Workers' Compensation: Search results for health care debate

Friday, October 7, 2016

US Department of Labor Urges Major Changes in the Nation's Workers' Compensation System

As The Path to Federalization of the US workers' compensation system broadens, the US Department of Labor has published a report urging expansion of the Federal role in reforming the entire patchwork of state systems. As the Presidential Election Cycle moves ahead, the ultimate outcome will impact the the nation's struggling workers' compensation scheme. Based on historical statements both "Hillarycare" or "Trump Medical," (lead by his advisor, Former Speaker Newt Gingrich, will focus on this issue. See my prior blog posts below.

Endless Assault on Health Care Reform

Today's post is shared rom nytimes.com
The opponents of the Affordable Care Act make no secret of their consuming hatred for the law that has already provided health care to millions of lower-income people.
From the beginning, they have tried everything they could to kill it. As one conservative scholar, Michael Greve, said in 2010: “I do not care how this is done, whether it’s dismembered, whether we drive a stake through its heart, whether we tar and feather it and drive it out of town, whether we strangle it.” Yet the challengers keep losing in Congress and in court.
The latest jerry-built effort to destroy health care reform could be defeated in the full federal appeals court in the District of Columbia. In July, a three-judge panel of that court — taking a ridiculously crabbed view of a section in the law — ruled 2-to-1 that tax-credit subsidies are allowed only for those buying insurance on a health exchange “established by the state.” Therefore, it said, no subsidies for people in 36 states where the federal government set up the exchange because the states refused to do so.
There is no evidence that Congress intended to make this distinction, which defies the law’s central purpose. In fact, this argument was rejected unanimously by a three-judge panel of the federal appeals court in Virginia.
Now the fight has shifted to an arcane legal debate over whether the full appeals court in the District of Columbia should rehear the case or allow it to be appealed...

Wednesday, June 10, 2009

The Lack of Equality in the CMS Reimbursement Policy

The current debate on national health care has brought to the forefront some of the most glaring problems that are compounding the workers’ compensation medical delivery system. Since the enactment of The Medicare Secondary Payer Act (MSP) in 1980, the Federal Government has desperately tried to prevent cost shifting from the workers’ compensation system to the Federal Medicare program. The efforts of The Centers for Medicare and Medicaid Service (CMS) to seek medical reimbursement of past and future medical care costs from workers’ compensation beneficiaries, in a uniform fashion across the entire national spectrum, is plagued with equality issues.

In a very insightful article, Robert Pear of The New York Times on June 9, 2009 reported that costs of medical care were not uniform through out the nation and that an increase in expenditures for treatment did not improve the outcome. These “disparities,” as Pear points out demonstrate major fluctuations in the cost of Medicare payments for the same types of treatment. “Nationally, according to the Dartmouth Atlas of Health Care, Medicare spent an average of $8,304 per beneficiary in 2006. Among states, New York was tops, at $9,564, and Hawaii was lowest, at $5,311.”

The costs for medical care paid by Medicare based upon geographical jurisdictions are unequal. More specifically, higher costs states were reported to be: Florida, Massachusetts, New Jersey and New York. The lower cost states were reported as: Iowa, Minnesota, Montana, North Dakota, Oregon and Washington.

CMS has sought to seek reimbursement under the MSP Act for medical care, present and future, based on a nationally tailored program. Unfortunately, the benefits paid by each state program are not the same.

While the program to deter the shift of billions of dollars Medicare funds yearly to pay for work related injuries and disease is a noble goal and legitimate function, it is now unequally applied to beneficiaries across the country since all workers’ compensation benefit programs are not the same and the costs of medical treatment vary.

The need for uniformity and equality should be address by Congress as it debates the future of medical care legislation. The enactment of a single payer medical care system would be a good first step to leveling the playing field for both employers and employees.

