, are trying to deny the rights of Hispanic claimants to Spanish-speaking doctors. Such a ruling in light of future increased Hispanic population growth is not only unconscionable, it smacks of racism and discrimination. But David DePaolo is correct in citing Bob Dylan’s song, “The Times, They Are A Changing.” Hopefully, future courts in Florida and elsewhere will correct this travesty of justice, and when medical tourism in workers’ comp becomes a reality, evaluations by Spanish-speaking physicians will be commonplace occurrences.

What A Long Strange Year It’s Been – My Year as a Medical Tourism Blogger

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Introduction

Today marks one year that I began my blog on medical tourism and its implementation into workers’ compensation.  From the beginning, I did not have any idea if my blog would be successful, or if it would be a complete failure. One year in, with over 8,000 views, and less than 100 followers, the jury is still out, so it remains to be seen where the blog goes in the next year.

Yet, just this month, on October 7th, I had 233 views (highest ever) and 205 visitors. But one thing is certain; I have had a very interesting time writing it, and have made some wonderful connections both in the medical tourism industry and out of the industry, from all over the world. But I have also had some rather disappointing experiences as well. This post then is a look back and maybe a look forward to another year of blogging, hopefully more rewarding, both career-wise and financially than this year coming to a close has been.

Why I started the Blog

I started the blog for three reasons: One, I had just attended the MTA Congress in Hollywood, Florida three days earlier, after they had published my White Paper on their website. The White Paper was too long for their online magazine, so they asked me if I would not mind it if they published as a White Paper. When I said yes, they eventually invited me to come to the Congress free of charge, for which I was very grateful, since I was unable to spend that much money to participate. After the Congress was over, I had learned from a few industry sources and two legal experts, that the MTA copyrighted my paper without my written permission, so I had one of the lawyers find me a template so that we could use to send them a letter asking them to either remove the copyright, and remove the Editor-In-Chief’s name from it, or remove it altogether and let me know in writing. They did remove the paper, but I had to find out for myself when I went to their website.

The second reason I started the blog was because of my MHA degree (Masters in Health Administration) which I received a year earlier, and for which I wrote the term paper that was the basis of the much longer White Paper. My Health Law class required a paper on a legal topic in Health Care, and since I had neither a legal background, nor a health care background, I went out to social media to find a topic. The first topic suggested to me did not yield much information and was not a good research subject, so again I went out to social media, and a lawyer in CA gave me the idea to write about the legal barriers to implementing international medical tourism into workers’ compensation. She helped with getting legal cases and some of the editing of the original paper, as well as some of the work expanding it into the larger White Paper. I was unsuccessful in getting any legal journals to publish it, so that is when I turned to the MTA.

The third and most important reason why I began my blog was to explore new avenues of employment in either medical tourism or in workers’ comp, or even health care. I did this because I felt my workers’ compensation and insurance experience, which consists of work in Auto No-Fault, Risk Management and Insurance Data Processing with regard to claims, brokerage and statistical reporting of workers’ compensation claims and policy data, would be valuable to organizations in those industries. Unfortunately, due to the economic downturn and jobless recovery, many companies have curtailed their hiring, and many are just filling jobs that require a finite set of skills and background that I do not possess. I have made connections both before my degree and after with executives in many companies, and in many parts of the US, but have gotten little or no response to my inquiries.

My career has been somewhat broad and varied, depending on the nature of jobs available at the time, but they have given me an insight into the world of insurance in general, and the world of workers’ compensation in particular, so after attending the Congress, and meeting different people from other countries, and hearing one company’s experience as a self-insured employer utilizing medical tourism for their employees on their health care plan, I thought that it might be possible to do the same for those employers who are self-insured for workers’ compensation, as well as those who purchase workers’ compensation insurance in the insurance market.

A Brief Review of Past Posts

My first post, on October 29, 2012 was a recap of what I learned at the Congress and what I thought about medical tourism as a viable alternative to high cost medical care in the US. The post, entitled, What I Learned at the 5th World Medical Tourism & Global Healthcare Congress, and Why It Matters to the Workers’ Compensation Industry, also discusses the three cases I cited in my paper which involved some form of medical tourism; either domestic medical tourism, or cross-border medical tourism,( i.e., Mexico), from CA and FL.

The third post I wrote was a shortened version of my White Paper, called Medical Tourism and Workers’ Compensation: What are the barriers? Here, I attempted to get the workers’ comp industry interested in the idea by giving them the highlights of my original paper. Almost immediately after I began blogging, my posts were picked up by other blogs and newsletters in the health care and medical tourism industries, and I am thankful for their faith in me as a blogger that they continue to do so.

As a further inducement to get some interest in the idea of implementing medical tourism into workers’ comp, I created a fictional case study about a self-insured employer who is self-insured for both health care and workers’ comp, but whose Risk Manager was unaware of how much money he could save if he followed what the Employee Benefits Manager was doing on the health care side with medical tourism. In the case study, A ‘Case Study’ in Implementing Medical Tourism into Workers’ Compensation, three workers sustained injuries while working at a job site and needed surgery that would have cost the company thousands of dollars. The Risk Manager told the Employee Benefits Manager about this, and learned that the company was sending its workers to countries in Central America for less expensive health care with better quality outcomes, and the Benefits Manager suggested he do the same with the injured workers.

