Republican Lawmakers Set To Unveil Health Law Replacement Plan

Health care is a known unknown in the future of workers' compensation. If the Scott Walker's Wisconsin plan to dismantle workers' compensation is implemented, will that lead to more uninsured workers, or a merger into a universal health care program? Will it be a step backward to the 1994 Contract With America and the Newt Gingrich plan to eliminate workers' altogether? The debate continues as the 2016 national election cycle continues to frame the issues. Today's post was shared by Kaiser Health News and comes from kaiserhealthnews.org

House Energy and Commerce Committee Chairman Fred Upton declined to give details on the plan. Some Republicans are pushing tax credits and deductions for health care, and others are pushing the idea of "portable" health coverage -- the ability to take your insurance from job to job. The Associated Press: GOP Lawmakers Ready A Plan To Replace Obama Health Care Law A Republican House committee chairman says he and two GOP senators are preparing to release a plan for replacing President Barack Obama's health care law. House Energy and Commerce Committee Chairman Fred Upton declined to discuss details Tuesday, but said the proposal will give Republicans a proposal that they can stand behind. The Michigan Republican said he, Senate Finance Committee Chairman Orrin Hatch of Utah and Sen. Richard Burr of North Carolina will unveil their proposal Thursday. (2/3) The Fiscal Times: New GOP Congress Develops Alternate Health Plans House lawmakers are planning to vote for a 60th time today to repeal the president’s health care law – a vote that’s legislatively pointless but politically symbolic. Many of the 47 GOP freshmen who were elected last November won at least in part because their constituents were anti-Obamacare. (Ehley, 2/3)

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Denial Rates: An Insurance Company Tactic That Compounds the Health Care Delivery Problem

As Congress considers changes in the nation’s health care program, US health insurance companies continue to be scrutinized. The methodologies of how insurance companies deny claims are being investigated.

A certified nurse assistant, Amelia Mendoza, age 52, of West Covina, California, was attacked twice in the same week by a patient while working at Huntington Hospital in Pasadena earlier this year. Amelia suffered injuries that resulted in her suffering a stroke in April, falling into a vegetative state and contracting pneumonia. The hospital insurance carrier cut off medical care for her, forcing her from the hospital, and leaving her family responsible for medical care for Amelia’s work-related injury that is the hospital’s responsibility.

Her husband, Ralph Mendoza, who met with reporters and supporters outside the hospital, commented, “I am shocked and extremely disappointed that Huntington Hospital would treat Amelia this way. Amelia gave her all to her job for more than six years, and she deserves better….Amelia was injured doing her job, and the hospital has avoided its responsibility for months. I watch my wonderful wife, a mother of four children, slip away in a vegetative state and I wonder whether she would be healthy today if the hospital had met its responsibility. I want the medical care that my wife deserves.”

After an attack by a violent patient, Amelia was examined in the hospital’s Emergency Room and told to return to work. After a second attack just two days later, Amelia went to the Emergency Room and was told to go to Huntington Hospital’s in-house workers’ compensation clinic. The hospital was aware that Amelia’s blood pressure was dangerously high after the attack, and that the patient had infectious diseases. The hospital even called Amelia and her husband to warn of the health dangers Amelia faced. Yet the hospital’s clinic turned Amelia away, saying they were too busy to see her. Amelia suffered a stroke less than three hours later. The attacks had caused bleeding in her brain.

“The workers’ compensation carrier, Sedgwick, has denied liability for Amelia’s medical care, claiming that their investigation did not support a claim of injury and no medical evidence supports the claim either,” said Amelia’s attorney, Chelsea Glauber of the Glauber/Berenson Law Firm. “Medical evidence does in fact exist which states in no uncertain terms that Amelia’s condition was caused by these attacks at work. Amelia is trapped in a horrible hell, between two insurance companies trying to avoid responsibility. So Huntington Hospital let Amelia go home, in a vegetative state, to be taken care of by her husband, who no matter how loving and well intentioned, is not qualified to provide the critical care that Amelia needs and deserves. What does it say about these insurance companies and a hospital that they would treat a hard-working human being in this awful manner?”

A recent report on insurance companies denial rates reveals that, “When it comes to claim denials, insurers may be putting profits ahead of patients’ best interests. Most major insurance companies have reassigned their medical directors—the doctors who approve or deny claims for medical reasons—to report to their business managers, whose main responsibility is to boost profits.”


An inefficient system is not helpful to anyone, including injured workers, insurance companies, and employers. Wasteful administration should be curbed. The U.S. healthcare system wastes between $505 billion and $850 billion every year, recently reported Robert Kelley, vice president of healthcare analytics at Thomson Reuters.

Lawmakers must concentrate the U.S. health debate on how the delivery of medical care can be more efficient and effective. Delays and denials presently occurring in the workers’ compensation system continue to highlight the fact that injured workers need a universal health care system.

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

The Path to Federalization: US Supreme Court Again Validates the Affordable Care Act

The US Supreme Court again affirmed the validity of The Affordable Care Act. The Obamacare program, as it has been nicknamed, will continue to lead to a medical delivery program than eventually will have major repercussions on the antiquated and ineffective medical care system of the existing patch work of state workers' compensation insurance acts.

