Jan
25

Wildly off-topic #13 – Tanks.

Last time we talked about weapons…how many each side had, what’s been lost, and the challenges in replacing those weapons.

Today’s newsfeed arrived with the VERY welcome news that Germany has OK’ed supplying Leopard 2 tanks, and we will be sending Abrams tanks to Ukraine. The UK had committed to send 14 of its Challenger II tanks to Ukraine… Note that countries that use Leopard 2s have to get permission from Germany before sending them to Ukraine; with this latest announcement sources indicate Ukraine will get at least 100 Leopard 2s.

This will supply roughly one brigade – and is about 1/3 of what Ukraines’ leaders say they need.

These are “main battle tanks” [MBTs], a term describing very heavy, very well armored vehicles with very powerful cannons. Unlike the other armored vehicles already sent to or on the way to Ukraine, MBTs are much more likely to survive an IED, land mine, rocket or artillery attack.

Highlights…

  • Leopard 2 tanks are very capable; well armored and with a very powerful cannon, highly mobile, durable and simpler to maintain than the US Abrams tank
  • there are thousands of them in more than 19 armies

  • The US Abrams is equally if not more capable, BUT…
    • guzzles fuel (although it can use jet fuel, gasoline, or diesel)
    • requires a lot more maintenance
    • is really heavy and thus harder to transport

Timing

These will not be there tomorrow…however I’d bet NATO countries will be sending tanks from their current units rather than pulling mothballed older versions and going through what could be a long and difficult process of upgrading them and preparing them for battle.

Then there’s spare parts, fuel, ammunition, training, repair and maintenance  personnel and facilities and transport. These are massive, very complex vehicles that require a lot of care and feeding.

Experts contend that Ukraine’s Army has shown itself quite able to learn complicated weapons systems quickly; it’s use of the HIMARS rocket system, artillery, and anti-ship missiles has been pretty impressive.

What does this mean?

This is a major move, one that will definitely improve Ukraine’s chances of retaking territory. 

That said, like any tool, it comes down to how well it is used. 


Jan
10

Workers’ comp 2023 – what does the year hold – part 2

Yesterday the annual crawling-out-on-a-limb began, today it concludes with 5 more predictions for workers’ comp in 2023.

6. The growing impact of global warming will force changes in risk assessment, management and mitigation; technology adoption; and claims.
The predicted (heat injuries, wildfires, hurricane intensity, sea level rise) and unforeseen (atmospheric river-driven flooding, landslides, and destruction and others) changes in climate and weather will lead to more and different injuries and illnesses, higher risks for fire fighters and public safety workers, and unpredictable problems related to polluted storm water runoff, water-borne disease and perhaps invasive species.
Expect revisions to both federal and state OSHA regulations especially around heat and outside workers along with calls for better planning to prepare for severe weather events.

7. Payers and perhaps regulators will make significant efforts to address rising facility costs.
As for-profit healthcare systems look to pad record profits and not-for-profits seek to survive, payers will be looking for better cost control answers than simply doing more of the same stuff they’ve been doing for the last two decades. Network discounts (NOT THE SAME AS SAVINGS) are declining as facilities wise up to most payers’ lackadaisical/ineffective attempts at employee direction and unsophisticated contracting strategies.
Smarter payers will deploy multiple payment integrity layers  – both pre- and post-payment. All should demand more – much more – from their bill review vendors/technology suppliers, all of whom have long refused to entertain the thought that they could do better – much better.

8. Premiums will increase – mostly late in the year.
As infrastructure, green energy, re-shoring of chip manufacturing and EV incentives ramp up in the fall so will employment. While there’s disagreement among economists (yeah, who woulda thought??) expect big hiring in categories from archeologists and bridge builders to wireless broadband construction workers.  Manufacturing, heavy construction, trades, logistics will all be hiring…as these tend to be higher frequency (more claims than average) and higher severity (claims are more severe and costly) this means higher premiums and more claims.

Good news indeed for my friends in Cincinnati!

Oh, and mark me down for one who does not see a significant recession in our near future.  I know, I’m no economist (who disagree a lot about this) but hiring is too strong, these major investments are on the horizon, and inflation is coming under control  – all indications that a “soft landing” is more likely than not.

9. SB1127 – aka the CAFE Act (California Attorney Full Employment Act) will cause heartburn and consternation among Golden State employers and tax payers.
SB1127 shortens the time period for employers to determine the compensability of claims, a change which will lead to – among other problems – more initial denials and less time for injured workers to receive medical care while their employer researches the claim. Further, AB1127 appears to allow for penalties of up to $50,000 for claims that are “unreasonably rejected” by the employer – but the bill a) doesn’t define what constitutes an “unreasonable rejection” and b) doesn’t exclude claims that are already closed.

