Tag Archives: Workers’ Compensation

The Road to Recovery: Post-Acute Care in Workers Compensation

The following is directed towards all those engaged in medical travel and have been following my blog for some time. Sorry I haven’t been writing in a while. I either did not see anything to write about, or just wasn’t in the mood.

But the article below should be of extreme interest to all of you who deal with post-acute care and after care, even though you are not involved as of yet in workers’ comp.

As the original focus of the blog was transforming workers’ comp, this should be read by those of you who have followed my ideas on the subject. Let me know what you think.

NCCI, for those of you not familiar with them, is the organization responsible for collecting and distributing data about the American workers’ comp industry, what is driving the costs of comp, and of claims, and other financial data relevant to the industry’s function.

Here is the link to their article:

Source: The Road to Recovery: Post-Acute Care in Workers Compensation

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At the Bottom: A Work Comp Perspective on the Need for Single Payer

It is rare when someone from the work comp blogosphere crosses into health care and advocates that the US learn from other countries that have universal health care, in whatever form it takes in those countries.

Tom Lynch of Lynch Ryan’s Workers’ Comp Insider blog, did just that with a very detailed analysis of the US health care system compared to that of other Organization for Economic and Cooperative Development (OECD) countries.

Here is Tom’s article:

What does a nation owe its citizens with respect to health care?

For nearly all members of the Organization for Economic and Cooperative Development (OECD), the answer is guaranteed, high-quality, universal care at reasonable, affordable cost. For OECD founding member America, the answer seems to have become an opportunity to access care, which may or may not be of high-quality at indeterminate, wildly fluctuating and geographically varying cost.

It is indisputable that the US devotes more of its GDP to health care than other countries. How much more? For that answer we can turn to many sources, roughly all saying the same thing. The OECD produces annual date, as does the World Health Organization, among others. Another reliable and respected source is The Commonwealth Fund, which conducted a study of eleven high income OECD members including the US. The collection of health care cost data lags, so data from this study is mostly from 2014. Here is the cost picture:

As you can see, in 1980, US spending was not much different from the other ten OECD countries in the study. While high, it was at least in the same universe. But now, at 50% more than Switzerland, our closest competitor in the “how much can we spend” sweepstakes”, we might be forgiven for asking, “What in the name of Hippocrates happened?” As if this weren’t enough, the 2014 GDP percentage of spend, 16.6%, has now risen to nearly 18%, according to the CMS.

So, what do we get for all that money? We ought to have the highest life expectancy, the lowest infant mortality rate and the best health care outcomes in the entire OECD. But we don’t.

For many readers, it is probably galling to see both the UK and Australia at the top of the health care system performance measure and at the bottom of the spending measure. In the early 2000s, each of these countries poured a significant amount of money into improving its performance, and the results speak for themselves.

Consider all of this mere background to the purpose of this blog post.

Last week, we wrote about the terrible, 40-year stagnation of real wage growth in the US, pointing out that in that period real wages in 1982-1984 constant dollars have risen only 4.5%. But, as we have seen, health care spending did not follow that trajectory. This has resulted in tremendous hardship for families as they have tried to keep pace with rising health care costs. For, just as US health care spending has risen dramatically since 1980, so has what families have to pay for it.

To put this in perspective, consider this. Since 1999 the US CPI has risen 54%, but, as the chart above shows, the cost of an employer offered family plan has risen 338%. If a family’s health care plan’s cost growth had been inflation-based, the total cost to employer and employee would be $8,898 in 2018, not $19,616. In 2018, the average family in an employer-based plan pays 30% of the plan’s cost ($6,850), plus a $2,000 deductible, plus co-pays that average $20 whenever health care is accessed, plus varying levels of co-pays for drugs.

On top of all that is the enormous difficulty people have in trying to navigate the dizzying health care system (if you can call it that). American health care is a dense forest of bewildering complexity, a many-headed Hydra that would make Hesiod proud, a labyrinthine geography in which even Theseus with his ball of string would find himself lost.

With wages and health care costs growing ever farther apart, America has a crisis of epic proportion. Yet all we can seem to do is shout at each other about it. When do you think that will end? When will we begin to answer the question that this post began with: What does a nation owe its citizens with respect to health care? When will our nation’s leaders realize we can actually learn from countries like Australia, the UK, Switzerland and all the other high performing, low cost members of the OECD? Continuing on the present course is no longer a viable option.

