February 8, 2010
The Medicare Secondary Payer Statute: In Search of Ariadne’s Thread
In Greek mythology, Daedalus built the Labyrinth for King Minos of Knossos to contain the awful half bull/half man Minotaur. Theseus eventually killed the Minotaur, but only found his way out of the Labyrinth because Ariadne had given him a magic thread to mark his way in and out of the maze. I’m beginning to think that American health care...February 1, 2010
One Toke Over the Line
My colleague Julie Ferguson raised some fascinating issues relating to the growing movement to approve marijuana as a medication. As is so often the case, the implications for workers comp diverge substantially from general health issues. A toke may be just what the doctor ordered for pain management, but in the context of the workplace, any such prescriptions are likely...December 1, 2009
Concussions: A Softening in the NFL's School of Hard Knocks
Hines Ward is the epitome of the NFL tough guy. As a wide receiver for the Pittsburgh Steelers, he is known for his flamboyant personality and his ability to give and take ferocious hits. He was the most valuable player in Superbowl XL. In his pursuit of athletic excellence, he is a gambler. No, he is not betting on games....November 16, 2009
The Geography of Health: US vs. Them
Given the discouraging and often appalling level of debate on health insurance in America, it was refreshing to view the PBS Frontline broadcast “Sick Around the World,” a documentary that dispassionately analyzed different health care systems from five developed countries: Britain, Japan, Germany, Taiwan and Switzerland. The program originally aired during the presidential campaign of 2008, but, given the current...September 28, 2009
Annals of Health: Why Smokers Cannot Quit
In all of our discussions about controlling the cost of workers comp, we continually come up against two lifestyle issues that have a direct impact on costs: obesity and smoking. Let's leave obesity for another day and focus on smoking. According to a compelling article by Stephen Smith in the Boston Globe, 70 percent of smokers want to stop, but...August 10, 2009
The End of Civil Discourse?
We live, alas, in interesting times. As the health care debate spirals downward, the fault lines in our culture become more and more evident. On one side, anti-reformers stack town meetings to prevent any meaningful dialogue from taking place. These folks are even trying to intimidate unions. What am I missing here? Who is supposed to intimidate whom? On both...July 6, 2009
Atul Gawande's The Cost Conundrum - Why haven't you read it yet?
Over the last twenty years, medical costs have gradually, but steadily, replaced indemnity wage replacement as the engine driving the workers' compensation train. This is the same period during which our nation's health care costs have grown from average among OECD countries (Organization for Economic Cooperation and Economic Development) to double the average (PDF). In other words, workers' compensation medical...June 29, 2009
Coordinated Health Care: Now There's An Idea!
For the last 3 or 4 years, I've been privileged to be a Trustee at Commonwealth Care Alliance, a Massachusetts non-profit HMO serving dual eligible elderly poor. In this case, "dual eligible" means people who qualify for both Medicare and Medicaid. CCA does great work, but it's always swimming upstream. It gets reimbursed by increasingly low and lower Medicare and...June 11, 2009
Health Wonk Review - special health care reform issue
Joe Paduda has posted this week's Health Wonk Review: Health Reform - what's happening and why. It includes analysis and commentary from our usual participating policy experts - as well as guest commentary from Senator Byron Dorgan (D ND), chair of the Senate Democratic Policy Committee, who gives us his thoughts on the importance of reform and a window into...June 9, 2009
Will Health Care Reform Crush Workers Comp?
If health care reform is the proverbial 800 pound gorilla, then the medical portion of workers comp is a 15 pound Maine Coon cat: it might big for a cat, but compared to a giant gorilla, it is barely noticeable. Nonetheless, this cat is blessed with a very strong notion of what it needs. As the nation moves closer to...May 26, 2009
Compensable Sunshine, Revisted
Our blog last week linking skin cancer to workers comp has already generated a few comments. "Workers comp attorney" raises some interesting questions: (1) How much weight do you give to the person's leisure activities and/or length of employment? It seems these would certainly be factors in assessing whether the employment is the predominate cause. When assessing the work-relatedness...March 23, 2009
Health Care Reform and the Cost of Comp
The Mercury News offers some potentially bad news for California employers. After four years of comp reform, with rates dropping a staggering 63 percent, the trend is now headed - perhaps precipitously - in the other direction. The Workers' Compensation Insurance Rating Bureau is requesting an increase of 24.4 percent, due mostly to sharp increases in medical costs. The gist...August 25, 2008
Quo Vadis Alabama?
It was only a matter of time before the perfect storm hit state employee healthcare. It happened this week, on August 20, in, of all places, Alabama. By 2011, Alabama employees who are obese, hypertensive, or have high cholesterol or high blood glucose will have to pay $25 more each month for their state health insurance. In 2010, they’ll pay...March 19, 2008
The Best Health Care in the World - Part Four: Do the Statistics Tell the Whole Truth?
We have seen that America spends more on health care than other developed democracies around the world for outcomes that, on the whole, are no better than those achieved by the average OECD country. Our health care "system" perpetuates ever-increasing spending without delivering results to justify the expense. Moreover, because of our country's isolation, both geographically and culturally, few Americans...March 17, 2008
The Best Health Care in the World - Part Three: What Do We Get for the Money?
In Part One of this series, we began looking at some of the many cost disparities between group health and workers' compensation. In Part Two, we compared US health care costs with costs in the other 29 member-countries of the Organization for Economic Cooperation and Development (OECD). OECD countries, all democracies, are considered the most economically advanced in the world....March 13, 2008
