Category Archives: Technology

Infographic on Mobile Health

Here’s an infographic courtesy of URAC. What will this mean for workers’ comp, health care and medical travel?

Millennials and Mobile.png

New York to London in Two Hours: What It May Mean for Medical Travel

The day is not too far off when passengers will embark on a flight from New York to London, and make the trip in just two hours.

That is what an article today on MSN.com suggests as a hypersonic, suborbital plane is being developed called the Paradoxal.

It will fly just high enough to allow passengers to see the curvature of the earth and the stars, as well as have a short-term experience with weightlessness.

So sending patients to hospital facilities in Europe or Asia will take no more than most domestic flights do in the US, two or three hours, more depending on destination, but certainly not hours, as is common now.

This is not the only new aircraft being designed. There is a plane called “Boom” that is expected to be faster than the Concorde and cost far less than Concorde did.

After suborbital flight, who knows what comes next? Matter-Energy transportation, perhaps, thereby eliminating altogether the aircraft.

Say Goodbye to Comp

Fellow blogger, Joe Paduda, today wrote a very prescient article about the impact the jobless economy will have on workers’ comp in the coming decades.

While the idea of driverless trucks may be something in the works, there are many factors working against it from becoming reality in the near term, and perhaps for many years to come. Laws and insurance requirements and what to do if the truck breaks down on a stretch of highway not easily accessible by repair trucks or miles from the nearest truck stop, will have to considered before driverless trucks put drivers out of work.

Yet, as Joe points out, manufacturing is already seeing a loss of jobs due to automation and higher productivity, which will lead to lower consumer costs, but will exact an even higher cost on the nation’s stability and will force politicians to come to grips with what to do with a permanently unemployed population, especially those in the service sector, who are being replaced, and will be replaced by automated cashiers, as well as those occupations tied to the workers’ comp industry.

If, as I reported yesterday, that 50% of all jobs will be gone by 2025, what do you do with those individuals who lose their jobs to machines and software?

It is a question that few have asked, and one that fewer have provided answers for. Also, what happens, as I also asked yesterday, if the 50% goes to 75% or higher?

The UBI is one idea floating around, but short of that, what else can we do to put permanently unemployed back into the workforce once technology makes them, in the words of that “Twilight Zone” episode, “Obsolete!”

It makes no sense, Joe states, to reform a system that won’t be around much longer. So, say goodbye to workers’ comp, say goodbye to claims adjusters, occupational therapists and physicians and nurses in same, pharmacy benefit managers, rehabilitation personnel, return to work specialists, case managers, utilization reviewers and bill reviewers, as well as underwriters and lawyers.

The Technological Revolution and Health Care: On the Same Track?

Yesterday, I ran across an interview on Truthout.com by Mark Karlin. Mr. Karlin was interviewing the two authors of a new book, People Get Ready, by Robert W. Mc Chesney and John Nichols.

Mr. Karlin’s first question, answered by Mr. Mc Chesney, intrigued me and got me thinking of what is happening in workers’ comp, as well as what is happening in health care.

As I mentioned briefly in my last post, automation and artificial intelligence will have a significant impact on the future of workers’ comp, and this is emphasized in Mc Chesney and Nichols’ book. There have been other books and articles recently on the subject, so this is nothing new.

But what got me thinking is that Mr. Karlin addressed the main question the book raises — namely that the conventional wisdom has always been that the more advanced technology becomes, the more beneficial it will be for humans.

Mr. Mc Chesney responded that convention wisdom said that new technologies will disrupt and eliminate many jobs and industries, and that they would be replaced by newer industries and better jobs.

Mc Chesney also said that they argue the idea that technology will create a new job to replace an old one is no longer operative; nor that the new job will be better than the old one.

According to Mr. Mc Chesney:

Capitalism is in a period of prolonged and arguably indefinite stagnation. There is immense unemployment and underemployment of workers, which we document in the book, taken from entirely uncontroversial data sources. There is downward pressure on wages and working conditions, which results is growing and grotesque inequality. Workers have less security and are far more precarious today than they were a generation ago; for workers under the age of 30, it is a nightmare compared to what I experienced in the 1970s.”

Likewise, Mr. Mc Chesney, continued:

there is an immense amount of “unemployed” capital; i.e. wealthy individuals and US corporations are holding around $2 trillion in cash for which they cannot find attractive investments. There is simply insufficient consumer demand for firms to risk additional capital investment. The only place that demand can come from is by shifting money from the rich to the poor and/or by aggressively increasing government spending, and those options are politically off-limits, except to jack up military spending, which is already absurdly and obscenely high.