The one topic that I have written the most about in the past year was about the impact of immigration reform on workers’ compensation, and subsequently, on medical tourism. The following posts were written because I came to believe that Latin America and the Caribbean was the most logical region of the world to pursue medical tourism, since it is so much closer to the mainland US and the workforce here is increasingly Latino and Caribbean.  These are the four posts:

The Stars Aligned: Mexico as a medical tourism destination for Mexican-born, US workers under Workers’ Compensation, Immigration Reform on the Horizon: What it means for Medical Tourism and Workers’ Compensation, Immigration and Workers’ Compensation: Round Two, Testimonial on Medical Tourism in Mexico.

The last post was supposed to be followed by even more testimonials, and may still be, but it will have to wait until after this one is posted. Finally, I decided that I should acquaint the workers’ comp industry with some of the medical tourism facilities that had booths at the MTA Congress, so I wrote the following post from literature I gathered during the last two days when the Exhibition Hall was open. No Back Alleys Here: Medical Tourism Hospitals, Clinics and Networks in Latin America and the Caribbean, simply listed the hospitals and clinics by country and listed the hospital’s websites, where available. It would be up to the reader, I felt to check them out.

What I have learned About Medical Tourism – The Good, the Bad, and the Ugly

My experience writing the blog has educated me about the medical tourism industry, even though I do not actually work in it at present. Perhaps being an outside observer gives me an honest and forthright perspective that many inside the industry don’t have, but in my email conversations with some of them, they are already aware of the nature of the beast, as it were, so here are my thoughts about the industry —the Good, the Bad, and the Ugly (with apologies to Sergio Leone, but not to “Mr. Talks-to -empty-chairs”).

The Good

In the past year, I have met some very nice and dedicated people who want to provide patients with quality health care, at affordable prices, plus a little extra on the side. Whether it was at the MTA Congress last October where I met people from Mexico, Guatemala (Belgian, actually), Australia, Singapore, China, Canada, Finland and the US, or online through my blog or my LinkedIn profile, I know that the medical tourism industry has very good promoters and patient advocates.

Many of the online connections I have made are in India, which is the primary destination for medical tourism. But there have been other connections made all across the globe from Europe, the Middle East, East Asia, Africa, and some from Latin America and the Caribbean. This proves to me that medical tourism is a growing and dynamic industry that will continue to grow, provided that it attracts the same kind of people I have connected with over the past year. Yet, as we shall see below, there is a grey cloud and a dark cloud over the industry, which threatens its long-term sustainability and growth…the bad and the ugly sides of medical tourism.

The Bad

Any industry and any business in that industry must be able to not only justify its existence, but to prove its value and worth to the customer, and medical tourism is no exception. So, it has been disheartening to me that I have been unable to get exact cost figures for certain surgeries that are common to workers’ compensation from some medical tourism facilities in Latin America and the Caribbean, as I described in my post, If You Have to Ask…Fuggedaboutit!.

In that post, I said that transparency on costs was vital if the medical tourism industry wanted to pursue business in the American workers’ compensation industry, because employers, insurance companies, and third party administrators will want to know up front if this is really a less expensive alternative to high-cost surgery in the US. I even cited surgical costs from some countries in the region, and some costs from Asian countries that I originally cited in my White Paper. These last figures, I have been told by some people are not accurate and therefore, are only a guesstimate of the actual costs.

In addition, I have been told that figures on the number of Americans going abroad for care are inflated, often because they count expatriates who are living and working in those countries as patients, besides those who actually did travel abroad for treatment, so again here is another area where transparency is needed.

Finally, as I point out in my post, Ensuring Patient Safety: Making Sure Medical Tourism Puts Its Money Where Its Mouth Is, patient safety and quality are also important areas where transparency must be observed if the medical tourism industry is to be more than just a rich man’s game. You have to prove to all stakeholders in the care and treatment of patients, and even the patients themselves, that you have equal or better quality outcomes than what is available in the US, and that patient safety, like costs and numbers of treated patients, are presented upfront and clearly to all interested parties. Failing to do so will only drag down the growth of medical tourism, and may even give it a black eye from which it may never recover.

The Ugly

As in any endeavor, individuals are bound to find detractors who critique and even attack you for your beliefs and for your efforts. I am no exception to that, and have received my share of critiques and attacks during the past year. I answered these critics in the following two posts, The Faith of My Conviction: Integrating Medical Tourism into Workers’ Compensation is Possible and is not a Pipe Dream, and Clearing the Air: My Defense of Implementing Medical Tourism into Workers’ Compensation.