Tuesday, October 22, 2013

The Great Coronary Angioplasty Debate: Giving Patients the Right to Speak | The Health Care Blog

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Nortin Hadler, MD
Earlier this month, the editors of THCB saw fit to post my essay, “The End of the Era of Coronary Angioplasty.”
The comments posted on THCB in response to the essay, and those the editors and I have directly received, have been most gratifying. The essay is an exercise in informing medical decisions, which is my creed as a clinician and perspective as a clinical investigator.
I use the recent British federal guideline document as my object lesson. This Guideline examines the science that speaks to the efficacy of the last consensus indication for angioplasty, the setting of an acute ST-elevation myocardial infarction (STEMI). Clinical science has rendered all other indications, by consensus, relative at best. But in the case of STEMI, the British guideline panel supports the consensus and concludes that angioplasty should be “offered” in a timely fashion.
I will not repeat my original essay here since it is only a click away. The exercise I display is how I would take this last consensus statement into a trusting, empathic patient-physician discourse. This is a hypothetical exercise to the extent that little in the way of clear thinking can be expected of a patient in the throes of a STEMI, and not much more of the patient’s caring community.
So all of us, we the people regardless of our credentials, need to consider and value the putative efficacy of angioplasty (with or without stenting) a priori. For me, personally, there is...

Click here to read the entire article, "The Lack of Correspondence Between Work-Related Disability and Receipt of Workers' Compensation Benefits," American Journal of Industrial Medicine 55:487-505 (2012).

Thursday, June 14, 2012

National Experts Call Workers Compensation System Irrational and Unjust

National workers' compensation experts, Law school Dean Emily A. Spieler and Professor John F. Burton, in a recently published article in the American Journal of Industrial Medicine conclude that the present that the present workers' compensation systems is "irrational" and "unjust."

Characterizing the program as "....dizzying and frustrating in its complexity, and apparent irrationality," they conclude that "a substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits." They review such alternatives as universal medical care, "providing healthcare to workers regardless of the source of injuries or disease."

Related Articles on Alternative Compensation Programs

The World Trade Center Health Program Expands The Path to

Dec 23, 2010

Yesterday the US Congress passed and sent to the President, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program. The Federally ...

Workers' Compensation: Agenda Announced for Public Meeting on ...

Feb 15, 2011

In December 2010 US Congress passed and President Obama signed, The World Trade Center Health Program, marking yet another advance on the path to federalize the nation's workers' compensation program.

Designing the New Federal Workers Compensation Program

Jul 05, 2010

The trend toward Federalization of workers' compensation benefits took a giant step forward by recent Presidential action creating the British Petroleum Oil Compensation Fund. While the details remain vague, the broad and ...

Workers' Compensation: Synchronizing Federal Care for Oil Spill ...

Jul 13, 2010

As The Path To Federalization expands, this debate will expand. A recent study by the Center for American Progress addresses these concerns. "Health threats from the oil spill may linger unseen, perhaps for more than a ...

Workers' Compensation: A Nuclear Workers' Compensation Disaster

Mar 16, 2011

Historically The Federal government's role has been to rise to the occasion and walk further down a path to federalization. On a smaller scale than the potential consequences of the Japanesse debacle, the US was first in line ...

Workers' Compensation: Vermont Universal Health Care to Embrace ...

Mar 05, 2011

Nationally, advocates to improve the delivery of medical benefits to injured workers have urged federalization of the medical delivery system into a single payer approach through universal health care. ... Compensation Claim Draws Major Public Attention (workers-compensation.blogspot.com); Vermont Governor Sets Out to Lead U.S. to True Universal Coverage (huffingtonpost.com); The World Trade Center Health Program Expands The Path to Federalization ...