Contemporary capitalism is increasingly seeing profits generated, he adds, not by its fairy tales of entrepreneurs creating new jobs satisfying consumer needs, (remember Mitt Romney’s ‘job creator’ line of bs?) — but by monopolies, corruption and by privatizing public services.

Finally, Mr. Mc Chesney states that:

Capitalism as we know it is a very bad fit for the technological revolution we are beginning to experience. We desperately need a new economy, one that is not capitalistic — based on the mindless and endless pursuit of maximum profit — or one where capitalism has been radically reformed, more than ever before in its history. It is the central political challenge of our times.

They are not the only ones arguing for such reform or revolution, Senator Sanders notwithstanding. In previous posts, I have mentioned the biopsychosocial theory, Spiral Dynamics, and the book by Said W. Dawlabani, MEMEnomics The Next-Generation Economic System.

Other authors such as Richard Wolff, and Robert Reich have written books about this subject, and like Mc Chesney and Nichols have reached similar conclusions. Yet, Dawlabani, accessing the Spiral Dynamics model, goes much deeper into why we got here and what we need to do to get out of it.

Such a future version of capitalism has been called by many different names that I have come across in the past decade or so. Natural Capitalism, conscious capitalism, and so on, to name a few. But the main point is as Mc Chesney and Nichols points out in their book, the technological revolution, rather than liberating humans and making our lives better, as Mc Chesney says in the interview, may have the perverse effect of reinforcing its stagnating tendency.

An issue related to automation and artificial intelligence and its impact on the future of work, is if we are all replaced by machines and software, how will people be able to live? How will the goods and services produced by automation be sold, and to whom? Only those who are fortunate to have employment in jobs that machines cannot do? Or will we have to go back to a time when money was only the purview of those who had it?

The answer to these questions have also been raised by those in the tech world, and one suggestion they have come up with is a national basic income (NBI), and naturally has already been shot down as a bad idea by those on the Right. I guess they really want people to be poor.

But this idea should be kept on the back burner for now, as given the political climate in this country, that idea will be dead on arrival. Yet, while many have acknowledged what Mc Chesney, Nichols and others have said is happening, the other side — namely the current Speaker of the House and others in his party, have doubled down on their stubborn adherence to the rantings of a two-bit novelist, Ayn Rand and Ayn Randism.

Which brings me to the other point I wish to discuss, and that bears on what happens in the overall economy at large.

If automation and artificial intelligence will lead to elimination of many, if not all jobs, and if that will require a new economy as Mc Chesney and Nichols, and others have argued, what does that mean for the health care industry that seems to be going in the opposite direction?

Even before the enactment of the ACA, health care has become more centralized, bureaucratic, consolidated and more profit-driven than ever. The ACA in many ways has accelerated this process, and the direction it is headed is towards a more consumer-driven form of health care, and one where large hospital systems have integrated physicians and insurance services into their business plan.

The move among some physicians and physician practices towards concierge medicine, also is a sign that health care is moving towards a more capitalistic health care, in that it creates two classes — those who can afford concierge medicine, and those who cannot.

The transition to a new economy will not happen overnight, and may not happen for some time, especially if the forces aligned against it remain strongly opposed to reform. But if the health care system collapses, as I mentioned previously in articles last week, then along with the stagnation of capitalism generally, there will be an opportunity to move in that direction in health care as well.

Calling for ‘Medicare for All’ now with firm opposition to anything that spends government money or has a social benefit other than producing profit for a few, is only a waste of time and a con job.

There are only two ways an economic system and its attendant political system changes; by revolution or evolution. One is violent and bloody, the other happens because the old is replaced by the new so seamlessly that no one gets too emotional when it happens. An election does not do that, especially when the opposition is headed toward fascism.

That issue is for another time and place, and the rest of Mc Chesney and Nichols’ book discusses the current presidential campaign. I wanted to discuss the dichotomy between where capitalism is headed and where health care is headed, and at some point, health care will have to fall in line with the new capitalism.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.

I am also looking for a partner who shares my vision of global health care for injured workers.

I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com.

Will accept invitations to speak or attend conferences.

Connect with me on LinkedIn, check out my website, FutureComp Consulting, and follow my blog at: richardkrasner.wordpress.com.

Transforming Workers’ Blog is now viewed all over the world in 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.

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Angry People Buy Guns, Smart People Write Articles

While perusing my email today, I chanced upon the scriblings of the self-styled, right-winger who had called medical travel a hoax and my idea a non-starter.

This individual saw fit to announce to the world that he had recently purchased 1000 rounds of ammunition, and said that it was for him and his wife.

The point of his rantings was something about letting in new ideas into workers’ comp, and called me an angry man. Funny, if I am angry, then how come he’s the one who bought ammo?

