Copyright
Thursday, June 25, 2015
The Path to Federalization: US Supreme Court Again Validates the Affordable Care Act
Thursday, February 25, 2010
The Occupational Disease Pilot Program & Healthcare
Click here to listen to the interview (duration 27:58): http://tinyurl.com/ycxee3y
MP3 Link: http://tinyurl.com/ybanu3v (20.6MB)
To read more about the Libby MT Pilot Project click here.
To read more about workers’ compensation and universal health care solutions click here.
Monday, February 21, 2011
Obama Care for All
Related articles
- Benefits Available Under the Zadroga 9/11 Victim Compensation Fund (workers-compensation.blogspot.com)
- Vermont Universal Health Care to Embrace Workers Compensation (workers-compensation.blogspot.com)
- The RICO Consequences of Managing Health Care in Workers Compensation (workers-compensation.blogspot.com)
- Out-Of-State Medical Treatment Deemed Authorized by Workers' Compensation Court (workers-compensation.blogspot.com)
- The Health Reform Act Charts a New Course for Occupational Health Care
Monday, December 21, 2009
Good Medicine for an Ailing Compensation System
The stage was set last June 17th, when the US Environmental Protection Agency (EPA) declared Libby, Montana, a Public Health Emergency, because of asbestos present at the site. The geographical location was the site of a W.R. Grace vermiculite mine.
The legislative provision was "buried" deep in the legislation at the last moment, reported Robert Pear of the NY Times. The amendment was made Senator Max Baucus of Montana, who lead the Senate legislative committee crafting the legislation. The convoluted political bartering over the last few days reflects a sentinel change in how injured workers may be receiving medical care in the years ahead. It is anticipated that major changes will be offered over the years ahead to modify and expand the coverage.
Occupational diseases have always been problematic to the State workers' compensation systems. They have been subject to serious and costly proof issues. They were "tag along" claims for a compensation system that initially was enacted in 1911 to cover only traumatic claims. The proposed legislation is a first major step to move occupationally induced illnesses into a universal health medical care system and will provide a pilot project for addressing the long awaited need to furnish medical care without serious and costly delays.
By allowing Medicare to become the primary payor and furnish medical care, those without a collateral safety net of insurance will be able to obtain medical care effectively and expeditiously. While cost shifting from workers' compensation to Medicare has been an historically systemic problem in the compensation arena, this legislation maybe a first major step to legitimatize the process. The legislation may allow for great accountability and expansion of the Medicare Secondary Payment Act (MSP) to end cost shifting that has become epidemic in proportion. It is good medicine for an ailing workers' compensation system.
Click here to read more about workers' compensation and universal health care.
Thursday, June 14, 2012
National Experts Call Workers Compensation System Irrational and Unjust
Related articles
Friday, August 9, 2013
A Conservative Re-Envisioning Of The Health Care Overhaul
Today's post was shared by Kaiser Health News and comes from capsules.kaiserhealthnews.org
Tired of hearing policy experts and politicians debate the 2010 health care law? What if you took the Affordable Care Act out of the conversation? If you could scrap the nation’s current health care system and build a new one, what would it look like?
A group of health care experts from Stanford University, the Harvard Kennedy School of Government and the University of Southern California, among other institutions, has compiled a report with their answer to that question. Funded by the conservative-leaning American Enterprise Institute’s National Research Initiative, the document offers a variety of ideas that its authors say would achieve universal coverage, protect the poor and the sick and restrain health care cost growth, among other priorities.
“In many ways, the ACA has been a distraction, because people think that all of the health care debate boils down to ‘do you support the ACA or do you oppose it?’ ” said Darius Lakdawalla, one of the authors and a visiting scholar at the American Enterprise Institute, as well as a professor of pharmaceutical economics in the University of Southern California School of Pharmacy. “To us, that is really a very narrow and misleading question.”
The report’s proposals include allowing health insurers to charge premiums that reflect consumers’ health care costs and providing generous subsidies to help the poor obtain...
Friday, October 7, 2016
US Department of Labor Urges Major Changes in the Nation's Workers' Compensation System
Friday, March 15, 2013
Workers' Compensation is Riding on the Road to Wellville with Obama Care
Thursday, November 13, 2008
Workers' Compensation Medical Benefits are in Critical Condition
It is not all surprising that Dr. Peter Barth reported to the WCRI Conference in Boston, that workers’ compensation programs may be swept up into a national health care system. He reminds us that this was attempted in the Clinton proposal. The enactment of such a proposal looks even more urgent now.