 

Note: You may be questioning The Commonwealth Fund’s research. To put your mind at ease about that, here are the study sources:

Our data come from a variety of sources. One is comparative survey research. Since 1998, The Commonwealth Fund, in collaboration with international partners, has supported surveys of patients and primary care physicians in advanced countries, collecting information for a standardized set of metrics on health system performance. Other comparative data are drawn from the most recent reports of the Organization for Economic Cooperation and Development (OECD), the European Observatory on Health Systems and Policies, and the World Health Organization (WHO).

Link: http://workerscompinsider.com/2018/11/at-the-bottom-looking-up/

Six Years and Counting: Yet No Opportunities

Those of you who wished me congratulations the past few weeks were told that you were a little early, as yesterday, the 29th was my actual anniversary for beginning this blog.

To refresh your memory, I began this blog three days after returning from the 5th World Medical Tourism & Global Healthcare Congress in Hollywood, Florida.

You may also have noticed that the focus of the blog has shifted from workers’ compensation and medical travel to health care, especially as the debate here in the US has gotten more attention over the ACA and Single Payer, as well as the myriad schemes some are trying to force down the throats of Americans that keep the status quo.

The blog has been viewed nearly 40,000 times over the six years, but at no time have I ever made any money from it, yet that was my intention when I began. I thought my writing would convince someone of my talent and skills. Sadly, that has not happened.

In fact, there are days where only a handful of individuals view my blog, but I push on. How long that will continue, I don’t know, or is up to you.

You’ve no doubt seen my posts for positions or opportunities, so why don’t you reach out to me.

You know where to find me.

Gauze: A Film by Suzanne Garber

Nearly a year ago, while channel surfing, I came across a short film being shown on my local South Florida Public Broadcasting System (PBS) station.

As I missed most of it, I was able to learn the name of the filmmaker from the credits, and saw that she had interviewed some of the leading names in the medical travel space.

One individual I saw listed in the credits was Keith Pollard, with whom I was connected with on LinkedIn, and had communicated over the years since I began blogging about medical travel. I reached out to Keith to ask him to put me in touch with the filmmaker, Suzanne Garber.

I later learned from Keith that before she gave Keith her permission to forward her email address to me, she wanted to know if I was legitimate. Keith vouched for me without hesitation, and I reached out to Suzanne.

Unfortunately, due to ownership of the rights to the film by PBS, it has taken nearly a year for me to get to see it. What follows is my review of her film, “Gauze Unraveling Global Healthcare”.

The film is a personal account of Suzanne’s exploration into the difference between US healthcare, with its bureaucracy and lack of transparency regarding cost to patients; plus its affordability, accessibility, and quality — the three characteristics of healthcare, according to Suzanne.

Suzanne had gone through some personal medical issues, and the film begins with her discussing statements she received that were very expensive. At one point, she describes how she was forced to sign a form at a hospital in order to get service that said she was responsible for the full amount if her insurance company refused to pay.

She asked the woman at the desk who gave her the form if she knew what it would cost her, and the woman replied that she did not know, so Suzanne said that she was signing away her right to know how much it could cost her.

Then Suzanne asked some of her friends the following question: where is the best healthcare?

Having been an executive credentialing hospitals for a company she was working for, Suzanne had vast experience visiting hospitals, and had personal experience of being admitted to a hospital in Spain as a child. She decided to go and visit some of the hospitals that cater to medical travel patients.

From 2014- 2015, she visited 24 countries, 174 hospitals, and interviewed over five dozen international healthcare experts. She wanted to know the answer to the following questions: Where to go, and where not to go?

But it was when she had a medical diagnosis of cancer that she traveled thousands of miles, flying from Philadelphia to Chicago, to Tokyo, and then to Bangkok, where she went to Bumrungrad Hospital. By that time, her position had been eliminated, she was unemployed and uninsured, so she took the chance and went.

She traveled to Singapore to get a second opinion with an orthopedist. A doctor there wanted to perform a bone density scan, and even though she brought along all of her MRIs, CAT scans, etc., the doctor had her go downstairs, wait forty-five minutes, and then go back upstairs to see the doctor after the results were entered into the computer.

In all, it cost Suzanne $29 dollars, not the amount she was quoted back in the US. And all this took one day.

