July 17, 2014


Catch up on your Health Policy Wonkery for the summer - Jennifer Salopek has posted Health Wonk Review: Polar Vortex Edition at Wing Of Zock. It's a great edition and one of only two to be published during the abbreviated summer schedule, so get your wonk fix now!

Up? Down? Sideways? What's up with health care costs? - Joe Paduda: "First, let's not confuse "costs" with "insurance premiums". Unfortunately, many mass media outlets don't understand that insurance premiums are not costs...which certainly contributes to the confusion ... Second, let's not confuse "price" with "cost", as this report does."

NCCI data reveal need for new model for workers' comp claims management - "What's easy to notice and applaud is the industry's improvement. Not only is the 2013 workers' comp combined ratio of 101 far from the 2001 peak of 122, it is also a seven-point improvement over the previous year. However, the improvement represented in this data must be considered carefully, as the second, more telling story highlights a systemic problem the industry has yet to reconcile."

It's Just Work Comp - DePaolo: "...why is there so much controversy in workers' compensation?"

Can You Link Insurance Premiums To Smoking? - "Another recent study found that smokers missed an average of 6.16 days of work per year as opposed to the 3.86 days missed by non-smokers, and that a smoker taking four 10-minute smoke breaks actually worked one month less over the course of a year than a non-smoking employee. The Centers for Disease Control (CDC) estimate that each smoking employee costs a company an additional $3,391 per year - including $1,760 in lost productivity and $1,623 in excess medical expenses. So, smoking employees seem to be an excellent target to help an employer manage its costs, and not just the cost of providing healthcare."

CDC: Opioid Painkiller Prescribing Varies Widely Among States - "Health care providers wrote 259 million prescriptions for opioid painkillers in 2012 - many more in some states than in others - according to a Vital Signs report recently released by the Centers for Disease Control and Prevention that highlights the danger of overdose. The report also has an example of a state that reversed its overdose trend."

News Briefs

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July 14, 2014


R.J. Weiss of Weiss Insurance hosted last week's Cavalcade of Risk #212 - check it out! And while in the neighborhood,. check out his blog, too.

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July 11, 2014


We've recently found interesting developments or updates on three stories that we've covered in the past: A settlement in criminal charges in the Sheri Sangji Lab death case; an in-depth feature on how the Chilean miners survived; and a four-year retrospective on the Tesoro Plant explosion that killed 7.

Patrick Harran And L.A. District Attorney Reach Deal In Sheri Sangji Case
We've talked about the gruesome lab death of 23 year-old research assistant Sheri Sangji in a UCLA science laboratory in numerous prior posts.

UCLA's chemistry professor Patrick Harran faced felony charges related to her death revolving around his alleged failure to provide protective equipment and clothing, failure to provide training, and failure to correct unsafe working conditions. In late June, the the LA DA and Harran's attorneys reached an agreement.

"The deal mandates that Harran complete multiple forms of community service and pay a $10,000 fine. The charges were not dismissed. Instead, the case against Harran is effectively on hold while he completes the terms of the five-year agreement."

The best overview of coverage and reactions to this settlement can be found at Chemjobber, a blog we've cited several times on this case. The comments in the article are well worth reading.

We've been interested in following this case from a safety culture viewpoint. Based on early reactions and comments that we saw on articles and blogs, many in the academic scientific community expressed views that an academic lab couldn't be held to the same pedestrian standards of health, safety and accountability; that it was too exotic an environment; that it would stifle learning and creativity, etc. We also saw many reactions that the responsibility/fault lay more with the deceased - certainly not a new sentiment in any accident. Watching this case has been one of observing an industry grapple with difficult accountability issues. This commentary by Paul Bracher of ChemBark is certainly worth a read.

The criminal proceedings and widespread coverage have dramatically pierced the aura of inviolability in academic labs, environments that the US Chemical Safety Board has called "fiefdoms." The real tribute to Sheri would be to see meaningful safety reforms. Certainly, UCLA is touting its new-found religion of lab safety and we can hope that time shows they are a leader; if the comments on articles and blogs are to be credited, the University has a long way to go in erasing skepticism about the depth of this commitment.

