(c) 2010-2024 Jon L Gelman, All Rights Reserved.

Monday, October 31, 2011

It is All The Same Apple

Another challenge to the Medicare Secondary Payer Act (MSP) has been introduced (H.R. 1063 in Congress. This is yet another attempt to bounce the dead cat on the floor.

The legislation is the third reiteration by insurance companies, and the cottage industry that has emerged to service conditional payment resolution. It is most likely doomed to failure reflecting the quick death of its predecessors and the worsening economic times.

Since the enactment of the  MSP in 1980, there has been a slow, yet pervasive and effective effort by the US government to stop the shifting ofmedical costs from the workers’ compensation system onto the  shoulders of the Medicare system.

Medicare has its own solvency problems, not withstanding cost-shifting by the workers’ compensation system. Medicare is trying to serve a growing constituency as costs soar and the base of available of income to tax dwindles. Medicare costs have become a major target for the “Super Committee” in Congress for cost reduction.

Statistics also reveal that the aging workforce is continuing to fall apart physically and file for Social Security Disability Insurance in lieu of workers' compensation at a greater rate than ever..  Even though more attention is now directed to major diseases such as cardio-vascular, cancer and diabetes, the aging bodies of the senior citizen population continue to need more medical care due to wear and tear alone. The barriers established through so-called reformed efforts have blocked the follow of new occupational disease cases into the workers' compensation system.

The aging workforce looks to Social Security Disability Benefits and Medicare as a more effective remedy, and one that takes precedence over applications for workers’ compensation. Fewer seniors, and those approaching that age, opt for workers’ compensation benefits. This pattern even puts more fiscal strain on the present Social Security and Medicare system. 

Medicare is really not a free-ride for seniors and the government. While workers and their employers have made contributions for a lifetime, the system consume a large portion of the nation's economic wealth. Two major hospitalizations by a beneficiary exhaust all the individual and employer economic contributions completely from the reserves, and the government is stuck covering excess bills for the individual's lifetime.

As the US government continues to mandate stricter reporting and payment procedures the state workers’ compensation programs as the state programs to become further stressed by the Centers for Medicare and Medicar Services (CMS) reimbursement procedures. Both the federal and state systems have the same goal of providing assistance to disabled workers and their families.

As each continue to battle for a resolution of their own economic issues, they are merely shooting each other in the foot and weakening the entire purpose of each of their noble missions. Until a more unified system is established, it is incumbent upon both programs to direct their efforts to designing a more non-contentious system of resolution. 

The mandatory arbitration of the cost medical reimbursement would be an interim step so that the workers’ compensation administrative process could go forward unimpeded. The problem of funding medical costs for the population should be considered one apple, and taking bites at it from every direction will merely result in a total deterioration of the entire process.