The medical system overall is now being stressed by: an aging workforce; medical conditions manifested by stress and aging; consumerism in health care; the attempt to shift costs from major medical plans and CMS to workers’ compensation; new and expensive treatment modalities, procedures and pharmaceutical products,and the expansion of palliative and “end of life care.” It is anticipated that the average cost may amount to $500.000 per claim.
The workers’ compensation system just can’t deliver medical treatment quickly and cheaply enough. The systems are frough with administrative costs delay. It is adversarial requiring legal timetables of investigation, litigation, adjudication and appeals. The progress of disease is not subject to court rules or judicial administration. Immediate and emergent medical treatment protocols follow a biological timetable not a legal one.
National health reform that embodies workers’ compensation as an element is a long awaited solution to coordinate and advance the delivery of health care to all Americans. Old, inefficient and archaic systems need to be abandoned if progress is to advance. Moving forward to the inclusion of workers' compensation into a universal and nationalized program for health care is an important and innovative change. The change is crticial and necessary to advance with science, the economy and the social structure of America.
Thursday, November 29, 2012
A Single Payer System Will Solve the Fiscal Cliff
The most important issue is not whether the country has "guns or butter," for in the end it will have both. The question is whether the nation will recognize that the US needs tol take the bold step previously taken by the European Community, finally adopt a single payer medical care program.
The perpetual cost generator that continues to rage out of control in workers' compensation programs is the medical component. Medical costs are crashing the system to failure across the country, with no hope in sight for relief.
Robert Reich clearly stated the issue today in a posting on his blog:
"What worries me most about the tactical maneuvers over the "fiscal cliff" and "grand bargain" is that official Washington seems to be losing sight of the larger picture: We still have a huge number of unemployed, and many of those who have jobs continue to lose ground. If we were a sane society, we'd raise taxes on the rich in order to afford a first-rate system of public education for all our people, starting with early-childhood and extending through four-year college or technical; we'd borrow at historically-low rates (the yield on the ten-year Treasury is still below 1.4 percent) to put millions to work upgrading our crumbling infrastructure; and we'd turn our extraordinarily inefficient and costly healthcare system -- the single biggest driver of future budget deficits -- into a single-payer system focused on prevention and on healthy outcomes. Instead, we're locked into a game of chicken over the budget deficit, and preparing to cut public investments and safety nets.....
Jon L.Gelman of Wayne NJ, is the author NJ Workers’ Compensation Law (West-Thompson) and co-author of the national treatise, Modern Workers’ Compensation Law (West-Thompson).
Read more about "single payer systems" and workers' compensation
NJ Urged to Adopt Single Payer System for Workmens Comp
Related articles
Tuesday, November 24, 2009
Congress, Health Care & Unintended Consequences
Highlights of the NASI (National Academy of Social Insurance) conference convened in Washington were findings presented by eminent leaders in the field. Professor John Burton, Rutgers University, pointed out that newly created barriers to workers’ compensation were pushing more injured workers to the Social Security disability system for benefits. This reflects a phenomenon that occurred in the late 1970’s when a study commissioned by the US Department of Labor and conducted by Mt. Sinai Hospitals’ Environmental Sciences Laboratory, revealed that the inadequate benefit delivery system of workers’ compensation for asbestos related illness, was forcing injured workers and their families into the civil justice arena for adequate compensation.
The problems have not changed in decades; they have only gotten worse, maturing into a system that is in critical condition and on life support. In 1980 Irving J. Selikoff, M.D. reported, “There has been widespread acknowledgement of significant problems with disability compensation for workers in the United States. One major area of concern has been the shortcomings with regard to occupational disease. Whatever the suitability of current workers’ compensation systems in the 50 states for injuries and work accidents, there has been little disagreement about the inadequacies of such systems for workers who become disabled by illness or, if they die, for their surviving dependents.”
Complex questions continue to exist between the scientific and legal communities as to the path to be taken. Barriers placed into the path of recovery, including pre-existing and co-existing conditions, which result in limited or delayed recovery and major shifting of the economic responsibility upon the public/private benefit systems need to be removed. The unspoken social consequences continue as a silent epidemic as families and survivors struggle in silence.