It must be obvious that he is the angry one, just like all the rest of his kind who shoot first (their mouths, then their guns) and ask questions later.

One is not angry if they advocate for an idea they believe will benefit injured workers, when the person calling you angry, buys 1000 rounds of ammo. One is visionary and forward-thinking, unlike the gun nut who shoots his mouth and gun off.

I am not really worried. You see, one day, he will be dead, and hopefully so will his outright hatred and disgust for medical care outside the “good ole US of A”, where we all know only Americans are good at providing quality medical care.

And I also know that when the space plane is made available later in this century for commercial flights, traveling to “Turkishmaninacanstan” will take no more time than going from NYC to Washington, DC, and maybe even less so.

No, the really angry man is the one who, making up for his shortcomings, both physical and mental, needs to buy 1000 rounds of ammunition to hold off new ideas in workers’ comp. Why? So that the status quo stays the status quo.

Or maybe, the only new ideas he likes are the ones that conform to his racist, bigoted, xenophobic hysteria, and that is why he needs 1000 rounds of ammo.

 

Trouble Ahead for Workers’ Comp

The Denver Business Journal today published an article by Steve Doss, VP of Commercial Lines at CCIG.

Here are the key takeaways from Conning, a Connecticut-based investment management company for the insurance industry:

  • Accident frequency has increased. A stronger U.S. economy has meant more inexperienced workers have joined the workforce, so high-hazard occupations like transportation and construction have seen increases in work-related injuries since 2012. For example, non-fatal work-related construction injuries jumped 9.5 percent from 2012 to 2013. Also, as older employees work longer, the number of accidents among those 65 and older rose 18.5 percent from 2012 to 2013.
  • Accident severity is rising. The Bureau of Labor Statistics reports that construction fatalities rose 5.6 percent from 2013 to 2015, and manufacturing fatalities rose 9.3 percent from 2013 to 2014. In addition, hospital and drug costs – the biggest expenses associated with workers’ compensation claims – are rising faster than inflation.
  • Evidence of cost-shifting. The Affordable Care Act may be driving physicians and hospitals to “leak” group health cases into the workers’ compensation system, where they can charge more for the same services than under a group health contract, according to Conning.

For those of you not familiar with workers’ compensation, and those of you who are, what each of the bullet points mean, in simple terms is this:

  • More accidents,
  • Degree of accident injury increasing and,
  • Cost-shifting is occurring.

Isn’t time to stop and realize that whatever programs are implemented, whatever analytical or predictive modeling techniques are utilized, whatever the so-called “experts” say is the cause of this or that problem, whatever so-called “reform” or work comp alternative is attempted, wouldn’t it be prudent to think outside the box, and outside the borders of your limited minds?

Schopenhauer said the following:

“Every man takes the limits of his field of vision for the limits of the world”

Those of you who will not listen to other ideas, no matter how far-fetched they may be, have limited your field of vision and taken them as the limit of the world. The world is globalizing, health care included.

Aerospace technology will very soon allow us to travel to any part of the world in under four hours. Don’t believe me? Ask Boeing why they are running commercials that tout that very same possibility.

Those who cite judges as saying no to medical travel must ask yourselves this question: Do doctors sentence people to death? (By that I mean execution, not natural death from disease or incompetence)

Those who say the laws won’t allow it, should know that laws can be changed, and laws written in the era of the horse and buggy should not dictate to the post-modern, jet-age, and soon-to-be sub-orbital space plane age. Would you like to live under the laws of Caesar or Charlemagne?

And finally, those who say the injured workers won’t go abroad to get better medical care, have you ever asked them, or are you just putting your words in their mouths?

Methinks you all doth protest a bit too much for the sake of injured workers and myself. Look in the mirror and ask yourselves why workers’ comp is failing. The answer is staring right back at you.

Borderless Healthcare: A Model for the Future of Medical Care in Workers’ Comp

By now, many of you, my faithful, and not so faithful readers (and critics) have been aware of my strong interest and passion about implementing medical tourism into workers’ comp.

The critics have not silenced me, they have only made me more determined than ever to get the word out…MEDICAL CARE UNDER WORKERS’ COMP IN THE US WILL HAVE TO GLOBALIZE, OR ELSE IT WILL FAIL TO PROVIDE ADEQUATE CARE AT LOWER COST AND AT EQUAL OR BETTER QUALITY THAN WHAT IS RECEIVED CURRENTLY.

I capitalized the above because in the three plus years I have been writing this blog, it takes a bit of shouting to get heard in this world.

To make the point I just shouted, I participated yesterday in a webinar on Bloomberg BNA.com produced by Manatt, Phelps & Phillips, LLP/Manatt Jones Global Solutions.