Sixty-Nine Days: the ordeal of the Chilean miners
In the New Yorker, Héctor Tobar revisits the 2010 Chilean mine collapse and offers an intimate look at how 33 miners survived the ordeal of being buried alive for 69 days. While the story gripped the world and we all know details, this is a fascinating account of events.

Four Years After Deadly Blast, Tesoro Mostly Unscathed
Seattle station KUOW has an excellent report on the 2010 Tesoro Refinery explosion that claimed the lives of 7 workers, noting that four years later, no one has been held publicly accountable for these deaths. The article chronicles many of the legal efforts still underway to hold the company accountable - as well as some efforts that have met with limited results.

"After a six-month investigation, the Washington Department of Labor and Industries accused Tesoro of willfully breaking the law 39 times. In October 2010, the agency hit Tesoro with the biggest workplace-safety fine in state history: $2.39 million.
That penalty made headlines, and it might sound like a strong deterrent to any company running a dangerous operation. But to a Fortune 100 company like Tesoro, a couple million is petty cash. The San Antonio, Texas, firm brings in that much revenue in about half an hour."

As is the case all too often, since the imposition of fines, they have been whittled down to $685,000 and could go lower. The article points out how minimal and how ineffective federal and state regulatory sanctions are in such cases.

For more, see the U.S. Chemical Safety Board's material on the Tesoro Refinery Fatal Explosion and Fire

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June 27, 2014



Are there many women in construction? They represent about 9% of the industry. Dorothée Moisan offers an excellent feature on New York's Women of Steel, illustrated beautifully with photos by Jonathan Alpeyrie. Early pioneers talk about what it was like to break into the field. One little vignette from days gone by:

"I remember a young woman very well," Janis says while smoking a cigarillo in her New York office. "This was really early in the game, in the late 1970s. The boss sent her into the field in order to do the kind of job that a superintendent would do. But the men yelled and threw rocks at her. The boss came and said, 'Guys, what's the matter with you? I want to train her.' And their response was, 'We don't want her here because now we can't pee on the steel!'"

Things have changed considerably since those days, as women in the article relate. You can also get a current feel for the profession in these associations:

The National Association of Women in Construction was founded in 1953 by 16 women working in the construction industry. Today its an an international association of women employed in construction, which promotes that industry and supports the advancement of women within it. In addition to its national charter, NAWIC has International Affiliation Agreements with the Canadian Association of Women in Construction, NAWIC-Australia, NAWIC-New Zealand, NAWIC-United Kingdom and South African Women in Construction. They offer women in construction stats in the chart below (or click here for the original Fact Sheet (PDF))

Another key organization is the Professional Women in Construction, with 6 chapters and over 1,000 members. PWC serves a constituency of close to 15,000, representing a broad spectrum of the industry. As its mission, PWC encourages and advances the goals and interests of woman and minority owned businesses.


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June 25, 2014


We're pleased to be hosting the 211th edition of Cavalcade of Risk and we give you the Lightning Round edition in honor of Lightning Safety Awareness Week. If you are struck by lightning, your odds are apparently pretty good of surviving the encounter - see the story of the Georgia man who was recently jolted out of his boots but lived to tell the amazing tale. Take a few minutes this week to learn how to lower your risk of a similar encounter because even tho survival rates are high, most lightning strike survivors suffer lifelong maladies from the experience.

OK, on to our other risk-related issues - here are our blog submissions of the week:

First up, a good news entry from Hank Stern of InsureBlog: A report on
a medical breakthrough for folks with diabetes which promises to reduce the risk of insulin crises. See: Hi-Tech Diabetes news

Bob Wilson of From Bob's Cluttered Desk fame brings us another good news item about how loving parents and an excellent support network can make the difference between living a life of disability and a life well lived. See: Rachel Mast's Second Coolest Program of the Day

At Health Business Blog, David Williams looks at the Veterans' Administration medical mess, noting that the data that the organization collects and uses for internal benchmarking and quality improvement is ironically part of what got them in trouble. While the numbers look pretty bad, he notes that we have no idea how private sector facilities would compare, since they don't collect or report such information. See: Are we picking on VA hospitals too much?

