It's been a while since we heard anything on the single source for medical payment front - the last being a nascent effort in New Jersey to fold medical treatment under the general health umbrella.
But Oklahoma, not a state one would generally associate with progressivism, is taking the lead in social experimentation. Not only is the state exploring an optional work comp plan for employers with 50 or more workers, but legislation has been introduced to authorize a three-year pilot program to provide "24-hour health care coverage" for employees by combining group health care with workers’ compensation.
Senate Bill 1510 by Sen. Eddie Fields, R-Wynona, would allow an employer who provides health insurance coverage to employees to contract with a licensed health care service plan as “the exclusive medical, surgical and hospital treatment for occupational and non-occupational injuries and illnesses” incurred by employees.
The plan would have to provide all job-related medical treatment without any deductibles, co-payments or share of premium being paid by employees. Employees of an employer participating in the pilot program would be restricted to choosing a doctor in the health care service plan.
The legislation has many opponents and this is Field's third attempt at moving forward with a single payer plan.
Jim Curry, president and secretary-treasurer of the Oklahoma AFL-CIO, told WorkCompCentral he doesn’t expect the latest proposal to create a 24-hour care program to have any more success than previous attempts.
Jennifer Monies, communications director for the Oklahoma State Chamber, reported to WorkCompCentral that the Chamber was reviewing the legislation but had not taken any position on it yet.
Among the issues inhibiting a single payer concept are that health care and workers' compensation plans involve different types of health care providers, that workers' compensation is intended to cover only occupational injuries and diseases, and that medical treatment under workers' compensation continues until the injury or illness is resolved.
Vermont last year passed legislation to examine combining comp with general health care. New Jersey legislation to explore the issue never moved very far. In the past California, Florida, and Georgia have also attempted to move forward with some single payer proposals, but none have found favor in the state legislatures.
I honestly don't give Oklahoma much more of a chance except that in conjunction with Field's proposal is the state's review of an optional system where larger employers can opt out of workers' compensation by offering comprehensive medical and disability plans under ERISA.
Probably the single biggest obstacle to implementing a single payer system are the requirements in ERISA - negotiating around this Federal law with state legislation ultimately kills these state attempts.
But if Oklahoma employers can opt out of workers' compensation, this may provide the incentive to create an optional single payer system as well. "Obama-Care" contains provisions for states to get ERISA exemptions if a single payer system is adopted.
Perhaps Oklahoma won't get a single source medical payment plan this legislative session, but I think the trend towards attempting such plans is picking up pace. I've opined before that moving towards a single source system in any state is a 10 to 20 year process - it's complex and there are many conflicting issues to resolve - but the perceived benefits of lower costs and higher quality care are very intoxicating.workers compensation, work comp, injured worker