Health Care Reform Stirs Workers' Comp Concerns

By Smith, S. L. | Occupational Hazards, April 1993 | Go to article overview

Health Care Reform Stirs Workers' Comp Concerns


Smith, S. L., Occupational Hazards


President Bill Clinton promises to revamp the nation's health care system. What will that mean for workers' comp?

Hillary Rodham Clinton has been given 90 days by the President to come up with a plan for national health care reform. Time runs out in May.

Although it has not been publicly discussed by the Clinton Administration, national health care reform will certainly impact on workers' compensation. Given the embryonic stage of the Clinton health care plan, no one knows exactly how these changes will manifest themselves, but experts already are voicing some concerns, including a basic question about whether workers' comp is being considered at all.

"I'm sure the people on a national level are well-intentioned and I'm sure they do not know anything about workers' comp. In their efforts, they might be oblivious to the needs of workers' comp. It has certainly not gotten the publicity national health care reform has received," said Prof. Peter Barth, Dept. of Economics, University of Connecticut.

What areas must be addressed by the health care reform task force if workers' comp is not going to suffer and is, perhaps, to be improved?

Health care reform could affect the medical cost component of workers' comp. Medical costs could be removed from the workers' comp system entirely. Other scenarios envision cost-shifting of some medical costs from national health care into the medical component of workers' comp.

Workers' comp acts as an incentive for safety programs. Unsafe employers pay more into workers' comp than companies with good safety records. Experts claim the entire structure of safety programs could change if the structure of workers' comp changes.

Health care reform could also impact safety programs if there are changes in: the recordkeeping of occupational injuries and illnesses which determine comp rates; the interaction between state workers' comp and federal health programs; and medical malpractice because of tort reform.

Those questions and concerns will all be addressed by the health care reform task force, according to administration sources.

"Reform of health care in this country is what is needed and what is expected of any proposals by the task force," a Clinton Administration source told Occupational Hazards. "The point is not only to provide health care to the people who don't have it now, but also to make the system better and more affordable for everyone it serves. Paying a high price for substandard care is not acceptable."

The Administration source said the Clinton team is aware of the concerns about workers' comp, and will take those concerns into consideration when developing a reform plan.

"We realize we don't live in a vacuum," said the source, "but people have to realize that this plan will not make everyone happy. If, in the end, everyone is a little bit unhappy, instead of some or all being completely enraged, then the Administration has probably done a good job."

National Health Care

What the Clinton Administration would like to see included in the national health care package will be revealed in May, but some aspects of the plan are certain. The estimated 37 million people without health care insurance -- most of whom are working Americans and their families -- will be covered.

In their book, Putting People First, President Bill Clinton and Vice President Al Gore outlined their vision for health care in America. They suggested:

* Establishing an annual health care budget for the nation to limit public and private expenditures.

* Prohibiting companies from denying coverage to individuals termed "bad risks."

* Establishing a core benefits package which would include ambulatory physician care, inpatient hospital care, prescription drugs, basic mental health care, and preventive treatment.

* Developing health networks and allowing those networks a fixed amount of money for each consumer. …

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