Sunday, November 24, 2013

The ePrognosis App: How Calculating Life Expectancy Can Influence Healthcare Decision-Making

Today's post was shared by The Health Care Blog and comes from thehealthcareblog.com

By Leslie Kernisan, MD

Last month an intriguing new decision support app launched, created by experts in geriatrics and palliative care. It’s meant to help with an important primary care issue: cancer screening in older adults.
Have you ever asked yourself, when considering cancer screening for an older adult, whether the likely harms outweigh the likely benefits?
Maybe you have, maybe you haven’t. The sentence above, after all, is a bit of wonky formulation for the following underlying questions:

How long is this person likely to live, given age and health situation?
Given this person’s prognosis, does cancer screening make sense?

The first question seems like one that could easily occur to a person — whether that be a patient, a family member, or a clinician – although I suspect it doesn’t occur to people perhaps as often as it should.
As for the second question, I’m not sure how often it pops up in people’s minds, although it’s certainly very important to consider, given what we now know about the frequent harms of cancer screening in the elderly, and usually less frequent benefits.
Furthermore, there is abundant evidence that “inappropriate” cancer screening remains common. “Inappropriate” meaning the screening of people who are so unwell and/or old that they’re unlikely to live long enough to benefit from screening.
For instance, one astounding study found that 25% of physicians said...

Thursday, September 10, 2009

Congressional Action on Workers’ Compensation

From coast to coast, the patchwork of state workers’ compensation systems continues to be under constant scrutiny for change. The problems seem global in characteristic as the frustrations continue to rise. The fate of the entire system may result in the effort to enact or defeat legislation to embrace a new national commission on workers’ compensation.

The States universally enacted Workers’ Compensation in 1911 in an effort to replace civil litigation with an administrative system. The approach was to provide a remedial system to injured workers in a summary manner while providing a cost effective approach for employers. Despite the efforts to reduce benefits and limit access States are struggling to maintain the system in one fashion or another. Rumors are spreading that New York, a former industrial jurisdiction, may join the list of radically modifying their system.

The once touted as a “no fault” system, the nation’s workers’ compensation has been besieged by efforts to assert more restrictive requirements for benefits. Medical delivery has stagnated in a complex world of etiology and evidential proof of occupational claims. The cost of soaring medical care, once shifted easily to collateral health insurance companies and the Social Security system, has been met with convoluted reimbursement efforts. Large corporations and public entities that in the past were able to provide an additional stream of revenue to injured workers are now rapidly drying up and or become non-existent under bankruptcy laws. State governments, that maintain the administrative system, are now facing a monumental shortage is revenue and are closing down operations and converting some for criminal and economic sanctions to merely benefit the general state revenues. The few remaining second injury funds have become insolvent and the future remains bleak as the premiums committed to finance these agencies and programs become depleted.

On January 22, 2009, Representative Joe Baca, a Democrat from California, introduced legislation (HR635) to establish a second National Commission on State Workers' Compensation Laws [Commission]. The first Commission was established under the Nixon administration in accordance with the Occupational Safety and Health Act. The new legislation that is now supported by representatives of injured workers lacks co-sponsors. Opposing the legislation is a long line of Industry based employers including the Americans Manufacturing Association and the National Chamber of Commerce.

John Burton, the former chair of the 1971 Commission, in a recent interview, commented that many of the present systems do not even comply with threshold recommendations of the original Commission and that many of the present programs face some serious challenges.

Patrice Woeppel, Ed.D., author of Depraved Indifference the Workers' Compensation System, has called for a single payer medical system to embrace both work and non-worker related injuries. By allowing the employer and insurance carrier to control the medical care she indicates, results in "restricting treatment to the cursorily palliative" or delay and denial of treatment to the injured worker. Additionally medical plan administrative costs of duplicative and wasteful.

As the national health care debate continues and the final legislation unfolds, the workers’ compensation medical delivery issues and wage replacements for temporary and permanent disability may become incorporated into direct or ancillary legislation. A second Commission, in one form or another, aimed at nationalizing the workers compensation system, may indeed become a reality.