As part of her journey, she visited the UK, India, and visited several hospitals in France. And what she found was that there is no one way to improve our healthcare, but it is possible. We need to ask questions, we need to contact our elected representatives, and we need to take responsibility for our healthcare.

A personal note: This film when shown on PBS last year, had a long list of names Suzanne interviewed. In addition to Keith Pollard, one other person, Rajesh Rao of IndUSHealth, was someone I met in 2014 at the ProMed conference in Miami Beach. Some other names in that list were familiar to me, but as of this screening, does not appear. One more comment, I was able to view the film online, but am not able to provide readers with a copy of it in this post.

This is a very important and timely film that should be viewed by both the health care industry and those in the workers’ compensation industry who have panned the idea of medical travel. The mere fact that Suzanne paid only $29 for a bone density scan, when she was told it would be $7,300 in the US, is not only criminal, it is insane to keep insisting that medical travel for workers’ comp is a stupid and ridiculous idea, and a non-starter, as one so-called expert has written.

When are you people in work comp going to wake up? You and your insurance carriers are being ripped off by an expensive medical-industrial complex. But you just go on doing the same things over and over again, and expect different results, or you boast that frequency is going down, yet medical costs are still too high. The choice is yours, but don’t keep making the same mistake.

I want to thank Suzanne for her patience in bearing with my periodic emails regarding my viewing the film, and for being courageous enough to put her personal struggles with health and health care front and center, and comparing it to our so-called health care system. I hope that Gauze Unraveling Global Healthcare will be seen by all those interested in better health care for all Americans, workers or not.

 

Injured Worker Arrested When Employer Could Not Cut WC Benefits

The Charlotte Observer today reported on the case of an injured worker who suffered a brain injury after a fall in 2003 at his employer’s workplace. And because they could not cut off his benefits, they had him arrested.

In case you find this incredible, here is the link to the article:

https://www.charlotteobserver.com/news/local/article217808590.html

Is this what it has come to today in Workers’ Comp? That insurance companies refuse to continue lifelong payments to injured workers because they believe he is faking his injuries, so they and his employer have him arrested?

This is more than harsh; this is despicable.

 

Trends in Workers’ Compensation Claims: Some Things to Think About for Medical Travel

It is rare that I post articles from the National Council on Compensation Insurance (NCCI) on this blog, and it has been some time since I discussed workers’ comp and medical travel in the same post, so I thought that this would be a good time to do so.

NCCI is the premier source for data collection in the workers’ compensation industry. Their focus is more involved with the factors that drive the cost of workers’ comp insurance, rather than specific issues in workers’ comp that one might find from reading the reports of the Workers’ Compensation Research Institute (WCRI).

As the article will note, there has been a decrease in frequency of claims, but an increase in severity. Claim frequency is defined by NCCI as the number of claims involving lost wage benefits paid, divided by earned premium. For those of you in the health care and medical travel worlds, just know that it means there are more claims reported to insurance carriers.

Claim severity, on the other hand, is defined as losses incurred, divided by the number of claims, for lost wage benefits paid. This will be of importance to the medical travel industry, as they have found a +16% increase in medical severity from 2011 to 2016.

I will let you read the rest of the article here.

Medical Travel/Health Care Thought Leader Seeks Opportunities

 

Medical Travel/HealthCare Thought Leader and Blogger, seeks opportunities to speak, write, and collaborate on projects to bring about greater participation of patients to global medical travel facilities.

NOTE: I am not a physician, nor do I have patients or clients to refer to you. I am seeking persons already engaged in medical travel who want to expand into a new market. I offer my services in an administrative or managerial capacity.

Experience:

Over five and a half years experience creating, maintaining, and analyzing current issues in Medical Travel, Health Care, and other topics.

Over six years research into the Medical Travel industry.

Promoted the implementation of medical travel into Workers’ Compensation insurance industry.

Analyzed the cost of healthcare and the options of alternative treatments abroad.

Presented White Paper to Medical Travel conference in Mexico in Nov. 2014.

Extensive experience in Insurance and Claims Management, especially in medical-related claims (Workers’ Compensation).

Strong administrative and financial skills.

Education:

Master’s in Health Administration, 2011

Interested in working remotely, willing to travel, willing to write and speak at conferences, has valid US passport.

Resume can be found here.

Blog: richardkrasner.wordpress.com

Phone number: +1 561-603-1685 (mobile)