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Opt-Out – unneeded, unnecessary, and ill-conceived

Legislators in Oklahoma carefully crafted their Opt-Out legislation, seeking to address concerns about Constitution issues, fairness to workers, and redress,

Despite that intent, the state Supreme Court ruled the law is unConstitutional.

Therein lies a lesson for advocates and detractors from Opt-Out.  However, advocates should be cautioned against focusing solely on legal issues, as there’s a much bigger issue with opt out.

Namely, workers’ comp is not “broken”.

Moreover, moves to “reform” via Opt-Out have inspired a backlash among those concerned that workers will be ill-treated if not outright harmed by Opt-Out.  While advocates cite legislation that purports to require equitable treatment, most of the “power” is on the side of the employer in Opt-Out, making it difficult indeed for aggrieved workers to seek and obtain fair treatment if their employers don’t abide by the letter of the law.

Folks who work in jobs where there’s a higher risk of occupational injury are angry about their loss of earning power, about jobs that are disappearing, about powerful employers gaining ever more power, about decreased opportunities for them and their kids.  And they have every right to be angry.

The aggressive push to overturn a workers’ comp system that has worked quite well for the vast majority of employers and workers for a century feels like yet another finger on the scale for employers, especially because there’s no need for it.

Does work comp need improvement…Heck yes.  Here are a few changes that would make almost any state’s system work better for everyone.

  • Get rid of caps on maximum weekly wages.  Why peg income maximums to an average weekly wage, when workers who make a lot more will NOT be able to provide for their families at an income that is a small fraction of their working earnings?  That is nonsensical, grossly unfair, and unethical.
  • Adopt real evidence-based treatment guidelines coupled tightly to utilization review, allowing for expedited, clinician-driven review.  Use the Institute of Medicine standards for evidence and guidelines.
  • Allow direction of care to network pharmacies to eliminate physician dispensing, a practice that prolongs disability, raises medical costs, and provides no benefit for anyone but dispensing companies and providers.
  • Fully fund and fully staff employer fraud departments.  Crack down hard on wage fraud, especially that perpetrated on construction projects.  The return on investment on this will be healthy indeed.

One change we hope to see is an end to the pointless debate about Opt-Out – it is unneeded, unnecessary, and ill-conceived.

One thought on “Opt-Out – unneeded, unnecessary, and ill-conceived”

  1. And motivated by desire to take the country back before the Socialists took over, you know who they are (T. Roosevelt and cousin Franklin, Truman, Eisenhower, Kennedy, Johnson (that traitor to white people), Nixon (who gave us OSHA and EPA), etc.)

    At the heart of opt-out is a return to 19th century capitalism where the employer was king.

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Joe Paduda is the principal of Health Strategy Associates



A national consulting firm specializing in managed care for workers’ compensation, group health and auto, and health care cost containment. We serve insurers, employers and health care providers.



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