I am not going to rehash this issue here again, but only bring it up as one part of what I see as the ugly side of medical tourism. There is too much personal animosity among certain individuals and organizations, especially in an industry that is still in its infancy. And while I have accepted an apology from one of my critics, there are still some ugly and vile behaviors that have been perpetrated against well-meaning and decent people who just want to grow this industry from the bottom up, instead of from the top down. There is no reason why people have to be nasty to each other, there is enough business on this planet of seven billion to go around.

Any organization that purports to represent the interests of an industry at large, and whose executives claim to be reputable spokespersons for that industry, must not engage in childish and unprofessional behavior that casts doubt on the individuals involved, the organization they belong to and the industry as a whole.

Holding fancy conferences around the world and charging big numbers only to see a handful of attendees actually paying and the rest being invited or begged to attend, does not suggest a healthy and vibrant industry, nor does it show that the leading organization promoting that industry is a trustworthy and honest one.

What I have not gotten from both industries

Medical Tourism industry

Perhaps it is because many in the industry have a background in general health care, or perhaps it is because they have experience in the travel, wellness and resort industries, that many of the people who have connected with me are not familiar or aware of what potential the US workers’ compensation market can be. I have received many offers of partnerships with these individuals, but I have to point out to them that I am not a doctor, I am not a medical tourism facilitator, nor do I have any other business that would partner with them in such an endeavor, and therefore, cannot refer patients to them.

Naturally, I thank them for considering me, but given that many of them are in Asia, and I am focusing on Latin America and the Caribbean, there is no reason for me to explore it. I would, however, like to hear from some organization or company doing business in that region who is seriously considering entering a new market such as workers’ compensation, given the increase in the Hispanic and Caribbean workforce in the US. That region has many “rising stars” in the medical tourism world, and can be very lucrative if the right people recognize its potential.

In addition, the newsletters and blogs that have re-posted my posts have for the most part, not generated much feedback or comments, and I wonder if anyone besides the publishers and their staffs are reading them. My own blog publishing site, WordPress.com, has garnered me nearly 10,000 views since I began blogging, but again, the response has been rather weak.

Workers’ Compensation industry

As I stated above, the most important reason why I began the blog was to simply find a job in the workers’ compensation industry after spending two years in school getting my MHA degree and looking for work after the recession and jobless recovery following the events of 9/11, the housing bubble that burst in 2007, and the financial collapse of 2008. The problem that I and many others are facing is that the industry is shrinking and companies are being bought by either their competitors, or by private equity firms, such as what just was announced recently when a company called Apax Partners bought One Call Care Management (OCCM), a workers’ compensation services company in a multi-billion dollar deal.

In May, I had lunch with one of OCCM’s Regional Sales Directors who shares my idea about medical tourism and workers’ compensation, and who thought we might be able to put something together that would address his clients’ concerns about the high cost of surgery. His company provides transportation, translation, home care equipment and medical devices to the work comp industry, and even has an in-house travel agency, which would make them the ideal medical tourism facilitator for workers’ compensation patients.

After several phone calls that ended without any further action on our parts, I decided to contact the top management of his company, even sending my White Paper and resume to the Chairman of the company and the President and CEO. That was back in September, and one month later, I have not heard from either of them.

I learned recently that because of this deal, it is unlikely that the President of the company will do anything with my idea. That seems to be the case with many other companies, and why I have gotten no traction with my idea from anyone else in the workers’ comp industry. When I post my blog posts on social media, it is like they are falling on deaf ears, or in this case, blind eyes. They seem to more concerned with being bought up, dealing with the opioid issue, or the physician dispensing issue (which is related to the opioid issue), or they just don’t see this as a viable alternative because they are too conservative and too cautious, and too willing to do the same things over and over again and expect different results. That, as I said before in a more recent post, is The Definition of Crazy.

Predictions

Making predictions nowadays is a little like knowing what Ted Cruz is going to do next for an encore; they’re unpredictable and designed to make the person doing so look good, so to spare you and me from any embarrassment, let me just add that health care is changing, and the direction that it takes will depend a lot on what has already happened, and what is currently happening, especially in light of the problems with the ACA rollout earlier this month.

But my recent post, Ten Years On: One Person’s View of Where the Medical Tourism Industry will be a decade from now, spells out some of the things that may influence the direction medical tourism takes in the future. Hospital costs, outpatient costs, consolidation of hospitals, cost to employees, immigration reform and technology will all play a role in determining the direction medical tourism takes in the next ten years and beyond.

Conclusion

As I begin a new year of blogging, I am grateful for the opportunity to provide my readers with new knowledge and insights to different topics, ideas and issues that affect not only workers’ compensation, but all of health care, medical tourism included. I hope that my writing has made many of you stop and think and look at things in a different light. I also hope that you have been entertained by my writing, as far as a serious subject can be entertaining when it pertains to human life.

But most important, I hope that this next year will provide with me everything I had hoped the last year would have; a new position, recognition of my idea as a viable alternative to high cost health care for workers’ compensation, and greater opportunities to personally interact and meet so many of the people engaged in the medical tourism industry around the world.

Here’s to a better blogging year!

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Thank you so much,

Richard