Monday, September 8, 2014

Some Embattled Democrats Embracing Obamacare

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

News outlets look at Democratic Sen. Mark Pryor's promotion of the health law in a campaign ad as a sign the law may be less radioactive. Meanwhile, Politico notes that 30 of the 34 House Democrats who voted against the law are no longer in office as the partisanship that it engendered grows.

The Associated Press: Democrats Reframe Debate On Health Care
One of the most vulnerable Senate Democrats is standing by his vote for President Barack Obama's health care law, a fresh sign that the unpopular mandate may be losing some of its political punch. In an ad released this week, two-term Arkansas Sen. Mark Pryor says he voted for a law that prevents insurers from canceling policies if someone gets sick, as he did 18 years ago when he was diagnosed with cancer. That prohibition on ending policies is one of the more popular elements of the 4-year-old law that Pryor never mentions by its official name — the Affordable Care Act (Cassata, 8/22).

The Hill: Dems Find Obamacare Ammo
Vulnerable Democrats are finding ways to tout ObamaCare in an election cycle where the unpopular law was expected to be a liability for their party. The most overt emphasis on healthcare came this week, when Sen. Mark Pryor (D-Ark.) debuted an ad centered on his 1996 bout with cancer and his vote for the 2010 legislation, which protects people with pre-existing medical conditions from losing insurance coverage. "No one should be fighting an insurance company while you're fighting for your...

Wednesday, May 11, 2011

Common Themes, The Green Mountain System & Newt Gingrich

Common themes of a single payer medical system are emerging. History can repeat itself. The announcement by Newt Gingrich to run for the presidency in 2012, and the anticipated signing of the Vermont Single Payer medical care legislation, may set the stage for "the perfect storm" to gather impetus for a system that brings workers' compensation care into a unified system.

As the Vermont legislation goes to Governor Peter Shumlin for signing in a couple of weeks, the eyes of the nation will switch focus to the debate in Washington and the presidential race of 2012. Congress and the new administration will be required to focus on the issue of waivers that will be effective in 2014.

Newt Gingrich had advocated in the past to move the cost occupational medical care onto the backs of employees. He would relieve employers from contributing to workers' compensation medical care and Medicare.

Workers' Compensation is a summary and remedial system that affords injured workers medical care to cure and relieve medical conditions that result from occupational exposures and accidents. In most instances employees find it necessary and prudent to retain the professional assistance of an attorney to assist them in obtaining medical treatment for work related accidents and occupational exposures.

For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.

Related articles

Friday, May 13, 2011

Common Themes, The Green Mountain System & Newt Gingrich

Editors note: This is a re-post of yesterday's blog. Google had a systemwide issue and during their maintenance they did not restore this post.

Common themes of a single payer medical system are emerging. History can repeat itself. The announcement by NewtGingrich to run for the presidency in 2012, and the anticipated signing of the Vermont Single Payer medical care legislation, may set the stage for "the perfect storm" to gather impetus for a system that brings workers' compensation care into a unified system.

Wednesday, November 20, 2013

New obesity treatment guideline released

Obesity is now been classified as disease. With such a designation of Worker's Compensation systems will be impacted by request for benefits in order to diminish obesity is a pre-existing and coexisting diagnosis. Treatment plans will need to be included for the reduction of weight in order to treat certain diseases by protocols including medication.Today's post was shared by RWJF PublicHealth and comes from www.bostonglobe.com

A new guideline for obesity treatment, released last week by the American Heart Association and American College of Cardiology, provides a solid road map for doctors challenged with helping overweight patients achieve a healthier weight.
Insurance coverage for weight-related counseling, such as helping patients plan new menus with fewer calories or outline a realistic fitness program, could improve under this new recommendation. More importantly, the panel of physicians and weight researchers outlined which interventions are the most effective based on clinical trials.
Doctors should treat patients who are obese — a BMI of 30 or above (180 pounds or more for a 5-foot-5 person — as well as those who are overweight with a BMI between 25 to 30 (150 to 180 pounds for a 5-foot-5 person) if they have certain heart disease risk factors such as type 2 diabetes, the guideline states. People at a healthy weight, or who are overweight without any health problems, should keep their weight steady.
“It’s not just about body weight, but whether excess body weight is associated with medical conditions,” said Dr. Timothy Church, director of preventive medicine research at Pennington Biomedical Research Center, who was not involved in writing the guideline.

