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

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.

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That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.

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Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

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