There’s a country with an unusual healthcare system. In it, you often spend about as much time with your lawyer as you do your doctor. There are special courts set up to decide what kinds of treatment you are allowed to have. And doctors have to be careful that they don’t say or do the wrong thing, or else they risk being blackballed by insurance companies.
The country: The United States of America.
You may not realize it, but if you hurt your back at work you end up in a different healthcare system than if you hurt your back at home. Sure, you may end up with similar doctors or hospitals, but your experience of healthcare will be completely different. Here’s why.
If you get hurt at work, you’re covered by the “workers compensation” system. That system has its roots over a century ago, when employers didn’t do much to take care of workers. So the system is based on laws that mandate employers to take care of injured workers, often for the rest of their lives. In exchange for this very comprehensive coverage, employers and their insurers get a great deal of control over what care workers get and where they get it.
Does the workers compensation system represent a model of how a future American healthcare system might work? It might.
Provisions of the healthcare reform law propose very scientific-sounding controls over how people will get their care. The risk is that these well-intentioned programs will become the basis for a new world of conflict and lawsuits. Just as they have in workers compensation.
But I’m not so pessimistic.
Last week I participated in a terrific panel on the present and future of workers compensation at the huge National Workers Compensation and Disability Conference & Expo. The panel was made up of 12 people representing all aspects of the workers compensation industry — lawyers, administrators, insurers, intermediaries, consultants, and, well, me (you can put me in whatever category you like – they had me down as a representing medical services companies).
One thing was clear from the discussion: No one was satisfied with the current state of the workers compensation industry. Everyone felt it had become too adversarial, too regulated, and too detached from the needs of the patient.
In this sense, while the current state of that industry is troubling, there are hopeful signs. Innovative companies are refusing to accept the old way of doing things. They find that by focusing on the needs of the patient, they can improve the quality of care, reduce costs, and help create a world where the employer and insurer, doctor and patient are all pulling in the same direction. The more these kinds of groups are successful, the more difficult it will be for our healthcare system to turn into something it ought not be.
And so the order of battle is established. One on side will be the notion that the best way to control cost in healthcare is to make sure that the needs of the patient come first. On the other will be those who want to go in a different direction.
We live in the time when this battle will be fought, and we all have a part to play in its outcome.
*This blog post was originally published at See First Blog*