Looking backward over the noble experiment in California which turned sour, Tom Rankin, former President of the California Labor Federation, AFL-CIO, expressed his regret of the reform. The former Labor leader theorized that the results were “unintended consequences.” Indeed he is looking forward to solutions springing forth in a “public option” embedded into the national health care legislation.
Some participants at the NASI conference alleged a major shortcoming of the California workers’ compensation legislative reform effort. Doug Kim, a lobbyist for the claimant’s attorneys, disclosed that the injured workers’ advocates were not invited to partake in the discussion that lead up to crafting the initial drafts of the 2004 California reform legislation SB 899.
History reveals, that when the theoretical reforms were practically applied, the injured workers suffered serious setbacks. If these were in fact “unintended consequences,” then one must consider the active involvement of all stakeholders when looking forward to solutions. The courts in California have consistently upheld challenges to the inequitable results, pointing to the legislative intent to reduce costs. Absent from the discussions of the presenters were practical systemic applications to improve the present system. The “blood and guts” of the traumatic, delay and denial, struggles of navigating in a crippled workers’ compensation system, in California and elsewhere, is verification that change is mandated.
As North Carolina attorney, Valerie A. Johnson, so eloquently remarked, “workers’ compensation is supposed to be a simple system.” The process has now been obstructed by encroaching elements of fault, contributory negligence, apportionment of pre-existing conditions and difficulties of the element of time, manifested by latent diseases unknown to the fathers of the system a century ago. The advance of medical science has brought forth new and innovated modalities that have contributed to soaring medical costs. The convergence of these issues has generated higher administrative costs.
Pecuniary Industry motives have worked adversely to improving safety in the workplace. The need for workers’ compensation would be minimized by adopting a safer occupational environment. Under reporting of workplace accidents continue as the Government Accountability Office announced. Nebraska Appleseed reveals that workers feel intimidated and are apprehensive to report injuries and unsafe work conditions. This is scenario is compounded by the fact that undocumented workers, who have even less job security, work in jobs with higher risk. The Bush Administration did not make efforts to allow OSHA to heighten enforcement efforts. All of these ingredients combine to create a recipe that just doesn’t work.
The US Senate advanced the health care legislation to a floor debate in an unusual late Saturday night session. This action may indeed provide an opportunity for the stakeholders in workers’ compensation to all join in the debate and look for solutions to the delivery of appropriate medical care in an efficient and timely fashion. To avoid “unintended consequences” yet again, injured workers and their advocates will need to be active participants and engage in the debate now.
.......
To read more about workers’ compensation and universal health care solutions click here.
Tuesday, June 20, 2023
Another Class of Benefits Proposed for Workers’ Compensation
The NJ Legislature is considering expanding the multitiered program to compensate the victims of industrial illness. This time a supplemental benefit program is being offered to compensate healthcare workers who contracted COVID-19.
Saturday, September 28, 2013
Building an Accountable Care Organization and Its Impact on Workers' Compensation
Suppose for a moment that you are an administrator in an organization that provides health care and your job is on the line for delivering both savings and improved care. Because you want to be part of the solution to the health-care-cost problem, you have signed contracts with payers that reward your institution or system for reducing the costs of care. These same contracts require you to pay a penalty if the costs of care go up more than inflation. What would be your first, second, and third move?
This is not a hypothetical question. More than 300 hundred administrators of accountable care organizations (ACOs) across the United States are facing it. My team at Partners HealthCare in Boston is faced with this exciting (and daunting) challenge. Having signed shared-savings contracts with both commercial payers and Medicare, our CEO, Gary Gottlieb, established a Population Health Management unit. A major focus of our work is to achieve shared savings in our contracts. That means controlling costs for the populations cared for by our primary care physicians. Since doctors and hospitals within Partners bill for a majority of the care these patients receive, you could say our success depends on reducing the income of our colleagues. Harvard Business School’s Clayton Christensen has taught us this is not possible — that an organization will not cannibalize itself. So when we go knocking on... |
Related articles
- Work Comp Steps Up to ACA (workers-compensation.blogspot.com)
- Home Care Workers Win Wage and Overtime Protection (workers-compensation.blogspot.com)
- What If I May Need Surgery Later? (workers-compensation.blogspot.com)
- US Supreme Court Asked to Review MSP Preemption Issue (workers-compensation.blogspot.com)
- No Shopping Zone: Medicare Is Not Part Of New Insurance Marketplaces (workers-compensation.blogspot.com)
- Needlestick Injuries Are a Costly Problem for the Health Care Industry (workers-compensation.blogspot.com)
Friday, January 25, 2008
Presidential Primaries Are Defining the Future Course of Workers' Compensation Medical Benefits
Sunday, March 22, 2009
The Voice of Change in the Medical Care Debate
Tuesday, November 19, 2013
The Shame of American Health Care
Even as Americans struggle with the changes required by health care reform, an international survey released last week by the Commonwealth Fund, a research organization, shows why change is so necessary.