Jason Shafrin of Healthcare Economist says that after Obamacare passed, the rate of uninsured in Minnesota fell by almost half. What is responsible for this decline in uninsurance rates? He takes a look: Health Reform in Minnesota.

We have a pair of posts that talk about risk mitigation through insurance, describing some specialized needs. At Insurance Thought Leadership, Nancy Germond looks at the insurance coverages a consulting firm needs . And at Workers Comp Roundup, Michael Stack notes that volunteering can be mutually beneficial to employer and employee alike, but he offers this caveat: Don't Overlook Workers Comp Needs for Volunteers.

Newcomer to Cavalcade Alan Whitton - aka "Big Cajun Man" talks about Atrociously Dangerious Investment Advice at the Canadian Personal Finance Site.

And here at Worker's Comp Insider, we point you to a pair of posts on the theme of this issue: Lightning Stike Survior Stories and The one in a million club you don't want to join.

That's it for this issue. The next host - two weeks from today - is RJ Weiss. Just in time for your poolside reading!

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June 19, 2014



While people all over the globe are gripped by World Cup fever, here in health-wonk-istan, our bloggers take a more philosophical approach to football. They are not distracted from their important mission of bringing you the best in the health policy arena. Without further hooplah, we give you our bloggers' best posts from the prior two weeks. Because our entries are all winners, we dish them up in the order in which they were received.

We begin with a steamy post from Henry Stern at InsureBlog, who reports on a (now former) anesthesiologist's - say THAT 10 times fast - unique (and disturbing) multi-tasking abilities in his submission More Red Hot Lover/Physician Tricks.

David Harlow of HealthBlawg interviews Roy Schoenberg, CEO of American Well about the model policy recently adopted by the Federation of State Medical Boards to get state medical boards up to speed quickly and to access standards of care that are both protective of patients' interests and offer baselines against which physician behavior may be judged by an individual board. (After this post went up, the AMA issued a halfhearted endorsement of the whole enterprise.)

David Williams has launched a Health Business TV YouTube channel as an adjunct to his respected Health Business Blog. You can see his debut edition, in which he discusses Castlight Health, the Affordable Care Act, and more.

At Health Care Renewal, Roy Poses continues watchdogging bad behavior by corporate health entities. He reports on two recent health settlements involving companies that are no strangers to legal misadventures in his post Fool Me Twice? - Boehringer Ingelheim, Medtronic Settle Lawsuits Alleging Deceptive Marketing. One settlement involved allegations that the company hid data about the adverse effects of a popular and heavily promoted drug; the other involved allegations of paying off doctors to promote use of expensive medical devices. The settlements provide a cloak of deniability so kudos to Dr. Poses for shedding light on perverse incentives.

Jason Shafrin says that numbers do not lie: health insurers with the largest market share have the largest increases in health insurance premiums. Check out his post on Healthcare Economist to find out why the numbers may not tell the whole story: Are market leaders raising health insurance premiums?

For Father's Day, Maggie Mahar dished up the scoop on the great cholesterol con at her Health Beat Blog. Despite a lack of medical evidence that statins helps anyone who hasn't already had a heart attack, the perpetuation of the idea that "bad cholesterol" causes heart attacks successfully demonized eggs - a perfectly good source of nutrients = while bolstering the bottom line for statin manufacturers.

Brad Wright talks about the Geographic Divide: How Federalism Has Formalized Health Disparities at Wright on Health. He looks at the Medicaid expansion (and non-expansion) and how this affects border communities that straddle sate lines. The issue of whether or not people have health insurance and access to care is a sometimes matter of which part of town they live in.

