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What people in Vegas will REALLY be talking about…

It’s not the latest Odyssey/MSC/OneCall deal…

Nor is it the increasing profitability (if one can call what’s really just the absence of continuing losses “increasing profitability”) of the comp industry.

Sure there’s going to be talk about Sandy and her impact on insurance rates, but that’s not it either.

Nope, it’s the election, and more specifically what is looking increasingly like the re-election. Please spare me the nonsense about lousy Dem turnout and left-leaning pollsters and faulty methodologies and other memes that are rooted not in reality but desperation.

If I’m wrong (and Bob and Cy and T Don and Sandy and other dear friends and treasured colleagues are hoping and praying I am) I’m going to have a really miserable conference…

But back to the key issue – we’re going to have a continuation of a split government – President Obama in the White House, the GOP with a smaller but nonetheless significant majority in the House, and Democrats nominally in control of the Senate (altho the Dems proved they can’t even control the Senate when they have 60 Senators, so 52-54 isn’t nearly enough).

PPACA aka Obamacare is going to be (almost fully) implemented in 15 months.  There will be about 30 million more people with insurance.

The most important single impact is this – When injured workers have coverage, there is no need for WC to pay for non-occ conditions for injured claimants (whether the WC payer follows thru on this is a separate issue).

This is also the most significant short term impact, especially in states such as Texas and Florida where almost one in four working age people doesn’t have health insurance. Think of it this way – a claimant needs surgery for a rotator cuff tear, has diabetes and hypertension. If they don’t have coverage, the work comp payer will pay to treat the diabetes and hypertension – those conditions have to be addressed if the claimant is going to recover and get back to work. Now the comp carrier can send those bills over to the health insurer. 

And, the adjuster, case manager and UR function won’t have to engage in the back-and-forth with the provider over treatment, delaying treatment and extending disability duration.

Finally, with about 30 million more Americans with health insurance there will be a lot less need for hospitals and other providers to cost shift to work comp to make up for revenues lost due to treating the uninsured. Sure, Medicaid reimbursement is lousy and Medicare only a bit better but something’s a lot better than nothing.

Of course, there’s going to be a lot of people trying to get care from providers who just won’t have capacity; this will – inevitably – lead to delays in accessing care for work comp claimants, which is a bad thing indeed.

It’s going to be an interesting conversation.

5 thoughts on “What people in Vegas will REALLY be talking about…”

  1. Wouldn’t it be interesting if we woke up Wednesday morning and did not know the winner? I think we could see a repeat of 2000 where the election is very close and the electorial college votes are highly disputed.

    Here come the lawsuits alleging disenfranchisement of voters in the northeast because of Sandy.

  2. Joe,

    You are living in a different universe if you believe 2014 will bring 30M new enrollees!

    The CBO can project all it wants (, but, unless the insurance is paid for 100% and enrollment is automatic, there is no way 30M currently uninsured people will, after receiving a partial subsidy ( elect to pay more, out of pocket, for insurance than pay the fine to the IRS or be in violation of the law.

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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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