Category Archives: United Kingdom

Damned If You Do, Damned If You Don’t

“You can always count on Americans to do the right thing – after they’ve tried everything else.”

Winston Churchill

“Our policy is to create a national health service in order to ensure that everybody in the country irrespective of means, age, sex or occupation shall have equal opportunities to benefit from the best and most up-to-date medical and allied services available.

Winston Churchill

 

Veering away from the usual topics covered in this blog, I thought about some recent articles I saw about the attempt to repeal and replace, or to simply repeal the Affordable Care Act (ACA), which the current political regime wants to do.

The first article, in yesterday’s [failing] New York Times, warned that repealing the ACA would make it harder for people to retire early. Those who retire early, before reaching 65, can get retiree coverage from their former employers, but not many companies offer that coverage.

Those early retirees poor enough could turn to Medicaid, and everyone else would have to go to the individual market. Without the ACA, health care coverage would be more difficult to get, cost consumers more where available, and provide fewer benefits.

According to the article, if the ACA is repealed, retiring early would become less feasible for many Americans. This is called job-lock, or the need to maintain a job to get health insurance.

This is one of the concerns the ACA was supposed to address, in that it would reduce or eliminate job lock. Repealing the law could, according to the article, affect employment and retirement decisions.

The second article, from Joe Paduda, also from yesterday, reported that improving healthcare will hurt the economy, and Joe lays out the arguments for doing something or doing nothing to improve health care and what effect they would have on economic growth.

For example, Joe states that healthcare employs 15.5 million full time workers, or 1 out of every 9 job. In two years, this will surpass retail employment. As Joe rightly points out, those jobs are funded by employers and taxpayers. He suggests that some experts argue that healthcare is “crowding out” economic expansion in other sectors, thereby hurting growth overall.

But Joe also points out that by controlling health care costs, employment will be cut, and stock prices for pharmaceutical companies, margins for medical device firms, and bonuses at health plans will also be affected.

So, if cost control and increasing efficiency works, these lost jobs, reduced profits, and lower margins, Joe says, will hurt the economy. The economy will suffer if the health care sector is more efficient, and since healthcare is also a huge employment generator and an inefficient industry, fixing that inefficiency will reduce employment and growth.

Thus, the title of this article, “Damned if you do, damned if you don’t.”

But wait, there’s more.

Yesterday, a certain quote has been making the rounds through the media. It was uttered by Number 45. “Nobody knew health care could be so complicated.”

Yes, it is complicated and complex, but does it have to be so? If we consider the second Churchill quote above, and realize that the UK, France, Germany, Canada, and many other Western countries have some form of single payer, then one must conclude that it is only the US that has complicated and made too complex, the providing of health care to all of its citizens.

There are many reasons for this, which is beyond the scope of this article or blog, but there is one overriding reason for this complexity…GREED. Not the greed of wanting more of one thing, but the greed of profit, as one executive from an insurance company stated recently.

This brings me to the last of the articles I ran across yesterday. It was posted on LinkedIn by Dave Chase, founder of the Health Rosetta Institute. He cited a segment on the Fox News Channel’s Tucker Carlson program, in which Carlson interviewed a former hospital president who said that pricing was the main problem with the US healthcare system.

Mr. Chase does not solely rely on Carlson’s guest in his article, but cites other experts in the field as evidence that pricing failure is to blame.

If we are to except this as true, then it buttresses my point that the overriding problem is greed, for what else is the failure to control prices but a symptom of greed inherent in the American health care system, and something that does not exist elsewhere in the Western world.

Which brings me to Churchill’s first quote above. Since we Americans have tried the free market system of health care wanting, and have tried a reformed free market system, perhaps it is time to go all the way to a government-sponsored, Medicare for All, single payer system.

The bottom line is: we’re damned if we do, damned if we don’t. The question is, which is the lesser of two evils.

UPDATE: Here is Joe’s take on what will happen to the ACA in the next two years. I agree with his assessment.

RIP GLOBALIZATION?

From all the commentary this weekend and on Friday about the referendum to leave the European Union (EU) in the UK, it would seem that the dream of a handful of international bankers, multinational corporation heads and politicians of both the left and the right since the end of the Second World War have made a terrible and unforeseen error in pushing for a globalized world economy.