The Occupational Disease Pilot Program & Healthcare

Health Care reform continues to be at the forefront of the Obama administration’s agenda.   Legal Talk Network Host and Attorney Alan S. Pierce welcomes Jon L. Gelman to discuss health care and workers’ compensation and the Occupational Disease Pilot Program: a close look at the delivery of  medical benefits when it comes to occupational disease and how workers' compensation may or may not fit into the big picture of universal health care or health care reform.


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. 

Obama Care for All

Over half our injured worker clients do not have health insurance. Many work for employers who do not provide health insurance, and they simply cannot afford private insurance on meager wages.

Since workers do not have group health insurance coverage, they are denied access to the medical care they need when their injury claims are denied by the worker's compensation insurer. And their claims are routinely denied based on the comp carrier's "hired gun" adverse medical examiner or reviewer. Understandably, hospitals and doctors, who have "bottom line" issues to face, will not provide treatment without some assurance of "upfront" payment, leaving injured workers in the lurch.

Wisconsin injured workers are fortunate that our State law provides a potential remedy for "prospective treatment"; a judge can order a worker's compensation insurance company to pay for treatment (including diagnostic testing, surgery, etc.). But the time lapse in waiting for a hearing (40-6 months) and inevitable insurance company appeal (another potential 6-8 months), realistically means that necessary treatment goes wanting. Injured workers without some insurance alternative to workers compensation suffer while waiting for treatment. Universal health insurance coverage provides an answer to this dilemma.

Thomas M. Domer practices in Milwaukee, Wisconsin (www.domerlaw.com). He has authored and edited several publications including the legal treatise Wisconsin Workers' Compensation Law (West) and  he is the Editor of the national publication, Workers' First Watch. Tom is past chair of the Workers' Compensation Section of the American Association for Justice.  He is a charter Fellow in the College of Workers' Compensation Lawyers. He co-authors the nationally recognized Wisconsin Workers' Compensation Experts Blog.

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Good Medicine for an Ailing Compensation System

An historic shift in the delivery of medical care for those injured by occupational exposures has been signaled by the US Senate. Following decades of debate, the proposed emerging health care legislation, amended at the last minute by the Majority Leader's manager amendments, shifts Libby, Montana's asbestos disease claims to Medicare as a primary payor.

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.

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."

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).

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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 ...

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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.

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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 ...

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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 ...

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Workers' Compensation: A Nuclear Workers' Compensation Disaster

Mar 16, 2011

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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 ...

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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...

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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.

Workers' Compensation is Riding on the Road to Wellville with Obama Care

As Obama Care [The Affordable Care Act] launches, workers' compensation programs will start to undergo subtle changes   The innovation of wellness programs and new treatment protocols will eventually cause major shifts to the delivery of workplace medicine.

Workers' compensation's future, ironically, has actually been viewed primarily in a rearview mirror. The shift to break with old habits has been a major struggle. The inertia will give way to a creative future based on new technologies and socio-economic challenges.

In a recent article by The Honorable David B. Torrey, Judge of Workers' Compensation ["The Affordable Care Act and Effects on the Workers' Compensation System, (7 PAWCSNL 114 at 30, March 2013)], the significance of  Obama Care is reported.  Judge Torrey recognizes that even those with major pecuniary interests in the compensation business have been unable to halt the momentum of change.

Workers' Compensation Medical Benefits are in Critical Condition

Now that Barach Obama is a going to be at the helm of the US, greater attention is being focused on the need for a national health care system incorporating workers’ compensation medical coverage. With private insurance companies failing, unemployment increasing, the cost of medical care soaring, more attention has now been placed on the elimination of medical care as a workers’ compensation benefit paid by Industry.

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.

A Single Payer System Will Solve the Fiscal Cliff

As time marches on to yet another US fiscal crisis, the politicians continue to attempt to direct public attention between the nation's rich and the poor. It has become yet another well produced political campaign of sound bites with no real substance.

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

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Vermont Single Payer System Called the Dawn of A New Era

Apr 03, 2011

The proposed state based Vermont Single-Payer health care system, that would embrace workers' compensation medical care, is gaining momentum. A recent article in the New England Journal of Medicine, citing increased ...

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RICO Issues Can Be Cured With A Single Payer Medical System

Mar 22, 2011

Vermont's proposed single payer system would seperate medical care from indemnity. Vermont's single proposed single-payer system would likely also provide a primary care doctor to every resident of Vermont. This would ...

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

Mar 05, 2011

The legislation " proposes to set forth a strategic plan for creating a single payer and unified health system. It would establish a board …. ; establish a health benefit exchange for Vermont as required under federal health care ...

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Congress, Health Care & Unintended Consequences

This past week some very dramatic things happened in the workers’ compensation world. The US Senate moved forward on initiating a floor debate on health care. At the same time, a group of workers’ compensation scholars met in Washington DC to discuss the future of workers’ compensation and the interplay with social security disability.

 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.

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.

