Archive for March, 2014

March Madness: Health Wonk Review & other notable news

Friday, March 28th, 2014

Chris Fleming has posted A March Madness Health Wonk Review at Health Affairs Blog. As might be expected, Obamacare is a big focus in the submissions, as well as some stellar entries on the healthcare scene in Massachusetts. There’s also a grab bag of assorted topics. Health Affairs Blog and the parent publication Health Affairs is one of the nation’s leading journals of health policy thought and research. If healthcare is a topic on your radar — and if you are an employer, it should be — it’s worth dropping by to keep up to date.
Other notable news:

A bit of humor
You had one job: Funny on-the-job flubs
Bronze Age Orientation Day
The Electronic Morale Booster – How things have changed since 1951
…if you missed the video of the dramatic rescue of a construction worker by the Dallas Fire Department, we’ve posted it below.

Dying On The Job in Boston

Thursday, March 27th, 2014

We lost two firefighters in Boston, yesterday.
A 9-alarm fire on Beacon Street in Boston’s Back Bay, aided by 45 to 50 mile per hour winds off the Charles River, took the lives of Lt. Edward J. Walsh and Firefighter Michael R. Kennedy. Walsh, 43, was married with three children; Kennedy, 33, was a Marine Corps veteran. They were trapped in the basement of the four story apartment building when a window blew out, the winds rushed in and part of the building exploded.
Deputy Chief Joseph Finn said, “In 30 years, I’ve never seen a fire travel that fast.”
Once again, we are reminded that firefighting is a lot like combat, a lot of waiting for something to happen, and then the world falls in.
This, from today’s Boston Globe, should give one a sense of the emotional trauma of the event:

After the seventh alarm sounded, all firefighters were ordered from the building through a haze of screams and sirens. But when word came that some firefighters were missing, some vowed to go back in.
“No companies should be going in anywhere; stay away from the building,” firefighters were instructed in the mayday call.
“We are aware of the potential we see in front of us; we’re going back inside the building,” came the reply.
But the firefighters were told, “Stay out of the building.”

It took five hours to recover Walsh’s body. As he was carried out on a stretcher, all the firefighters formed an Honor Guard line. “Everyone saluted him, and Eddie was taken for his last ride,” said Steve MacDonald, a Fire Department spokesperson. If that doesn’t stir emotions inside you, then you have something other than blood coursing through your veins.
Reminiscent of the 1972 Hotel Vendome fire just a couple of blocks away that killed nine firefighters, and the 1999 Worcester Cold Storage Warehouse fire that took the lives of six, yesterday’s inferno sledgehammers us with the understanding that firefighting is a deadly business.
Seeing the soot-covered, teary faces of the men and women who watched Lt. Walsh take his “last ride” made me think of the other end of the pole, the sometimes messy business of workers comp.
In most states, injured workers are given two-thirds of their average weekly salary (60% in Massachusetts), tax free, while they’re recovering and unable to return to work. Police and firefighters, on the other hand, public sector employees, receive 100% of their average weekly salaries, also tax free. In essence, it’s a promotion.
This different treatment can sometimes anger taxpayers, usually when abuse occurs. And abuse does occur, not often, but when it does it can make headlines. In Massachusetts, we vividly remember the case of Albert Arroyo, a 20-year veteran of the Fire Department, who, after being deemed “totally and permanently disabled,” which allowed him to receive 100% of his salary, tax free, made the Boston Globe front page when he finished eighth in the 2008 Pro Natural American Bodybuilding Championship, with a picture to prove it.
Although Arroyo was acquitted of fraud charges in 2011 by a federal jury, the whole thing left a bit of a stink. US Attorney Carmen Ortiz, Boston Mayor Tom Menino and just about everyone else in authority complained loudly and in print that justice had not been done.
We all want our tax dollars spent well, but every once in a while, like yesterday, we come up against two truths that won’t go away: First, protecting the citizenry can be a tragic and deadly business; and second, with the exception of soldiers, I don’t know of any other occupations where people give their lives in the line of duty to protect others. Do you?

Bi-weekly Risk Roundup

Thursday, March 20th, 2014

Atty. Van Mayhall offers up a new roundup of risk-related matters in a fresh Cavalcade of Risk #204 posted at his Insurance Regulatory Law blog – check it out!

Mud Season Health Wonk Review

Thursday, March 13th, 2014

Brad Wright has found the perfect metaphor for the current healthcare and health policy environment: Health Wonk Review: Mud Season Edition. It’s a great edition illustrated with some nice — albeit dismal – seasonal photos. But take heart, where mud season is, spring is not far behind.
Check it out, it’s a great way to keep current via some of the best minds in the health policy blogosphere!