Expect attorneys to look for the Golden Ticket case – one that they think will establish precedence – and pursue it like a starving person at a Vegas buffet (or Cafe’).

There’s good news too…I don’t see much else on the regulatory horizon that is cause for concern.

10. More consolidation among payers and service providers.

Despite a major drop-off in financial investors’ interest in work comp, we’ll see  more consolidation as “strategics” aka TPAs and service providers acquire smaller TPAs and service providers. This is classic mature industry…scale is key, significant growth will mostly be driven by acquiring competitors or companies in complementary or related service and margins are in peril.

The bad news is 2023 prices will likely be a good deal less than in the recent past. Fewer potential buyers, less interest from PE firms, and a growing recognition that workers comp is a declining business (what took these people so long to see this?!) are all contributors.

What does this mean for you?

Prepare for climate change and more employment in higher frequency and severity sectors, and make your bill review company get its act together.


Jan
9

Workers’ comp 2023 – what does the year hold?

Its that time again, when I throw caution (and good sense) to the wind, polish up the crystal ball and guess reveal what big things will happen in worker’s comp this year.

Off the diving board, and hope there’s water in the pool…

  1.  The soft market continues…
    And it won’t harden in 2023. Medical costs remain very much under control (with  an exception), rates continue to drop, employment remains very strong (essential for return-to-work) and there’s lots of payers fighting for market share.
  2. Medical spend is NOT a problem – and will NOT be in 2023.
    With a couple notable exceptions – to be covered in a future post – medical inflation will remain under control. In part this is driven by much lower drug spend and more specifically the continued decline in opioid spend. The latter has a big impact on claim closure and total medical spend.
  3. Behavioral health and its various iterations will gain a lot of traction.
    More State Funds, carriers and TPAs will adopt BH programs, more patients will benefit, and more dollars will be spent. There’s a growing recognition that medical issues aren’t hindering “recovery” near as much as psycho-social ones. This is great/wonderful/long-needed and will really benefit patients and payers alike. Kudos to early adopters, and LETS GO to you laggards!
  4. One Call will be sold. 
    I keep forecasting this…and one day I’ll be right.  It has to be this year. CEO Jay Krueger and colleagues have OCCM on a better track, but structural problems (i.e. declining claim volume) and internalization of One Call-type services by Sedgwick and others make the future…less than promising. Couple that with recent ratings actions by Moody’s and S&P and it’s time to do the deal.
  5. New technology will make its impact felt.
    Wearables, chatbots (I HATE THEM), and Virtual Reality-driven care are three ways tech platforms/systems/things will significantly ramp up in ’23. Expect several large/mid-tier payers to adopt new tech in a major way – aka not just a small pilot.
    Structural issues with health care (try to find a LCSW or Psych-trained counselor), lack of trained adjusters, and frustration with rising rehab expenses are all contributors.  

Later this week – the other 5 predictions.


Jan
3

Today’s the latest in a three-part update on Russia’s war on Ukraine – we covered military manpower and the motivation to fight before the holidays, today we finish with (a very brief) discussion of losses and supplies of materiel and ammunition, and the overall supply (logistics) situation.

Weapons

According to Ukraine’s Ministry of Defense, Russia has lost over 2000 artillery systems, 4700 trucks and fuel tanks, 550 planes and helicopters, 3000 tanks and over 6000 armored trucks to date. I’m skeptical; opponents’ claims re the casualties and destroyed materiel and machines suffered by the other side are usually pretty – if not downright wildly – optimistic.

I’d suggest the UK’s figures are more accurate:

4,500 armored vehicles, 63 fixed-wing aircraft, 70 helicopters, 150 unmanned aerial vehicles (UAVs), 12 naval vessels, and over 600 artillery systems.

And yet another source which seems to have pretty specific data…and is summed up neatly in this piece.

The latest analysis shows that in the ongoing war in Ukraine, total Russian equipment losses reach 8,515 as of 21 December. In contrast, Ukraine’s military has lost 2,613 pieces of equipment in combat.

Russia had far more materiel at the outset, but is having a very difficult time replacing losses of their more modern equipment and vehicles.

From Army Technology – Ukraine has received:

the Patriot air defence missile system is on the way – this will help combat Russia’s assault on civilian infrastructure

US has provided or promised to provide more than 11,000 military platforms for the land, sea, and air domains (crewed and uncrewed) and more than 105 million small arms, mortar, and artillery munitions, among an undisclosed number of other high-end missiles.