Doctors can offer drugs or bariatric surgery to help reverse obesity, but they should first try providing patients with intensive counseling to help them exercise and eat right.

Monday, December 1, 2014

Suit on Health Law Puts Focus on Funding Powers

Today's post is shared from nytimes.com/
WASHINGTON — In mounting the latest court challenge to the Affordable Care Act, House Republicans are focusing on a little-noticed provision of the law that offers financial assistance to low- and moderate-income people.
Under this part of the law, insurance companies must reduce co-payments, deductibles and other out-of-pocket costs for some people in health plans purchased through the new public insurance exchanges. The federal government reimburses insurers for the “cost-sharing reductions.”
In their lawsuit, House Republicans say the Obama administration needed, but never received, an appropriation to make these payments to insurance companies. As a result, they contend, the spending violates the Constitution, which says, “No money shall be drawn from the Treasury, but in consequence of appropriations made by law.”
President Obama requested the money as part of the budget he sent Congress in April 2013, but Congress did not act on the request. Seeing the issue as an urgent priority, the administration began making the payments early this year, using money from a separate account established for tax refunds and tax credits.
“The cost-sharing reductions are really important and valuable,” said Judith Solomon, a vice president at the Center on Budget and Policy Priorities, a liberal-leaning research and advocacy group.
Under a standard insurance policy, for example, consumers might have to pay a deductible of $2,500 before the health...

Friday, April 30, 2010

OSHA Releases 15 Years Worth of Valuable Measurement Data

The US Occupational Safety and Health Administration has released 15 years worth of measurement data and has placed the information on-line for easy access. This Chemical Exposure Health Data is comprised of measurements taken during the course of Occupational Safety and Health Administration (OSHA) inspections and includes exposure levels to hazardous chemicals including asbestos, benzene, beryllium, cadmium, lead, nickel, silica, and others.

Dr. David Michaels is the Assistant Secretary for the Occupational Safety and Health Administration, U.S. Department of Labor., stated that "....Making this dataset available to the public for the first time will offer new insight into the levels of toxic chemicals commonly found in workplaces, as well as how exposures to specific chemicals are distributed across industries, geographical areas and time. This information will ultimately lead to a more robust and focused debate on what still needs to be done to protect workers in all sectors, especially in the chemical industry."

To read more about health care and workers' compensation click here.

Sunday, September 28, 2014

Debate Grows Over Employer Plans With No Hospital Benefits

Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

Lance Shnider is confident Obamacare regulators knew exactly what they were doing when they created an online calculator that gives a green light to new employer coverage without hospital benefits.
“There’s not a glitch in this system,” said Shnider, president of Voluntary Benefits Agency, an Ohio firm working with some 100 employers to implement such plans. “This is the way the calculator was designed.”
Timothy Jost is pretty sure the whole thing was a mistake.
“There’s got to be a problem with the calculator,” said Jost, a law professor at Washington and Lee University and health-benefits authority. Letting employers avoid health-law penalties by offering plans without hospital benefits “is certainly not what Congress intended,” he said.

As companies prepare to offer medical coverage for 2015, debate has grown over government software that critics say can trap workers in inadequate plans while barring them from subsidies to buy fuller coverage on their own.
At the center of contention is the calculator — an online spreadsheet to certify whether plans meet the Affordable Care Act’s toughest standard for large employers, the “minimum value” test for adequate benefits.
The software is used by large, self-insured employers that pay their own medical claims but often outsource the plan design and administration. Offering a...