The report found that by virtually all measures of cost, access to care and ease of dealing with insurance problems, Americans fared poorly compared with people in other advanced countries. The survey covered 20,000 adults in the United States and 10 other industrial nations — Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and Britain, all of which put in place universal or near-universal health coverage decades ago. The United States spends far more than any of these countries on a per capita basis and as a percent of the national economy.
For that, it gets meager results. Some 37 percent of American adults went without recommended care, did not see a doctor when sick or failed to fill prescriptions in the past year because of costs, compared with 4 percent in Britain and 6 percent in Sweden. Nearly a quarter of American adults could not pay medical bills or had serious problems paying them compared with less than 13 percent in France and 7 percent or less in five other countries. Even Americans who were insured for the entire year were more likely than adults abroad to forgo care because of costs, an indication of how skimpy some insurance policies are.
When Americans got sick, they had to wait longer than people in...
|
Related articles
- ObamaCare's Union Favor (workers-compensation.blogspot.com)
- Europeans Fault American Safety Effort in Bangladesh (workers-compensation.blogspot.com)
- Obama Moves to Avert Cancellation of Insurance (workers-compensation.blogspot.com)
- Lousy Medicaid Arguments (workers-compensation.blogspot.com)
- Why Are Children Working in American Tobacco Fields? (workers-compensation.blogspot.com)
- Study: Calif. workers compensation overhaul too new to parse (workers-compensation.blogspot.com)
- mHealth: A Potential Player for Workers' Compensation (workers-compensation.blogspot.com)
Saturday, June 6, 2009
Fixing The Broken Health Care System
In his weekly address to the nation The President said, "Simply put, the status quo is broken. We cannot continue this way. If we do nothing, everyone’s health care will be put in jeopardy. Within a decade, we’ll spend one dollar out of every five we earn on health care – and we’ll keep getting less for our money." Furthermore, "That’s why fixing what’s wrong with our health care system is no longer a luxury we hope to achieve – it’s a necessity we cannot postpone any longer."
The delivery of adequate medical benefits is a metastatic problem that goes to the very heart of the ability of the network of State workers' compensation system to operate. The costs of the delivery, co-ordination and administration of benefits continue to strangle the system into growing stagnation.
In a noble experiment the State of NJ, in response to critical reports, has proposed new regulations to establish an administrative system to expedite "emergent" medical benefits if an "irreparable harm" can be established. The irony is that the standard and requirement is so stringent, that imminent death does not even meet the standard.
The workers' compensation system was enacted in 1911, when the path was simple and short to provide medical care to "relieve and cure." The complexities that developed into the highway of benefits, has brought the major vehicle producers into bankruptcy, ie. Chrysler and General Motors. New vehicles will now need to be manufactured to meet the new needs of today and tomorrow.
It is time that Congress looks toward the workers' compensation system to develop a new vehicle to provide innovative approaches for a better medical delivery system for injured workers. A single medical care program that provides universal medical care would be a wise and appropriate route for America.
Wednesday, July 3, 2013
Obama Administration Delays and Simplifies Rules on Health Care
Friday, November 9, 2012
Our Journey Forward on Occupational Medical Care
President Barack Obama |
Read more about Universal Medical Care – The “Libby Care” Prototype
Workers' Compensation: Libby Care Launches - Center for Asbestos ...
Apr 03, 2010
The recent health care reform legislation provided for the Libby Care which will provide universal medical care for victims of asbestos related disease. The plan is a pilot program for occupational disease medical care fully ...
http://workers-compensation.blogspot.com/
Workers' Compensation: Libby Care Program Begins Enrollment ...
May 19, 2010
The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs will now be available to ...
http://workers-compensation.blogspot.com/
Workers' Compensation: The Health Reform Act Charts a New ...
Apr 12, 2010
The “Libby Care” provisions, and its envisioned prodigies, will embrace more exposed workers, diseases and geographical locations, than any other program of the past. Potential pilot programs will now be available to ...
http://workers-compensation.blogspot.com/