Archive for September, 2013

Fresh Health Wonk Review & Other Noteworthy News

Thursday, September 26th, 2013

Check out the latest Health Wonk Review
At Healthcare Talent Transformation, Peggy Salvatore has posted The 700th Anniversary Blog Question Is….Will a Government Shutdown Stop ObamaCare? lots of opinions from various sources. (And while on the topic of stopping Obamacare, don’t miss Joe Paduda’s take on the Ted Cruz affair. )
Prescription Drugs
New research on prescription drug expenditures from NCCI reveals that prescription costs per claim continue to grow, with utilization being a major driver of total cost changes; the share of Rx costs for physician dispensed drugs continues to increase; narcotics account for 25% of drug costs; and more than 45% of narcotics costs are for drugs with Oxycodone HCL as an active ingredient. For the full report: Workers’ Compensation Prescription Drug Study, 2013 Update. (PDF)
Related – See CompPharma’s 1oth Annual Survey Summary on Prescription Drug Management in Workers’ Compensation – for an overview, see Joe Paduda’s summary. Also the Workers Compensation Research Institute recently issued The Prevalence and Costs of Physician-Dispensed Drugs – a 24-state reference book that allows policymakers and others to see how their state compares with other states as well as what actions other states have taken with regard to this issue.
In what has become a familiar routine, the insurance industry finds itself trying to persuade legislators of the importance of the Terrorism Risk Insurance Act (TRIA), the federal backstop that allows insurers to provide coverage for unpredictable acts of terrorism. It’s schedule to expire at the end of the year – the last two times this occurred, there were eleventh hour “saved by the bell” approvals, but not without wreaking the havoc of uncertainty in a busy renewal season. Think that TRIA has outlived its usefulness? See the terrorism threat map from the Property Casualty Insurers Association of America to see threat events (actual and thwarted) since September 2001 – click by state. The American Insurance Association (AIA) makes the point that TRIA enables a stable terrorism risk insurance market for a peril that would be otherwise uninsurable. “TRIA enables insurers to cover what would otherwise remain an uninsurable risk because unlike weather events, it can’t be modeled. See their full statement on TRIA. Also, check out what Robert Hartwig had to say in his testimony before the U.S. Senate Banking Committee on Future of Terrorism Risk Insurance Act (TRIA) Program
Emergency Planning
The Boston Marathon bombing, the recent Navy Yard shooting, the horrific Nairobii shopping mall attack … these events pose a challenge for risk managers. The September cover story of The American Society of Safety Engineers’ (ASSE) Professional Safety journal focuses on Emergency Response & Business Continuity: The Next Generation in Planning PDF), a timely topic for September as National Preparedness Month.
Immigrant workers
At Working Immigrants, Peter Rousmaniere makes the case for why we must address immigrant work safety now. One compelling reason? “Foreign-born workers (including legal and undocumented) comprised about one tenth of the country’s workforce in 1990. Today they amount to about 17 percent, and are much more widely distributed geographically. ” His post addresses various ways that, as an industry, we’ve been failing to address the problems.
Cool tools

Other noteworthy news

Cavalcade of Risk #192 Gallops Into View

Wednesday, September 18th, 2013

Nancy Germond hosts a great edition of Cavalcade of risk posted on her Insurance Writer blog: Cavalcade of Risk #192 Gallops Into View. We echo her suggestion to take a few minutes, grab a cup of coffee and visit with the contributors!

USDA: What’s up with your “for the birds” food processing legislation?

Monday, September 16th, 2013

Chickens have been a hot potato on the legislative circuit lately — well, the processing of chickens, that is. Even if you thought you had absolutely no interest in poultry processing, if consuming tasty chicken is something you enjoy, you may want to know about these laws. We’re wondering what’s up with the US Department of Agriculture (USDA) – could there be something in the water?
Elizabeth Grossman of The Pump Handle offers the lowdown on one of those laws in her post Hazards behind a chicken dinner: US poultry workers ask USDA and OSHA to protect their safety. Last year, about a half million poultry workers processed about 8 billion chickens, many handling about 100 birds a minute. Now a rate like that is pretty amusing when you see Lucille Ball on a chocolate packing assembly line in the old sitcoms, but it’s a little less comical for workers wielding sharp knives while “standing in chilled processing plant facilities, cutting, gutting, scalding, defeathering and hanging birds as they speed by on automated machinery.”
But as Grossman notes, this apparently isn’t fast enough:

“If a rule proposed by USDA and supported by the poultry industry is finalized and goes into effect, the speed at which chickens and other poultry are typically processed could increase to as much as 175 birds per minute – a rate at which some plants are already operating.”

And one more thing:

“The proposed USDA rule would change the way poultry processing plant inspections work. It would shift the inspection process to one in which individual companies set inspection guidelines for their own plants.”

Now that’s not good for the workers, who are already plagued with notoriously poor working conditions and an injury rate that is about twice the national average (see also Unsafe at These Speeds) — it doesn’t sound too propitious for consumer quality, either. We’ll forgo the fox guarding the hen-house analogies and simply pose the radical idea that guidelines set by profit-driven companies may not always be in the interests of the greater good in an era that is flirting with drug-resistant Salmonella and other super pathogens.
It hasn’t worked so well in pilot programs in pork plants: See Kimberly Kindy’s Washington Post article: USDA Pilot Program fails to stop contaminated meat. Her article notes:

“Auditors from the inspector general’s office found that three of the five plants in the pilot program had racked up scores of health and safety violations, many of them for problems that were never fixed. The report did not identify the five plants and said that, since no study had been done, it was difficult to determine if contamination and other deficiencies could be attributed directly to the inspection system.

But the auditors pointed out that the safety records at the three most-troubled pilot plants were worse than those at hundreds of other U.S. swine plants that continued to operate under the traditional system, which features slower processing speeds and about double the number of government inspectors.”