Building an Accountable Care Organization and Its Impact on Workers' Compensation

Medical cost containment is a universal problem for insurance companies and employers. For those states with fee schedules indexed to the Medicare system, limitations are in place. For those jurisdiction where fee limitations are not in place, ie. NJ,costs may continue to soar without containment. Today's post was shared by NEJM and comes from blogs.hbr.org

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...

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Presidential Primaries Are Defining the Future Course of Workers' Compensation Medical Benefits

Workers' Compensation medical benefits continue to be up for grabs as the US Presidential Primaries continue. The problematic compensation delivery system continues to provide little cost containment, high administrative costs and continues to drain the system by endless delay hampering the delivery of effective medical care.

A recent survey article in the New England Journal Medicine, baes on a Kaiser Family Foundation and Harvard School of Public Health review, crystallizes the political future of universal health care based upon present perceptions and future solutions. The review article analyzes multiple surveys and concludes that while polarization continues in many areas there are common grounds. It are those similarities that will define the future of medical care in the US.

While both Democrats (79%) and Republicans (52%) agree that the nation's health care system is "poor," they both Democrats (46%) and Republicans (28%) agree that it does not need to be completely rebuilt.

Both parties content that the failure to health insurance is a serious problem, Democrats (94%) and Republicans (55%) and the overwhelming majority of both parties feel that employers should not bear the responsibility for medical care, Democrats (19%) and Republicans (19%). The issue over the implementation of a universal coverage program seems to be split consistently along party lines, Democrats (79%) and Republicans (53%).

Interestingly enough very few surveyed wish to reduce Federal government programs, Democrats (5%) and Republicans (12%) which implies that a shift to a more efficient and effective Federal universal system would be warranted. Incorporating workers' compensation medical benefits into such a universally designed system would appear to be the direction where things are headed.

The Voice of Change in the Medical Care Debate

The Workers' Compensation industry  appears to lack a meaningful voice in the US health care legislative debate. As the interested parties are being tapped by a coalition of Senate leadership for support, the fractionalized workers' compensation industry remains on the sidelines waiting for the opportunity to be asked to dance at the party.

The Henry J. Kaiser Family Foundation reports that Senator Edward M. Kennedy (D-Mass) and a core group of other Senators, including Republicans, have formed a coalition to craft health care legislation. The legislation will be introduced before the August recess.

Based on a report from CongressDaily, it appears that the Senators are forming a coalition of strategic partners  with a variety of economic positions. The target is the introduction of a single bipartisan health care bill. 

This is consistent with reports appearing in The Hill which reflect that a conciliatory approach is being followed by the Obama Administration and the legislative leadership. This creates a very uneasy position for the traditional Republican leadership and the traditional lobbying groups.

The workers' compensation industry now consists of a broad and fractionalized group of stakeholders. They seek  individual economic survival in the current frantic and fearful economy. Their adverse interests have been a huge factor in the expansion of the administrative process and increasing stagnation within the present system. 

As the individual stakeholders find that their interests are being represented individually in a new and non-traditional setting, the need for their economic survival will over power the existing organizational lobbying effort. That lobbying effort was very successful in past decades to defeat legislative initiatives for a universal health care system.

Should this new legislative strategy advance and succeed, the voices of the past will be silenced. The transformation process has already commenced. Public opinion surveys report a majority of Americans want change. It is that voice that will govern the legislative process. This occurred in the  non-partisan outrage over AIG bonuses.  In the end, the process will be successful, for after all, we are a county of " The People,"and it  is their voice that will be the voice of change.

The Shame of American Health Care

The workers' compensation medical treatment delivery system is problematic as it as delays and denials and epidemic in the program. Looking for a solution, hope beams bright in the implementation of a single-payer universal program. Today's post was shared by Steven Greenhouse and comes from www.nytimes.com

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...

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Fixing The Broken Health Care System

This week President Obama reached out to Labor and Industry, employers and employees and Congress and the voters, in an effort to increase the momentum for repairing the medical delivery system. The problems are universal and the remedies will need to be global.

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.

Obama Administration Delays and Simplifies Rules on Health Care

"As we implement this law, we have and will continue to make changes as needed. In our ongoing discussions with businesses we have heard that you need the time to get this right. We are listening. So in response to your concerns, we are making two changes.  

"First, we are cutting red tape and simplifying the reporting process. We have heard the concern that the reporting called for under the law about each worker’s access to and enrollment in health insurance requires new data collection systems and coordination. So we plan to re-vamp and simplify the reporting process. Some of this detailed reporting may be unnecessary for businesses that more than meet the minimum standards in the law. We will convene employers, insurers, and experts to propose a smarter system and, in the interim, suspend reporting for 2014.

"Second, we are giving businesses more time to comply. As we make these changes, we believe we need to give employers more time to comply with the new rules. Since employer responsibility payments can only be assessed based on this new reporting, payments won’t be collected for 2014. This allows employers the time to test the new reporting systems and make any necessary adaptations to their health benefits while staying the course toward making health coverage more affordable and accessible for their workers.

Click here to read the complete announcement: