Column: Roger's Soapbox

Stupidity: A Medical Mystery

By: | August 29, 2017 • 3 min read
Roger Crombie is a United Kingdom-based columnist for Risk & Insurance®. He can be reached at [email protected]

Civilization began some 8,000 years ago. Yet we have never sorted out health care. Man on the moon? Instant worldwide communications? No problem.

Efficient health care for all? Not a hope.

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Three main systems have been tried. In the U.S., whatever help you can afford is available, but millions can’t afford any.

In the UK, everyone is entitled to free health care, but must wait their turn. In parts of the East, health care premiums are paid only by the healthy, but not everyone can afford to be well.

The U.S. situation is fluid, and I know little of the Orient, but I can speak on socialized medicine. And I shall.

Insurers live by the law of averages (and golf). Having enjoyed pretty good health over my lifetime, the law of averages dictates that I would eventually need more frequent medical attention.

This summer, I met socialized medicine and fought it to a tie.

In the UK, the National Health Service (NHS) provides free care to anyone in the country for any reason.

It’s a wonderful concept, but an often harsh reality. Serious underfunding renders people and equipment scarce. That’s a recipe for catastrophe, but in the main it works. It’s probably impossible to effect political change that would improve it meaningfully.

We worship money, but it’s useless if you’re unwell. For all the great medical achievements, the best we can offer around the world is half-assed medical care. What are we, just stupid?

The politicians who so callously underfund the NHS have private health insurance. I have private health insurance, covering only major medical. It would move me nearer the front of the line in case of urgency.

When the first disorder appeared a few weeks ago, I went to a private hospital. The receptionist asked why I had not gone to the NHS. I said I didn’t want to eat up its limited resources, and would rather pay for treatment.

Too bad. One may not, by law, see a private doctor before seeing one’s NHS doctor to seek a referral. “This is not America!” the receptionist barked at me. How I wished it were, Trump and all.

Off, then, to my NHS doctor’s office to make an appointment. A 10-day wait to see him was required. On appeal, I was allowed to see a trainee doctor a few days later. She solved the problem: mission accomplished.

An unrelated serious disorder broke out a week later. On my way to book a doctor, I took a turn for the nurse — my father’s perennial joke when illness threatened. And so to the NHS emergency room.  A doctor diagnosed a severe infection and prescribed antibiotics, which led to manifold allergic reactions. That meant a visit to an NHS walk-in clinic.

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That very afternoon, a new problem arose. I’m a wreck, baby. Back to the emergency room. After four hours waiting, my symptoms disappeared, so I did too. Days later, I was back at the clinic, referred to emergency (jamais deux sans trois) and given steroids.

In all, I’ve seen four different doctors and three nurses, and received four medicines. Total cost: $0.

Steroids supposedly induce rage.

Here’s some rage: We worship money, but it’s useless if you’re unwell. For all the great medical achievements, the best we can offer around the world is half-assed medical care. What are we, just stupid?

More from Risk & Insurance

More from Risk & Insurance

2017 Teddy Awards

The Era of Engagement

The very best workers’ compensation programs are the ones where workers aren’t just the subject of the program, they’re a part of it.
By: | November 1, 2017 • 5 min read

Employee engagement, employee advocacy, employee participation — these are common threads running through the programs we honor this year in the 2017 Theodore Roosevelt Workers’ Compensation and Disability Management Awards, sponsored by PMA Companies.

A panel of judges — including workers’ comp executives who actively engage their own employees — selected this year’s winners on the basis of performance, sustainability, innovation and teamwork. The winners hail from different industries and regions, but all make people part of the solution to unique challenges.

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Valley Health System is all-too keenly aware of the risk of violence in health care settings, running the gamut from disruptive patients to grieving, overwrought family members to mentally unstable active shooters.

Valley Health employs a proactive and comprehensive plan to respond to violent scenarios, involving its Code Atlas Team — 50 members of the clinical staff and security departments who undergo specialized training. Valley Health drills regularly, including intense annual active shooter drills that involve participation from local law enforcement.

The drills are unnerving for many, but the program is making a difference — the health system cut its workplace violence injuries in half in the course of just one year.

“We’re looking at patient safety and employee safety like never before,” said Barbara Schultz, director of employee health and wellness.

At Rochester Regional Health’s five hospitals and six long-term care facilities, a key loss driver was slips and falls. The system’s mandatory safety shoe program saw only moderate take-up, but the reason wasn’t clear.

Rather than force managers to write up non-compliant employees, senior manager of workers’ compensation and employee safety Monica Manske got proactive, using a survey as well as one-on-one communication to suss out the obstacles. After making changes based on the feedback, shoe compliance shot up from 35 percent to 85 percent, contributing to a 42 percent reduction in lost-time claims and a 46 percent reduction in injuries.

For the shoe program, as well as every RRH safety initiative, Manske’s team takes the same approach: engaging employees to teach and encourage safe behaviors rather than punishing them for lapses.

For some of this year’s Teddy winners, success was born of the company’s willingness to make dramatic program changes.

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Delta Air Lines made two ambitious program changes since 2013. First it adopted an employee advocacy model for its disability and leave of absence programs. After tasting success, the company transitioned all lines including workers’ compensation to an integrated absence management program bundled under a single TPA.

While skeptics assume “employee advocacy” means more claims and higher costs, Delta answers with a reality that’s quite the opposite. A year after the transition, Delta reduced open claims from 3,479 to 1,367, with its total incurred amount decreased by $50.1 million — head and shoulders above its projected goals.

For the Massachusetts Port Authority, change meant ending the era of having a self-administered program and partnering with a TPA. It also meant switching from a guaranteed cost program to a self-insured program for a significant segment of its workforce.

Massport’s results make a great argument for embracing change: The organization saved $21 million over the past six years. Freeing up resources allowed Massport to increase focus on safety as well as medical management and chopped its medical costs per claim in half — even while allowing employees to choose their own health care providers.

Risk & Insurance® congratulates the 2017 Teddy Award winners and holds them in high esteem for their tireless commitment to a safe workforce that’s fully engaged in its own care. &

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More coverage of the 2017 Teddy Award Winners and Honorable Mentions:

Advocacy Takes Off: At Delta Air Lines, putting employees first is the right thing to do, for employees and employer alike.

 

Proactive Approach to Employee SafetyThe Valley Health System shifted its philosophy on workers’ compensation, putting employee and patient safety at the forefront.

 

Getting It Right: Better coordination of workers’ compensation risk management spelled success for the Massachusetts Port Authority.

 

Carrots: Not SticksAt Rochester Regional Health, the workers’ comp and safety team champion employee engagement and positive reinforcement.

 

Fit for Duty: Recognizing parallels between athletes and public safety officials, the city of Denver made tailored fitness training part of its safety plan.

 

Triage, Transparency and TeamworkWhen the City of Surprise, Ariz. got proactive about reining in its claims, it also took steps to get employees engaged in making things better for everyone.

A Lesson in Leadership: Shared responsibility, data analysis and a commitment to employees are the hallmarks of Benco Dental’s workers’ comp program.

 

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]