Tag Archives: Immigrant Workers

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.

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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.

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

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

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!

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

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: richard_krasner@hotmail.com. Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: richardkrasner.wordpress.com. Share this article, or leave a comment below.

 

 

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.

Health Care Across US-Mexico Border: A Two-Way Street

The following article appeared on Friday in the Medical Tourism Association’s (MTA) online magazine, Medical Tourism Magazine.

Those of you who have been following my blog for some time now, know that the MTA copyrighted my White Paper without my written permission. However, because this article deals with a subject that I have already written about in the past, I thought it would be a dereliction of my responsibility as a blogger to not post this to my blog and to deprive my readers of the information it contained.

Here is the link to the article.

http://www.medicaltourismmag.com/blog/2014/09/ask-patient-medical-tourism-consumers-know-health-worth-price/

The US workforce is increasingly Latino and will be for the foreseeable future, especially in CA, AZ, NM and TX, not to mention other states like CO and NV.

To allow cross-border health care and not cross-border workers’ comp medical care is quite frankly, wrong and short-sighted. There should be no difference between getting knee surgeries in Houston and knee surgeries in Tijuana and Baja. 

Survey says most immigrant workers unaware of Workers’ Compensation: What this means to Workers’ Compensation and Medical Tourism

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Introduction
Back in January, you may recall that I wrote a post about immigration reform and had invited a guest blogger to write about immigration as well. Also that month, I wrote about the hospitals located in Latin America and the Caribbean that I saw at the Medical Tourism Association Congress last October.

My purpose in writing those two posts was to tell people in the workers’ compensation and medical tourism industries that immigration reform was going to happen, that it could have an important impact on both industries, and that as far as the workers’ compensation industry was concerned, it would be a wise thing for them to consider medical tourism, especially to the “rising stars” of medical tourism in Latin America and the Caribbean, as the number of Latinos in the US is growing and more and more workers are of Hispanic descent, and because of immigration reform, more of them will become legal citizens able to come and go from the US to their countries of origin without fear of not being able to return or being deported once they did return.

Immigrant Survey Report
Now comes a report from New Hampshire, courtesy of David De Paolo’s blog, De Paolo’s Work Comp World, which says that a majority of immigrants to the US do not know that if they are injured on the job, they can get their medical care paid for by workers’ compensation. According to De Paolo, the New Hampshire Department of Health and Human Services (DHHS) reported that a recent survey of immigrants showed that most of them never heard of workers’ compensation.

The participants in the survey were asked if someone in the US ever told them that their medical bills would be paid for by workers’ compensation insurance, if they suffered an injury on the job. If they said yes, they were told to write down who had told them about workers’ compensation.

The report, Occupational Health Surveillance Immigrant Survey Report, conducted in February, indicated that 227 participants out of 366, or 62%, were not aware of workers’ compensation. Only 76 individuals, the report states, out of 126 who said yes to understanding workers’ compensation wrote down who told them about it. This included supervisors, human resources personnel, family members, friends, doctors, co-workers, teachers and the New Hampshire Coalition of Occupational Safety and Health (COSH) through classes on safety.

Twenty-nine of the 366 participants said they had been injured at work, with injuries to common body parts such as hands, fingers, wrists, backs, knees, feet, elbows, and abdomen. The majority of these injured had been in the US for either 4-6 years, or more than 6 years. 17 of the 29, who said they were injured on the job, had lost time claims.

23 participants had told their supervisors about their injuries, 4 did not report because they left the job due to the injuries, a cut finger was not considered “serious”, one felt that if the injury was reported, “nothing would change”, and one said they would be fired.

Report Statistics
The report includes several tables and graphs detailing respondents work experience in the US, population change in New Hampshire from 1990 to 2010 by ethnicity, demographics, continent of origin, race and ethnicity, education, jobs they held in the US and other employment data, as well as knowledge of workers’ compensation, number of weeks out of work, who paid the bills, treatment of injuries, working conditions and safety at work, supervisor support, and if they experienced bad treatment.

182 or 50% of respondents said they now worked for pay in the US, whereas 135 or 37% said they never worked for pay in the US before their present employment. The population change in NH from 1990 to 2010 saw a decrease in the White population from under 100,000 in 1990 to 40,000 in 2010, while the Black, Hispanic, Asian population increased, but not as much as the White population decreased. There was a decrease however in the Other category from 1990 to 2010. The largest group increase was among the Hispanic population.

The demographics showed that of the 366 immigrants, 41% were men and 58% were women (1% did not answer). The majority of respondents were between the ages of 21 to 60, with the 21 to 30 group representing 21%, the 31 to 40 group representing 24%, the 41 to 50 group representing 21%, and the 51 to 60 group representing 17%. The Under 21 group was 3% and the 60-plus group was 12%, with 1% leaving age blank.

