The Maritime Component of Health Care Reform?
International Medical Islands floated as one potential consequence of the socialized health care reforms now being considered by U.S. lawmakers. Unlikely? Don’t bet against it. Under the loose category of unlikely, futuristic, far fetched and pie-in-the-sky ideas, a new phase in American health care could emerge in the not-too-distant future. And, no, I’m not talking about Obama’s quest to save us from the American health care system. But, we are referring to a maritime health care application that involves marine platforms operating in close proximity to – but outside the jurisdiction of – U.S. territorial waters. A U.S.-based international investor characterizes these (proposed) vessels as International Medical Islands. In real practice, the concept might just blossom if any of the proposed health care solutions being bandied about on the Hill comes to fruition. Here’s why: As bad as things might seem for millions of under-insured Americans who face serious health care challenges, the Canadian model for health care that often gets held up as the panacea for U.S. woes might, if implemented, just take our health care system down altogether. Recently, one of my relatives in Canada waited 7-1/2 months for a hernia operation. Eventually, it got done. Here in the United States, I know of a similar procedure that just got scheduled (for an unnamed maritime editor) in a fraction of that time. And although the Canadian system is rightfully hailed as a fair vehicle for elder and pediatric health care, not everybody fits into that square peg. The balance of our northern neighbor’s society waits in increasingly long lines for routine issues and serious procedures alike. In all likelihood, and notwithstanding the good qualities of the Canadian system, laying that template (which currently serves less than 35 million people) onto the needs of about 300 million is a recipe for disaster. There may well be a better system that will lead us to the Promised Land, but given the track record of our elected officials on other equally important matters, I rather doubt that it can be found and implemented. On the other hand, the likelihood of something being legislated and enacted on a national level is increasing daily. Given the makeup of Congress and the Executive branch today, I certainly wouldn’t bet what’s left of my 401K nut that something won’t come to fruition before the end of the current year. It is the fallout from that eventuality that might just make international investor and energy expert Spiro Vassilopoulos want to try his hand at managing an offshore medical system. According to Vassilopoulos, it will work something like this: Using appropriate ships positioned in close proximity to U.S. waters, these fully equipped hospitals, laboratory and hospice facilities could serve a robust market for inexpensive, timely and competent health care services. “Existing medical ships would be the ideal platform, but more likely, a cruise ship that is nearing the end of its useful lifespan in that market (that otherwise might be on its way to becoming a floating hotel) would be used,” explains Vassilopoulos. He adds, “These ships would be DP-capable with the latest in stability and propulsion systems, providing stable platforms for the procedures that would take place on board.” Without a doubt, the vessels would be of flag-of-convenience registry. The concept goes far beyond the maritime aspect of its infrastructure, however. The ship component will be crewed by Greek officers and other nationals. The medical contingent will be made up of American and foreign English-speaking physicians along with all support staff. These offshore hospitals and clinics would also address some of the less appealing aspects of a U.S. health care system that, at its best, can deliver the finest care in the world. The litigious shoreside atmosphere also requires exorbitant malpractice insurance premiums and other costs which, in the end, have brought us to where we are today. For his part, Vassilopoulos promises, “competent, timely and affordable healthcare delivered with corporate umbrella insurance and without the costs inherent in our current medical system or any socialized versions that might follow it.” Unspoken in all of that is the appeal that such a system might have for today’s U.S.-based physicians, most of whom are weary of the malpractice costs and legal pitfalls lurking around every corner. Vassilopoulos, who has recently traveled to Greece and New York to gauge interest in the nascent concept from the Hellenic shipping contingent, can’t take credit for the idea. Instead, he says, the concept was first discussed at a recent gathering of doctors in the U.S. Southwest. As might be expected, the idea that the current administration might be on its way to implementing some sort of at least quasi-socialized healthcare solution came up in conversation. And, of course, the talk naturally turned to what existing physicians might do in the wake of a major upheaval of the current American healthcare system. According to Vassilopoulos, the offshore option “was taken seriously along with dire predictions that as many as one-half of all U.S. doctors would consider ending their practices.” We could be a long way from any sort of healthcare “reform” here in the United States. The ultimate shape of what might come could also dictate that “out-of-the-box” thinking be employed in the wake of such an initiative. Spiro Vassilopoulos is no stranger to the maritime world through the world of energy, LNG and some earlier attempts to revive dormant but viable, laid-up MARAD vessels for a variety of purposes. And, while those efforts involved navigating Port Commissions, rabid environmentalists, FERC, DOE, and Jones Act issues, this is one project that will steer a wide berth of all possible governmental obstacles. He insists, “I think that we can reduce healthcare costs by as much as 70 percent. This new President has yet to fathom that markets are perverse and that his fiddling will force us to ultimately turn to better and less costly ways to provide healthcare.” The concept of an offshore fleet of first rate medical facilities, positioned to easily serve major U.S. markets, isn’t so far fetched. Certainly, it is no more fantastic than the assumption that Barack Obama can economically engineer a socialized system of health care for 300 million Americans, without tearing down all that has come before it. As for myself, I’d rather take the helicopter offshore before waiting 7-1/2 months for the same hernia procedure. What about you? – MarEx. Joseph Keefe is the Editor in Chief of THE MARITIME EXECUTIVE. He can be reached with comments on this editorial at firstname.lastname@example.org. Join the Maritime Executive ‘Linked In’ group at by clicking http://www.linkedin.com/e/gis/47685>