At the NCPA's Health Policy Blog, NCPA Senior Fellow Devon Herrick talks about how so-called specialty drugs are displacing traditional drugs as the primary component of drug spending, noting that there are a number of regulation challenges that will impact how patients will get access to these drugs and how much they will pay. See his post, At a Pharmacy Near You: The Specialty Drug Turf War

While mountains of commentary appeared about the problems with the so-called "roll out" of the computer system for the federal Affordable Care Act, there were also similar problems in several states that had decided to run their own public exchanges. At Healthcare Talent Transformation, Patrick Pine looks at some of the reasons why the feds and several states had so many problems setting up computer programs for the public exchanges.

At Health Affairs Blog, Joel Kupersmith, former head of research at the Veterans Health Administration, CEO of Kupersmith Associates, and an adjunct professor at Georgetown offers his thoughts on the VA scandal and the future. He outlines the VA's scope and assets, its problems, and strategies for moving forward in both the short and long terms.

On the front lines of the Affordable Care Act roll out, Louise Norris of Colorado Health Insurance Insider reports that health insurance enrollment continues to climb, even in this "off-season." She reports hard numbers on on enrollment growth and offers predictions for how tie enrollment period will likely look when it wraps up in the next five months, and the prospects for 2015.

At Managed Care Matters Joe Paduda looks at the "collateral damage" that occurred in layoffs related to a recent spate of workers compensation mergers & acquisition activity. He notes that strong non-compete agreements executed under duress needlessly and unfairly tie the hands of experienced professionals in his post The Good, the Bad, and the Ugly.

Here at Workers' Comp Insider we point you to Tom Lynch's excellent tribute to industry thought leader Dr. Jennifer Christian. He chronicles her past achievements as well as some of her current initiatives in occupational health.

That concludes this issue off Health Wonk Review - we're kicking the ball to Jennifer Salopek at Wing of Zock, who will host the July 17 edition.

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June 18, 2014


Pardon us while we self promote for a minute... but many thanks to Steve Schmutz at Claimwire for featuring Tom Lynch in his interview series. For those of you who don't know Tom and would like to learn a little more about him, you can read the interview here: Industry Spotlight: 20 Questions with Tom Lynch, CEO at Lynch, Ryan & Associates...and when you've read that, here is an archive of all Steve's prior interviews with insurance leaders. They are interesting reading because they dig below the professional surface with some questions designed to reveal what makes these well-known insurance professionals tick - who influenced them, what their career paths have been like, who they admire and other interesting questions that give insight. Thanks, Steve, for including Tom in your series.

Since this is blog post with Tom Lynch as a topic, it gives me a podium to add my personal perspective. As someone who has known and worked with and for Tom for more than 20 years, I would add that he is remarkable visionary and has been a key influencer in our industry -- as well as on the lives and careers of his many employees over the years.

Today. many of the day-to-day employer best practices in managing workers' comp claims that we take for granted were nurtured in the Lynch Ryan "labs" in the early days of the company. In those bad old days, Tom brought the true entrepreneurial spirit to addressing a broken system. "Changing the paradigm" is a shopworn cliche that rarely plays out beyond press releases, but Lynch Ryan truly shifted the approach by focusing on managing the human event rather than the financial transaction, a change in focus that enabled better and healthier outcomes for worker and employer alike. Tom & team identified many of the flaws and friction points in a malfunctioning system: a system in which most employers had better plans in place to address their copy machine breakdowns than they did for their injured workers; a system that was essentially geared to treating the "bad apple" on the bell curve, but not the preponderance of honest and legitimately injured workers; a system in which employers took a hands-off stance at point-of-injury, a critical management/human juncture; a system in which employers were paying large sums of money for a service it knew little to nothing about. Tom applied common sense management principles and a human-focused approach to fixing these problems saving employers a bundle in the process. Treating people well and fairly was actually more cost effective than treating people suspiciously and punitively -- who knew!

Tom hired a remarkable team in those early days (if I do say so myself, heh), inspired them with passion and gave them wide latitude to enact their ideas - effecting some out-sized industry-wide practices that continue to this day. I can say that it has been a true privilege to work with Tom.

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