Platforms provided include Mi-17 helicopters and T-72 tanks, and western equipment such as the High Mobility Artillery Rocket System, 155mm, 122mm, and 105mm artillery, and armoured mobility vehicles such as the M113, M1117, and Mine Resistant Protected Vehicles, also known as MRAPs.

While Russia is getting drones, some armored vehicles and tanks and ammunition from a few allies/suppliers, it doesn’t have near the supply chain enjoyed by Ukraine. The NATO equipment is more modern, more lethal, and harder to locate and destroy than much of the equipment Russia is now using as replacements for lost equipment.

US Javelin rocket – used against armored vehicles

HOWEVER, a rule of thumb is about a third of equipment is out of action at any one time due to maintenance, repair, upgrade, or training.

AND, there are reports that NATO and US supplies of some munitions and equipment are running low, and replacement/restocking will take time. A very detailed study is here.

Logistics

I wrote a pretty detailed post 10 months ago about logistics, which is simply getting enough supplies to the units that need them – when they need them. Simple enough in concept  – incredibly hard in practice, and while one could certainly think planning is everything, history suggests that pre-war plans are usually based on the wrong assumptions.

Here are key takeaways…

  • Russia’s incredibly corrupt government has enriched a handful of oligarchs. These gazillionaires got huge contracts to supply tires, medical kits, rations, clothing, winter gear and spare parts; build military bases; fabricate tanks, airplanes, helicopters, rockets, ammunition, armored vehicles, airplanes, trucks and artillery; and spent most of those rubles on huge yachts, estates in Switzerland, supercars, Caribbean resorts, designer baubles and personal security staff. As a result, the military is short of pretty much everything, which is why…
  • Russia is running out of ammunition.  Reports indicate it may need to use artillery shells that are years past their use-by dates. turning to Iran and North Korea for ammunition, drones, and other materiel.
    This from Military.com

    • Degraded ammunition can injure or kill troops who fire it. “You load the ammunition and you cross your fingers and hope it’s going to fire, or when it lands that it’s going to explode,” the official said.

(a very good discussion of this is Martin van Creveld’s SUPPLYING WAR)

What does this mean?

Ukraine is winning. That does NOT mean it has – or will – win.

That depends on continued support from NATO and all of us. 


Dec
22

Wildly off-topic #11 – the Will to Fight

Last night, Ukraine President Volodymyr Zelenskyy spoke to both Houses of Congress, both parties, and all of us.  He spoke eloquently and passionately, describing the suffering of his people and their total commitment to defeating Russia and reclaiming all Ukrainian lands stolen by Putin.

What Zelenskyy knows – and I mean KNOWS – is the more Putin bombs Ukrainians, the stronger those Ukrainians become, and the more committed they are to seeing this through to Putin’s bitter end.

Net – Putin’s attack on civilian targets will strengthen Ukrainian resolve, not weaken it.

Here’s why.

I had long thought that the horrific bombing campaigns of World War II helped bring the war to a close by battering Germans and Japanese into submission. [full disclosure – my father was a machine gunner, bombardier, and armorer in the 8th Air Force in England during the second World War.]

Boy was I wrong.

Credible research indicates German production actually increased during the war; while it didn’t reach planned levels (which were likely overly optimistic) it did exceed pre-bombing campaign volumes. Research by the US Strategic Bombing Survey came to the opposite conclusion, however there’s a) big time confirmation bias and b) no evidence that the Survey captured civilian morale data.

Research conducted during Germany’s Blitz (aerial bombing) of UK cities concluded…

the Germans gained nothing from their investment in bombing British civilian targets as part of “The Blitz” (1940-41). Before “The Blitz”, they may not have been happy about having their air force destroyed by the Nazis, but they were also not eager to put their lives on the line to support a hereditary aristocracy that just over 20 years earlier had wasted a substantial portion of a generation of young men in a senseless war. However, as their homes were being destroy and their neighbors killed or wounded by German bombs, ordinary British men and women did not all rabidly support Churchill’s exhortation, “We shall never surrender“, but they continued to work, and they took action to ensure that essential services were provided when their official leaders failed to do so.

long as I get my cuppa tea, dearie…

TO be sure, this was NOT the whole story; there were many instances of looting, bigotry and finger-pointing, panic and social conflicts. That said, definitive research into civilian morale during the Blitz found the bombing produced:

a people who became actively committed to the project their leaders put before them, who cooperated with the drastic re-ordering of daily life that this entailed, and who, on the whole, did so in a spirit of stoical endurance that did not exclude good humour’. [emphasis added]

Further research on the impact of aerial bombing from 1917 to 1999 found:

(1) air power coercion attempts are more likely to work if they exploit military rather than civilian vulnerabilities, (2) the regime type of the target affects the chances of success, and (3) success is less likely if the attacker demands that the target change its leadership. Results show that coercion is more likely to work if the target’s military vulnerability is higher, but higher levels of civilian vulnerability have no effect on the chances of coercion success; that target regime type has no effect; and that success is less likely when the attacker demands the target change its leadership

In his book TRIBE, author Sebastian Junger details how people react to  having a common enemy, using examples from the Serb-Croat war’s effects on teenagers in Sarajevo and data on depression, anxiety, suicide among British citizens during the Blitz…the net is those issues declined rather significantly. Junger concludes that a common enemy draws people together, all working as one to defeat a single threat.

What does this mean for you?

Ukraine will win.

The more support we give them, the sooner this happens and the fewer Ukrainians will suffer and die. 

 


Dec
21

Wildly off-topic #10 – Manpower

It’s been four months since we talked about Ukraine, a period during which Russia put scores of thousands of poorly-equipped, pretty-much-untrained, and wholly incompetent civilian men into army uniforms (or facsimiles thereof) and fed them into the meat grinder that is Donetsk, Kherson, Bakhmut and surrounding areas.

With this result.

With things on the front lines pretty static, it’s time to think through the factors that will decide who wins. In layperson’s terms, I’d say there are three main drivers

People to do the fighting – today’s topic

Will to fight

Stuff to fight with

Yes, this is pretty basic, but stick with me here.

The “people” need to be found, trained, equipped, clothed, fed and led. These are all hard to do – especially in winter, in Ukraine, after 10 months of often-brutal combat dominated by death-by-artillery.

In addition to the usual recruiting efforts focused on patriotism and duty, Putin has resorted to two primary sources – poor men from far eastern Russia, many of whom don’t speak Russian, have never traveled outside their immediate area, are poorly educated and according to some reports not really interested in fighting.

Prisoners who, in exchange for a release from jail, agree to enter the army, often in mercenary units set up by the Wagner Group make up a large portion of the new recruits.

Reports from these new “soldiers” indicate they are mostly cannon fodder, placed on the front line to be killed by Ukrainian forces while the regular Russian army sites in relatively safe trenches in the rear.

This is typical (from Ukrayinska Pravda)

Quote from Agafonov: “We were dumped into the forest and ordered to entrench; we had only three shovels for the battalion, and there was no support at all. We entrenched as best we could, and in the morning the [Ukrainian] attack started. [Ukrainian forces used] artillery, Grad MLRS, mortars and copters; we were just shot.

What is disturbing is the lack of information about casualties and replacements in the Armed Forces of Ukraine (AFU). After way too much time spent searching the interwebs I was unable to find any credible data on recent losses, replacements, or changes in AFU manpower.

It’s highly likely that Russia has more men, even after both sides have suffered horrendous losses. (while there are women in both countries’ armed forces, men make up the vast majority of the fighting forces) It’s also clear that many new Ukrainian recruits are not exactly fully trained.

However, 5 weeks training by professional soldiers in Britain is a lot better than a few days with minimal training on how to actually shoot, load, and clean a rifle, bandage a wound, use a radio, read a map, and recognize a Russian or Ukrainian fighter jet.

Oh, and the UK and other European countries supporting the training give every trainee “combat clothing, body armour and ear defence, waterproofs and sleeping bags plus a fully stocked individual first aid kit and extreme cold weather kits…”

(for more on this I suggest you review multiple sources, as this will enable you to question each of them and arrive at your own conclusions…  War on the Rocks, Phillips Payson O’Brien, Institute for the Study of War are three I’ve found useful)

Tomorrow – the will to fight.


Dec
9

Solving “problems” by making bigger ones

Leave it to some misguided folks in the California legislature to come up with solutions to non-problems, solutions that will do more harm than good.

That’s just what AB1127 does…shortening the time period for employers to determine the compensability of claims, a change which will lead to – among other problems – more initial denials and less time for injured workers to receive medical care while their employer researches the claim. Further, AB1127 appears to allow for penalties of up to $50,000 for claims that are “unreasonably rejected” by the employer – but the bill a) doesn’t define what constitutes an “unreasonable rejection” and b) doesn’t exclude claims that are already closed.

That last is pretty bizarre – then again the entire thing is a mishmash of unfounded assumptions and poorly conceived “solutions” that will add litigation expense while doing little to improve the lives of injured workers.

One of the major problems is the timeframe to investigate some claims is shortened – but much of what happens during that investigation is beyond the control of the employer/adjuster.