How did we get to this place? Simple, as a result of the economic policies of the 1920’s and 1930’s, Europe and her allies in North America, were plunged into a second global conflict. Near the end of the conflict, the economic leaders of the Allied nations gathered in Bretton Woods, NH to carve out the Bretton Woods Agreement, which established the World Bank and the International Monetary Fund.

Along with this, came the United Nations to deal with the political and military crises that would arise in the second half of the twentieth century. To provide greater perspective, we must go back to the First World War and recognize that here in the US, many Americans were woefully ignorant not only about world affairs, but of geography as well. In 1914, I doubt many Americans could point out just where Sarajevo or Serbia was, or where any of the other nations drawn up into that war were located.

Following on the heels of an earlier organization, the National Civic Federation, several prominent business, political, academic, labor and other leaders formed the Council on Foreign Relations. The Council promoted the study of geography and political science in colleges and universities, as well as promoting social studies in high schools and junior high schools.

The Council also published Foreign Affairs magazine, which became a forum for the discussion of world events and dissemination of political theories and policies from leading academics and business leaders. But there was one other thing that the Council did. It provided the US government with its future Secretaries of State, War, Treasury, and later Defense, among other lesser administration positions from the 1920’s onward.

My first major in college was political science, and more specifically, international relations and foreign policy. I also had a graduate course in American Foreign Policy at NYU as part of my History Masters degree.

After WWII, the Cold War forced many of the Western countries to realize that in order to defend against Communism, as they had against Fascism, they needed to have greater cooperation. So the North Atlantic Treaty Organization, or NATO was born, and within Western Europe, the idea of European cooperation led to the formation of the Common Market, of which the UK was a member.

In the 1950’s and 60’s, the European Coal and Steel Community (ECSC) and  was created, followed by the European Economic Community (EEC). These developments were spelled out in the Brussels Treaty of 1948, the Paris Treaty of 1951, the Modified Brussels Treaty of 1954, and the Rome Treaty of 1957.

In the 1960’s, the Merger Treaty of 1965 created the European Communities, made up of the European Atomic Energy Community (EURATOM), as well as the  ECSC and EEC.

The Maastrict Treaty of 1992 created the European Union, and its membership has grown steadily, especially after the fall of Communism in Eastern Europe and the breakup of the Soviet Union and Warsaw Pact.

Meanwhile, in other regions of the world, similar ideas were taking shape. In Asia, the Association of Southeast Asian Nations (ASEAN) was formed to do for Southeast Asia what NATO and the European Communities were doing for Europe.

To foster greater cooperation between North America, Western Europe and Japan, the three industrial regions of the world, David Rockefeller, Chairman of Chase Manhattan Bank and Zbigniew Brzezinski created the Trilateral Commission. In the next two decades, membership in the Commission was expanded to every other region of the world.

Like the Council on Foreign Relations, members of the Commission could be involved in politics in their respective countries, but once they achieved national office of any kind, they resigned from the Commission. Membership was recommended by current members, and the incoming Jimmy Carter Administration of 1977-1981 saw the following members leave the Commission: Jimmy Carter, Walter Mondale, Harold Brown, Zbigniew Brzezinski, Cyrus Vance, among many others.

It was in college that I studied global politics, or what would become known as Globalization, and with the expansion of the Commission’s member countries, and the fall of Communism, it seemed that globalization would continue.

Yet, they made one big mistake. Neglecting to replace the jobs lost to globalization from the 70’s to the present and thinking that “free trade” conducted through treaties such as NAFTA, CAFTA, TPP, and under the approval of the WTO would benefit both the developed and underdeveloped worlds. Hardly, as the Brexit vote and the rise of Trump in the US, as well as Bernie Sanders on the left can testify to.

Globalization has been mostly a one-way street out of the developed countries and into the undeveloped or developing countries. It has had the unintended consequences of stirring up racism, bigotry and resentment, as well as distrust in institutions and government. It has also favored the wealthy and those international players already in the game, but locks out those who are attempting to benefit from it, as many in the medical travel industry have tried and failed to do.

With other European nations threatening to leave the EU, and opposition here to TPP, and other trade deals (“I’m going to make better deals”), it would seem that globalization, far from dead yet, may at least be stopped in its tracks for the foreseeable future. That may happen if the US does the stupid too, and elects a moron.


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

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

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

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

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

Will accept invitations to speak or attend conferences.

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

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