Tuesday, December 6, 2011

The Value in Work Comp: Non-discriminating Medical Care

In an editorial in the Los Angeles Times yesterday, Spike Dolomite Ward apologized to President Obama. She had contracted cancer but didn't have health insurance. Then she learned that she could not be discriminated against due to a provision in the President's health care reform law known commonly and derisively as "ObamaCare". The editorial had one telling paragraph that I think is an important message to anyone in the workers' compensation industry:

"If you are fortunate enough to still be employed and have insurance through your employers, you may feel insulated from the sufferings of people like me right now. But things can change abruptly. If you still have a good job with insurance, that doesn't mean that you're better than me, more deserving than me or smarter than me. It just means that you are luckier. And access to healthcare shouldn't depend on luck."

Workers' compensation is, in its purest form, a universal health care system - if you qualify (i.e. get hurt or ill at work) then you get medical care. Care is generally meted out according to guidelines (as in ObamaCare) so there is some loss of control over the direction care goes, but you don't have to pay even a deductible - certainly most people would look upon the beneficence of such as system as a great social value. And there is no luck being qualified for system benefits - if you're employed you're covered.

I read that editorial before reading in the news this morning the story of hockey player Derek Boogaard. Derek didn't think about head injuries playing professional hockey - he cared about "enforcing", a hockey term for being the bad-ass on the ice that takes out other players at the direction of the coach.

Boogaard died at age 28 from a drug overdose. I don't know whether Boogaard had a work comp claim at the time of his death, or whether his drug overdose was related to any work comp treatment regimen (as I had been pointing out with other published case law the past couple of posts here). According to media reports, Boogaard had advanced stages of chronic traumatic encephalopathy (CTE) when he died and his doctor reportedly told the family that if Boogaard had survived his OD he would have had advanced dementia-like symptoms.

At age 28...

The connection I'm making is that the general public has no regard, no understanding of the value of workers' compensation until it is too late. To the business owner workers' compensation is a troubling bill that adds to the expense of doing business, to provide money to deadbeats who would rather not work. To the employee that falls into the system it is a maddening labyrinth of regulations, forms, and adversity that gets in the way of recovery. To the politician workers' compensation is a complex entitlement system that plays well to deal making and grand standing.

Each of these people don't appreciate that medical care in workers' compensation is delivered without discrimination, without regard for pre-existing conditions (those may affect indemnity, but not medical care), and at no cost to the recipient - not even a deductible.

Value in workers' compensation is not appreciated by such people, until disaster hits.

Disaster did hit a Texas business when it got stung with a $2.8 million jury verdict for the fatal fall of a worker.

Disaster hit Boogaard and his family with the onset of CTE (and perhaps all of the National League Football players who have brought suit against the league for unsafe equipment).

Disaster almost hit Ms. Ward when she contracted cancer and found that she was uninsured until she realized that she could not be discriminated against for pre-existing conditions in obtaining health insurance.

We're on the inside. People don't see workers' compensation like we do. We work the system daily in our various roles. We know what to expect with the system.

We are lousy at communicating the value of workers' compensation to the general public though.

The next time you're at a cocktail party, or sitting next to someone in an airliner, or wherever, and the conversation inevitably gets to the "so what do you do for a living" course, how do you respond? Like most of us, I bet you start out by saying that you are involved in workers' compensation. Unless you are talking to someone else in the work comp world you'll observe either rolled eyes, a smirk, some look of disdain, or a combination of all three.

Perhaps the response should be something along the lines of, "I help ensure the delivery of value in the biggest, most comprehensive medical care delivery system in the world," and that you are proud that the delivery of medical care is without regard to prior condition, or discrimination.

And that the value you provide keeps Americans working in America at American jobs.

No comments:

Post a Comment