As a result, payers facing down a deadline may have to issue a provisional denial if they can’t get evaluations scheduled, obtain medical records or med-legal reports or those records and reports are incomplete.

There’s a lot to unpack here – the fine folks at CWCI have provided a detailed analysis of AB1127 here – free to members and at nominal cost for others.

What does this mean for you?

How this benefits injured workers is a mystery indeed, how it benefits applicant attorneys is crystal clear.


Nov
28

Happy Monday – for my American readers, hope your holiday was most excellent.

here’s good stuff you might have missed…

WCRI is hosting a no-cost webinar on Behavioral Health in Workers’ Compensation Thursday Dec 15 at 2 pm eastern. The webinar will discus their recent primer on BH in WC (available here for download)

The good folks at NCCI published their latest take on work comp industry financials...suffice it to say the party continues…although it may be getting close to ending.

courtesy NCCI

The final countrywide analysis of 2021 results shows:

      • WC Calendar Year 2021 private carrier net written premium (NWP) increased from 2020 by 0.5% to $38.2 billion
      • The WC Calendar Year 2021 private carrier combined ratio was 87.2%, and the operating gain was 23.7%

Meanwhile early data makes 2022 look even better; direct written premiums were up almost 10% over 2021, while the loss ratio for the first two quarters of 2022 is even lower (!!!) then 2021 (no figures cited).

Unpacking this –

  • If 2022 numbers hold up 2022 will be the tenth year in a row profits exceeded the historical average…
  • And the sixth consecutive year the operating margin was above 20%
  • Oh, and this all happened while rates decreased every year since 2014

My take…insurers are still enormously profitable because rate declines aren’t accurately accounting for the opioid hangover.

[A CWCI report addressed this issue; my informed opinion is claims without opioids are much less costly, therefore the continued drop in opioid prescriptions is driving lower claims costs…actuaries develop rates based on historical data – which is not keeping up with what’s actually happening.]

Former Labor Secretary Robert Reich believes organizations aren’t valuing workers correctly…Reich notes workers are considered “costs” instead of assets, a mis-characterization that leads to all manner of bad executive decisions.

Key line –

“increasingly, corporations aren’t just production systems. They’re systems for directing the know-howknow-whatknow-where, and know-why of the people who work within them.”

Hat tip to a very good friend for the head’s up.

What does this mean for you?

  1. It’s great to see behavioral health get more exposure – it is a key driver of recovery.

  2. Actuaries use historical data to project the future; execs should factor in what’s really happening to understand where things are heading.

Nov
7

The core issue – the anti-Americans.

Those who continue to deny the results of the 2020 elections are anti-American; they seek to reject any result they don’t like. That is incredibly dangerous and a threat to our Republic.

Across more than 60 cases in 12 states, final rulings in every court case – including every one overseen by Trump-appointed judges – rejected allegations of fraud and confirmed the results of the election. 

If you care about democracy, you need to know which candidates are election deniers – or more accurately anti-American.

here’s just a few…

To find election deniers running for office in your state; just click on this link, then your state to identify those who refuse to accept the will of the people.

Need more info?

Trump’s own Presidential Advisory Commission on Election Integrity disbanded having discovered nothing.

The Heritage Foundation Election Fraud Database has compiled every instance of any kind of voter fraud it could find since 1982. It contains 1,296 incidents, a minuscule percentage of the votes cast.

study of results in three states where all voters are mailed actual ballots, a practice some allege to be rife with fraud, found just 372 possible cases of illegal voting of 14.6 million cast in the 2016 and 2018 general elections — 0.0025 percent.


Oct
5

You have to go

to comp laude.

It’s unlike any other work comp conference – it is focused on what people and organizations are doing right, the right way – and the impact that has on the people we serve – injured workers.

There are some pretty emotional moments…injured workers sharing their stories about horrific accidents and their months if not years of recovery. One came from Brance Tully, a young man of eighteen who fell through a skylight two years ago – when he was 16.

After dozens of surgeries, untold hours of therapy and what could have only been an incredibly painful and seemingly-interminable journey, he is back at work. He called his adjuster the day he returned to be met with incredulity – justifiably so.

That was just one. Injured workers recovered from shootings, fires, vehicle accidents, falls and all manner of accidents.

There are several other reasons to attend:

  • plenty of time to connect and network
  • solid attendee list with folks from large employers, payers, and other buyers
  • terrific location – the Pasea Hotel is pretty nice.

Kudos to Yvonne Guibert – a dear friend and colleague, and the best marketer in workers comp – for making this happen. Shout out to GB and Greg McKenna – his engagement with the “stories” folks are remarkable.