WCRI Conference: Day One

Wednesday, March 12th, 2014

Four sessions today, beginning with MIT’s Jonathon Gruber in a stemwinder. Gruber, one of the principal architects of the Affordable Care Act (ACA), and, with John McDonough, a prime mover in the Massachusetts health care reform of 2006, must spend 80% of his waking hours debunking rumors, which have become urban myths, which have turned into alleged “facts” regarding all things ACA. Witness for the prosecution – Sarah Palin’s Death Panels.
Dr. Gruber pointed out that one of the important differences between the Massachusetts reform, which he convincingly demonstrated was the template for the ACA, and the ACA was that Massachusetts did not have to focus on costs, because Ted Kennedy and Governor Mitt Romney had maneuvered to have the costs covered with an annual infusion of $500 million dollars of federal money. The Massachusetts reform could not have happened without this.
Nonetheless, the goal of Romney’s reform was to provide health insurance for all of Massachusetts’s citizens. And with more than 97% of the population covered, this has happened.
Gruber went on to say that, despite the rocky beginning, the federal exchanges are now running “as they should.” He suggested that a prime goal of the ACA, Medicaid expansion, is falling behind expectations, because many of the governors in the southern states have chosen to not participate. In effect, they have turned down 100% federal funding for three years and 90% funding thereafter. Frankly, I consider this an abomination. Millions of Americans will be harmed because of this politically idealogical decision. Perhaps, this will change in the future. One can hope.
Dr. Gruber reminded attendees that it took about three years to find out if the Massachusetts reform was working the way it was supposed to (It was). He suggested that a similar period would have to pass before we know if the ACA has done what it was engineered to do. Until then, we should be “humble” to recognize what we don’t know and “patient,” because the ACA is a process, not an event.
The rest of the day was devoted to Dr. Carol Telles reporting on the results of health care reforms in Texas, where costs have declined significantly, and Dr. Rebecca Yang reporting on the effects of the Illinois 30% reduction in the medical fee schedule. It appears that in Illinois costs of professional services (primary care and the like) have declined by 24%, but costs of surgical services have risen significantly to a point where they are now 382% higher than Medicare. It would have been nice to know the impact on total health care costs.
I look forward to a stimulating day tomorrow.

WCRI Conference

Wednesday, March 12th, 2014

I’ll be live-Tweeting from the WCRI Conference from Wed through Thurs so follow me at Twitter for updates.

Death on a Georgia Railroad Trestle Sparking Calls for Safety Reforms in Hollywood

Tuesday, March 11th, 2014

If film making news isn’t on your radar, you might have missed the story about a gruesome death on a film set near near Jessup, Georgia in late February. Like many workplace deaths, it didn’t attract a lot of immediate notice beyond the local sphere and within the film industry. But the sadness and the anger at the preventable death of 27-year-old camera assistant Sarah Jones has been gaining momentum and prompting calls for increased safety in the film industry.
On February 20, a film crew for Midnight Rider, a biopic about Gregg Allman, was set up on a narrow railroad trestle bridge in Georgia. A train arrived unexpectedly and crew scrabbled frantically to save themselves: 27-year-old camera assistant Sarah Jones was killed by the train and seven other crew members were injured. You can read about the events, including reports from other crew members, in the Hollywood Reporter’s story, A Train, a Narrow Trestle and 60 Seconds to Escape: How ‘Midnight Rider’ Victim Sarah Jones Lost Her Life.
The incident is under investigation by several parties, including OSHA and the Georgia Bureau of Investigation. But within the industry, many are not waiting for reports to speak out:

“The exact details of what precautions were — or were not — taken on the set that day and whether the production even had permission to film on the tracks are being sorted out. But in the days following the disaster, recriminations of shockingly lax safety protocols began to emerge.

“This was no accident,” says Ray Brown, president of the Motion Picture Studio Mechanics union local 479 in Atlanta and a Jones colleague, suggesting the incident was avoidable. “When I have done train work or around trains for smaller productions up to major blockbusters, there are always several railroad personnel there with their hard hats, glasses and radios, and I can’t imagine a more structured safety protocol even beyond airlines than the rail system.”

While the facts will come out, initial reports indicate that the owner of the track said it never granted permission to film, there were no railway safety personnel monitoring the set, there were no medics on scene and the crew had such trepidation about the work environment that they began the shoot with a group prayer for safety.
The film industry is rife with risks and crew safety ail too frequently given short shrift, particularly in low budget films with high-pressure deadlines. You can read some poignant thoughts about Sarah’s death and what it’s like to be on a film crew in the blog post You Think It’s About Magic But It’s Really About Money

“We have rules and we have safety meetings and we have unions to look out for us, yes. We have reps, and we have shop stewards, and we have grips who are supposed to be keeping an eye on safety on set — along with rigging and setting stands and laying track and pushing the dolly and the 30 other things that make up a grip’s job. But these folks can’t be everywhere at once, and, just like the rest of us, they can’t always stand up to the machine, especially when everyone is always in a hurry and making calls on the fly. When crews band together, we can say “no” and pull the plug at 18 hours. But nobody wants to be the first one to suggest that, because we all need to work for a living and get hired on the next job.

Since the tragic events, the film making community has been working to call attention to Sarah’s preventable death as well as to advocate for increased focus on film crew safety. Members of the film industry lobbied to have Sarah recognized during the Osacars (her name was added at the end of the In Memoriam segment) and the industry has launched a moving “Slates for Sarah” social media tribute and call to action.
If the film crews can’t effect changes, the lawyers may. BusinessWeek notes that the Accidental Death on Midnight Rider Set Enters Lawyer Phase.
This terrible incident brings to mind a prior film tragedy: the 1983 deaths of Vic Morrow, and child actors Renee Chen and Myca Dinh Le when a helicopter crashed on the set of The Twilight Zone. See Slate‘s A New Dimension of Filmmaking: How tragedy on the set of the 1983 feature-length adaptation of The Twilight Zone changed the way movies are made and the Crime Library‘s The Twilight Zone Tragedy.
Sounds like it’s time to shake up the industry again. It’s no more acceptable for the film industry to play fast and loose with worker lives than it is for coal mining, manufacturing, or any other industry.

Cavalcade of Risk at Bob’s Cluttered Desk

Wednesday, March 5th, 2014

This week’s host of Cavalcade of Risk – #203 is Bob Wilson of and of the highly esteemed “Bob’s Cluttered Desk” blog where a spoonful of humor always makes the medicine go down. In this issue of Cav, he offers a roundup of posts across the risk spectrum – check it out. And while you’re visiting, if you haven’t read any of Bob’s greatest hits yet, set aside a few minutes to do so. How many insurance blogs do you read that have the temerity to cover flatulence?