But wait, there’s more. If you care about poultry workers and or food safety — pick one or both (although we see them as issues that are inextricably linked) — the news gets even worse.
Wired reports: USDA: Chicken Processed in China Can be Sold in the US Without Labels to Say So. So in addition to increasing US worker output, USDA now allows for off-shoring some of the chicken processing jobs to the wonderful folks that produced glow-in-the-dark pork. Do you trust your kids chicken nuggets to be processed by the country that produced these rather alarming food products? Of ocurse, you’ll have no way of knowing because these processed meats won’t be subject to Country Of Origin Labeling (COOL) the way that fresh meats are.
For now, the chickens will be bred, raised and slaughtered in the US and China will only be doing the processing. Note the key phrase “for now” – many industry insiders expect that this is a prelude to allowing China to export domestically raised chickens to the US.
Additional info
NIOSH study finds widespread carpal tunnel among poultry workers, underscores why Poultry Rule is a bad idea
OSHA: Poultry Processing

Will you know when your chicken was processed in China?
Your chicken nuggets may soon come from China

Health Wonk Review at Boston Health News and an Interesting Challenge

Thursday, September 12th, 2013

Tinker Ready is hosting this week’s edition of Health Wonk Review at Boston Health News: Data, medicine, insurance reform and a round up of health policy blogs. It’s a tasty smorgasbord from some of the best minds in the health policy blogosphere.
Tinker opens her post talking about the Knight News Challenge. To learn more about this, be sure to click the last entry in the roundup. It’s Tinker Ready’s idea submitted to the Challenge: HealthDecider: Using data to stay healthy and get well – we think it’s an excellent concept and if you do too, sign up and give her a vote.
The Knight News Challenge is pretty interesting with a stated goal to “…accelerate media innovation by funding breakthrough ideas in news and information. Winners receive a share of $5 million in funding – and support from Knight’s network of influential peers and advisors to help advance their ideas. Innovators from all industries and countries are invited to participate. Winners include leading Internet entrepreneurs, emerging media innovators and legacy newsrooms.”
Check out past winners and see submissions for this year’s Challenge, to date.
If you have an idea, you’ll need to act fast – there are only 5 days left to get an entry in to his year’s Challenge before the feedback phase begins.

Cavalcade of Risk #191: Your Daily Shower Can Kill You

Wednesday, September 4th, 2013

We’re happy to be hosting Cavalcade of Risk #191. Risk is a topic that we think about a lot, so a recent post about risk on the group blog Metafilter caught our attention. It pointed to Jared Diamond’s excellent essay, The Daily Shower Can Be a Killer. The author shares a risk management lesson that he learned in 50 years of field work on the island of New Guinea: the importance of being attentive to hazards that carry a low risk each time but are encountered frequently. He notes:

“Studies have compared Americans’ perceived ranking of dangers with the rankings of real dangers, measured either by actual accident figures or by estimated numbers of averted accidents. It turns out that we exaggerate the risks of events that are beyond our control, that cause many deaths at once or that kill in spectacular ways — crazy gunmen, terrorists, plane crashes, nuclear radiation, genetically modified crops. At the same time, we underestimate the risks of events that we can control (“That would never happen to me — I’m careful”) and of events that kill just one person in a mundane way.”

The Metafilter post also included a link to this fun video on the topic of risk management. I nominate it as the Cavalcade of Risk official theme song.

With that preamble on risk management, we delve into this week’s submissions.
Life Insurance – First up to bat, we offer a nod and shout out to Hank Stern of InsureBlog, our fearless leader who has been managing the Cavalcade’s biweekly efforts for close to 200 issues now. Kudos and thanks, Hank. He poses the question: What if you’re diagnosed with cancer while buying new life insurance? Well, as it turns out, there may actually be a decent chance of obtaining coverage. Read how in Underwriting Cancer.
ACA spin vs. reality – Louise Norris of Colorado Health Insurance Insider is on the front lines when it comes to implementing ACA in the real world so we always take particular note of her opinions on the matter. In her post
Early Renewal Provides a Good Alternative for 2014, she takes on some of the misinformation and spin from both the right and the left that can make things confusing for consumers. She cites misinformation about the Aetna plan as one example of spin not matching reality.
Technology – Our colleague Bob Wilson can always be counted on to offer a unique and often humorous take on things at his eponymously named blog Bob’s Cluttered Desk. He notes that mobile technology is making tremendous advances that will speed treatment and lower medical costs, which is critical for those of us paying the bills and managing claims — but he questions the wisdom of having Siri as a Medical provider, and whether she can be trusted to stay on the straight and narrow.
Oral Chemotherapy Parity – David Williams knows his stuff when it comes to the ins and outs of the business of healthcare, and if that is on your radar, there is no better guide than his Health Business Blog. This week, he talks about the oral anticancer parity law, noting that while it’s not necessarily a bad idea to require health plans to charge the same out-of-pocket costs for oral anti-cancer drugs as they do for infused products, the law has unintended consequences, including rolling back co-pays on generic chemo meds used for other indications
Investing – At the blog Mom and Dad Money, Matt Becker says that investing in the stock market carries with it a very large risk, one that is rarely talked about in the financial media. In his post The Real Risk of Investing in the Stock Market, he challenges some of the conventional wisdom about investing, noting that success and failure may not be the only outcomes we should measure.
Risk of incarceration – Here at Workers’ Comp Insider, we recently assessed the risk of jail time for workers comp lawbreakers and advise any claimants with felonious intent to steer clear of Wyoming. Corporate malfeasants, not so much…
That’s it for this week’s Cav. The next host — two weeks from today — will be Nancy Germond at Insurance Writer Blog.