Most of the respondents indicated that their continent of origin was Asia (44%), followed by the Dominican Republic/Haiti/Cuba at 14%, South America at 11%, Central America at 10%, Africa at 11%, Europe and the Middle East at 4% each, and 1% blank. If you add the Dominican Republic/Haiti/Cuba, South and Central America, you get 35%, indicating that the second largest region of origin is Latin America and the Caribbean, something medical tourism facilitators for that region should be aware of.

What does this mean for the Workers’ Compensation and Medical Tourism Industries?
It should be fairly obvious that for the workers’ compensation industry, this report means that they have not done a good job of keeping up with the changing face of the American workforce, and have ignored the immigrant worker for far too long, so that many of them do not know that when they are injured on the job, they can get their medical bills paid for, and can be compensated for lost time from work, which would help them get them back on their feet and keep their families secure.

It also means that labor unions and advocates for immigrants and workers have not done as good a job as they should have in getting the legal, and even the illegal immigrants the proper legal remedies they are entitled to under our laws. Perhaps it is fear that if the immigrants know about workers’ compensation, they will file more claims and thus raise their employer’s claims frequency, resulting in higher costs and premiums. Or perhaps they are afraid if they tell immigrants about workers’ compensation insurance, that somehow they will be deported for having made a claim. Whatever the reason is, it is quite obvious that there is a breakdown in communication between employer and employee, between unions and workers, between advocates for immigrant rights and the legal system and those they are dedicated to serve.

Some of the things that can be done are as follows:

  • When I did my internship for my MHA degree, the company I worked for had me check their database to update workers’ compensation rules and regulations regarding wall cards or panel cards that are required to be placed in an area of the employer’s workplace where workers can see it that will tell them what to do in case of an injury and how and where to file a claim, as well as to list any doctors chosen by the employer or insurer, or the state work comp agency that the claimant must use. It should be mandatory for all states to post wall cards, even if that state does not require a panel of physicians to be posted.
  • The wall cards should be written in several different languages, depending on the predominant ethnic and language groups in the particular state.
  • Allow advocates of the poor and immigrants, such as churches, unions, and advocacy groups to file claims for those injured immigrant workers who are too afraid to report claims to their bosses, or don’t know how to file, or who to trust. This should be in conjunction with legal personnel versed in the state’s workers’ compensation laws.

As for the medical tourism industry, this is an opportunity for the industry to step out of the shadows and open up to an underserved market of recent immigrants to the US from many of the same regions of the world in which the medical tourism industry is already sending Americans overseas for less costly and better quality healthcare. It is also an opportunity for the medical tourism industry to move away from being solely a province of affluent or middle class patients, and help serve those at the bottom of the social scale to get the same quality care the affluent and middle class are getting in medical tourism.

I have written some on the region more than a third of the respondents said they came from, Latin America and the Caribbean. With the majority in the survey saying they are from Asia that would mean that medical tourism could be implemented in workers ’ compensation by facilitators and destinations already providing medical care services in Asia, Latin America and the Caribbean. So it would not mean that they would have to do anything different than what they are already doing, just doing so for a different patient population.

It would require training and educating all levels of medical tourism to understand the difference in treating patients who are coming for care because they cannot get or afford such care back home, from those who get injured on the job and need care coordination, utilization management and review, and aftercare. But most important, it would require a change in direction for those facilitators and medical tourism destinations that only serve the well-to-do or middle class client.

Conclusion
It is apparent from the New Hampshire report that there is a serious problem in this country with regard to the awareness and knowledge of the laws and rights workers have when they are injured on the job. It was more than 100 years since the Triangle Shirtwaist Factory fire that took the lives of over 100 young women and girls, many of them Italian and Jewish immigrants, not unlike the immigrants of today.

Every state in the union eventually passed workers’ compensation laws as a result of that tragic fire, and workers won other rights such as unemployment insurance, the right to join the union of their choice as my grandparents did, the right to strike and collective bargain, and the right to have a decent retirement paid for by money they and their employers put into pensions and social security funds. All that is being, or has been lost or eroded over the past forty years, and there are people today in this country who would like nothing more than to eliminate all the gains workers have made in the last one hundred years.

The survey indicates just how fragile these gains are, because if future workers don’t know they have these rights; then it is much easier for the opponents of these reforms to get rid of them altogether and claim they never existed. The threat this survey poses to workers, employers and the workers’ compensation industry is not as great as the opportunity it affords for better workers, better productivity and less time lost from accidents on the job, and even lower claims costs if medical tourism is added to the mix.

The threat to the medical tourism industry from this survey is minimal, since right now it mainly deals with patients who can afford to go abroad or whose insurance companies will allow them to do so. The opportunity it represents is enormous, so it is in the best interest of all parties that the medical tourism and workers’ compensation industries work together, so that all patients can get the best and most cost-efficient healthcare available.