For all of you political junkies out there, Charles Manatt was the Chairman of the Democratic Party from 1981 to 1985, in the first term of that has-been Hollywood actor the GOP shoved down our throats.

The webinar, “Healthcare without Borders: The Opportunities and Challenges of Medical Tourism”, was an almost ninety minute, four-part presentation given by two Managing Directors, a Partner, and a Medical Director of a Mexican hospital system.

The presenters were Jon Glaudemans, Managing Director of Manatt Health Solutions, Andrew Rudman, Managing Director of Manatt Jones Global Solutions, Linda Tiano, Partner with Manatt, Phelps & Phillips, LLP, and Dr. Alfonso Vargas Rodriguez, Medical Director of Hospitales H+.

While the focus of the middle of the presentation dealt with conducting medical tourism in Mexico, the information presented by Mr. Glaudermans was concerned about the trends in healthcare that are pointing to greater demand for medical tourism, and are elaborated in the following graphic:

Megatrends

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

Here are the key points from Mr. Glaudemans’ presentation slides:

  • Consumers pay more and make more care decision, using social
    media/apps to acquire price/network data.
  • Providers take risk for population/patient/product outcomes, requiring new care models and contracts
  • Care monitoring and delivery move out of traditional settings, shifting the locus of/focus on patient loyalty
  • Providers and payers consolidate to manage costs and enhance power, fighting for CM (care management) space
  • States become more active regulators and purchasers, creating marketplace mosaics and more “experiments”
  • Data on health status and effectiveness become widely available, changing practice and payment patterns
  • Bigger datasets yield insights, informing personalized care and challenging price-setting and patient privacy
  • Employers’ role continues to erode, while exchange plans sharpen focus on multi-year patient loyalty
  • Digital natives’ and baby boomers’ interests coalesce, forcing focus on new ‘late-life/end-of-life’ care models
  • Visibility into global pricing and care models improves, requiring providers to justify value and pricing
  • Social determinants accepted as major cost driver, leading to increased focus on service integration

Naturally, many of these megatrends will not pertain to workers’ comp, but given the fact that comp sometimes follows the lead of healthcare, it is not out of the realm of possibility that some of these trends will be felt in medical care for workers’ comp.

Andrew Rudman’s presentation focused on what medical tourism is, and why Mexico is an ideal medical tourism destination for Americans. The main thrust of his presentation is the proximity to the US, the flight times between major American cities and those Mexican medical tourism destinations he focused on in the discussion.

Mr. Rudman also provided a cost comparison chart between US and Mexican costs of certain medical procedures, which is shown below.

Cost comparison 2012

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP/PROMEXICO

Dr. Rodriquez discussed how Mexican doctors become certified in their sub-specialties and how they get re-certified once they are certified by their respective boards. In addition, he showed slides about the various hospitals in the Hospitales H+ system, and for our purposes here, outlined the price differential for certain orthopedic surgeries at the various hospitals in their system versus that of the US.

Ortho surgery prices

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP/Hospitales H+

Lastly, Linda Tiano covered the legal issues of medical tourism, and those of you who have been reading this blog for three years, know that my original paper covered some of these issues, and I raised them in my presentation in Reynosa, Mexico in November 2014.

Here are the key points Linda made regarding medical tourism benefits.

Medical Tourism Benefits

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

3rd Party Facilitator

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

Liability issues

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

HIPAA

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

State Regs

Source:  2016+Medical+Tourism+Deck.pdf Manatt, Phelps & Phillips, LLP

At the end, I asked the question, “do you see the possibility of implementing medical tourism into workers’ comp, and what are the legal issues with that?” Ms. Tiano mentioned the state-specific laws regarding workers’ comp, and said that the workers’ comp industry is way behind health care, to which I heartily agreed.

So you can see from this brief, but thorough review of the presentation, that medical tourism is a serious research area for many interested parties. Yet, you guys in work comp refuse to see, hear or speak about the truth of what is happening around you. So here is another picture for you.

hear-no-evil-see-no-evil-speak-no-evil

This is the workers’ comp industry on the subject of global health care and medical tourism…three deaf, dumb and blind monkeys clinging to the same old statutes, laws and regulations that haven’t changed since the days of Taft and Wilson.

So when are you going to catch up to the rest of the world, and to the globalization of health care? In the 23rd century? When are you going to admit to yourselves that automation, new technology, the Internet of Things, telemedicine, etc., are going to make you guys OBSOLETE… to borrow a term from “The Twilight Zone”.

I have a vision for the future of medical care in workers’ comp. What you have is the same old, same old, and expecting different results. That’s not only crazy, that is doing a disservice to the people workers’ comp is supposed to be for, the claimant.

But suit yourselves…the dinosaurs are waiting to greet you.