Workers Comp and The Health Insurance Void

August 8th, 2005 by

Our co-blogger (is that the term of art?) Julie Ferguson mentions the latest Robert Wood Johnson Foundation report (PDF) on the status of the uninsured in America. We suspect that there is a strong correlation between the costs of workers compensation and the prevalence in the workforce of workers who lack health insurance. The latest study shows that at least two of the really high cost states for comp, Texas and Florida, also have far above average percentages of workers who lack health insurance (26% and 20% respectively).
The Obvious
The report finds that adults who lack health care coverage are more likely to not see a doctor when needed due to cost than adults with coverage. I’m not looking for an “amen!” here — a simple “duh!” will suffice. It seems pretty clear that adults without health insurance will postpone treatment as long as they can. They will try to ignore symptoms. Perhaps most important, they are unlikely to work with a doctor to develop a concrete strategy to enhance their own health over time. Faced with the same problems we all face — depression, bone loss, sleep disorders, etc., — they are far more likely to muddle their way through rather than pay a doctor’s examination fee out of pocket. Until they drag themselves into an emergency room, the benefits of modern medicine and pharmacology are simply beyond their reach.
The report goes on to say that adults who lack health care coverage are more likely to report poor or fair health than adults with coverage. Here the percentages are a bit surprising: 20.4 per cent of the uninsured report fair to poor health, compared to 11.7 per cent for the insured. I would have expected the pessimism among the uninsured to be higher. It’s a tribute to their determination and optimism that 80% of the uninsured think they are in good health.
Workers Comp Implications
As health costs go up, more and more employers are pulling out of the system. The expense is just too great. Or they ask employees to pick up more of the burden — not just in the premiums, but in the co-pays for office visits and medications. By contrast, workers comp benefits stand out like the proverbial sore thumb. No premiums for the employee. No co-pays and no deductibles, ever. On top of that, employees can collect indemnity benefits for time away from work. It’s a good deal, and it looks better every day as the cost of conventional health insurance shoots upward.
Here’s one more point of convergence between rising health care costs and workers comp. Regardless of the optimism demonstrated by the uninsured in this report, workers lacking health insurance are more at risk for poor health. In avoiding the health care system, in ignoring symptoms, they are at constant risk for deteriorating health. They bring these problems to work, where they are at higher risk for injury because their non work-related symptoms are not being addressed. Here we have a prescription for trouble that is all too common in the American workplace. Until we solve the health coverage conundrum, there is the distinct possibility that, by default, workers comp will end up footing the bill for the unaddressed health problems of the uninsured.