Richard Krasner: The Stars Aligned: Mexico as a medical tourism destination for Mexican-born US workers under Workers’ Compensation

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Sometimes the stars align, and a writer such as myself finds a topic to write about. This is what happened to me this week. The topic I found was Mexican workers getting medical treatment in Mexico for work-related injuries. The topic presented itself when I received a new blog post from Joe Paduda. This was the first star to align. Joe’s post was about the end of workers’ compensation as a statutory benefit. In it, he discusses a recently released study by Peter Rousmaniere, one of my LinkedIn connections who writes about issues in workers’ compensation. Peter’s study, Workers’ Compensation Opt-Out: Can Privatization Work?, looks at the Texas experience with an employer opt-out model of workers’ compensation, and the proposal that failed in the Oklahoma legislature earlier this year. Under the Texas model, employers have three choices. They can stay in the statutory system maintained by the state, opt-out of the statutory system and create their own “non-subscriber” program, or opt-out altogether and risk legal liability. The second star that aligned was an article written by Martha R. Gore, a freelance writer in national politics whose article was originally published at Examiner.com. The article was then published in Medical Travel Today, a medical tourism newsletter. The article was titled, Medical tourism in Mexico an answer to Obamacare restrictions for Americans?, and highlighted some of the factors that might make Americans consider traveling to Mexico to get medical services that Obamacare may restrict. These services include heart surgery, dental work, cosmetic surgery, orthopedic treatments and weight loss surgery. Gore pointed out that the Medical Tourism Corporation (MTC) stated that some new Mexican hospitals are state-of-the art and can be compared to the best in the world, with a recent boom in small clinics and surgery centers, as well as high-quality hospitals. According to the MTC, Gore states, Mexican doctors often have more experience than American doctors, because either the procedure has not been approved by the Food and Drug Administration (FDA), or was only recently approved. She also mentioned a study by University of California, Los Angeles researchers and colleagues that reported that almost a million California residents travel to Mexico each year for medical treatment and surgery. This was expected to increase in response to limitations under Obamacare. Gore’s article also mentioned three hospitals that the MTC listed in their report. The third star aligned when I read an interview in Medical Travel Today in their SPOTLIGHT section with Maria Todd, founder and CEO of The Mercury Healthcare Companies. Maria is also a LinkedIn connection of mine, and an expert in the medical tourism industry. This interview was prompted by several press releases from Mercury about their work in Nigeria and Mexico, where they were involved with the development of a cancer center. The interview also pointed out that they recently conducted several audits in Guadalajara as part of their work with healthcare clusters. It then occurred to me that I should write about Mexican workers in the US going back to Mexico for work-related injuries because much of what I had received this week was about Mexico. Although Peter’s study is more involved with insurance rather than medical tourism, the fact that Texas and Oklahoma are Southwestern states, and many of the workers there are Mexican, made this a perfect topic to write about. Add to this the result of the recent election where states like Colorado, Nevada and New Mexico gave Barack Obama a large percentage of the Latino vote. Texas and other Southern states may follow suit in the next cycles, and more Mexican workers will need medical treatment either under Obamacare once the immigration issue is settled, or under workers’ compensation. So this is when the stars aligned. Peter commented to me in one of our email conversations that Mexican workers might be more receptive to medical advice and instructions if delivered by a Mexican clinician. I told him that this was a good point, and then recalled that I mentioned something like this in one of my earlier posts where I created a fictional case study of a self-funded employer for both healthcare and workers’ compensation that offered medical tourism to their employees from Latin American and the Caribbean as an option. In that post, I mentioned something someone else told me about the employee having better self-esteem, knowing that their families and friends back home could visit them, and that they would be able speak the same language as the hospital staff and be in a familiar culture — all of which would translate into a better outcome and a faster recovery and return to work. As more US states follow Texas’ example and allow employers to opt-out of statutory workers’ compensation, the possibility that medical tourism can become a part of their “non-subscriber” program increases. While many of the services mentioned in the Gore article are not generally covered by workers’ compensation, there are rare cases where cosmetic surgery, dental work and weight loss surgery, — especially since the National Council on Compensation Insurance, Inc. (NCCI) recently released a report on co-morbidities in workers’ compensation — are covered. Even orthopedic treatments such as spinal fusion, knee and hip replacement or repair, which is covered under workers’ compensation, would be lower cost and have better quality in Mexico compared with the US. So, the future of medical treatment in Mexico for workers’ compensation looks promising, as soon as more Mexican workers here, both documented and undocumented, get healthcare coverage or are given an opportunity to gain citizenship under immigration reform. This would be a boon for medical tourism. About Richard Krasner Krasner has worked in the insurance and risk management industry for more than 30 years in New York, Florida and Texas in the Claims and Risk Management spheres, primarily in Workers’ Compensation Claims, Auto No-Fault and Property & Casualty Claims Administration and Claims Management. In addition, he has experience in Risk and Insurance Business Analysis, Risk Management Information Systems, and Insurance Data Processing and Data Management. Krasner is available for speaking engagements and consulting. Phone: 561-738-0458 Cell: 561-603-1685 Email: richard_krasner@hotmail.com Skype: richardkrasner

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