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Could Obamacare Cause Workers Comp Medical Treatment Rationing?


Medical Treatment Rationing Possibility

Would Obamacare cause Workers Comp medical treatment rationing?  Over the past few years, I had commented very often on the interfacing of Obamacare with Workers Compensation.

Picture Of Medical Personnel Holding Medical Treatment Rationing Medicine

The number one effect that seems to go unmentioned is the fact that medical care may (keyword may) be rationed overall.

My opinion is not based on any political agenda.  It is based on the economic models of Adam Smith developed in the 1700’s – basic supply and demand.   One of the hallmarks of the recent economic models (all based on Smith’s) is that if demand is increased for a good or service while the supply stays constant, the price will increase.  However, if there is any type of governmental interference, then the whole market goes completely out of whack.

Governmental quotas, price supports, etc. have always thrown the market out of kilter.  Would Obamacare be seen as the same type of governmental interference in the market?  Supposedly, the numbers of “covered Americans” would approach 100%.

The basic Smith economic models says that when there is an increase in demand – more people seeking healthcare – while there are no more physicians or other healthcare providers being added, then where does that leave the injured Workers Comp patient?

Nurse Preparing Medical Treatment Rationing Syringe Injection

What happens if instead of seeing the physician monthly all of a sudden all Workers Comp patients could only been seen bi-monthly?   If a carrier/employer/self insured is paying temporary total benefits, this could be a very vexing problem.

If I was an adjuster, that would drive me totally bonkers.  The part of my caseload that was drawing benefits would now be competing with the 100% -covered Americans.  Would a boutique network established with for instance, an orthopedist, let my injured workers be seen more often?
The boutique WC network would be a carve-out of a network while an insurance carrier or TPA would pay MORE to have their injured workers seen on a timelier basis.

Of course, none of this may come to fruition.  Many articles have been published where Obamacare may not actually cover 100% of Americans.  Regardless,  there will still be a larger number of people competing for those medical care slots.

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James J Moore - Workers Comp Expert

Raleigh, NC, United States

About The Author...

James founded a Workers’ Compensation consulting firm, J&L Risk Management Consultants, Inc. in 1996. J&L’s mission is to reduce our clients’ Workers Compensation premiums by using time-tested techniques. J&L’s claims, premium, reserve and Experience Mod reviews have saved employers over $9.8 million in earned premiums over the last three years. J&L has saved numerous companies from bankruptcy proceedings as a result of insurance overpayments.

James has over 27 years of experience in insurance claims, audit, and underwriting, specializing in Workers’ Compensation. He has supervised, and managed the administration of Workers’ Compensation claims, and underwriting in over 45 states. His professional experience includes being the Director of Risk Management for the North Carolina School Boards Association. He created a very successful Workers’ Compensation Injury Rehabilitation Unit for school personnel.

James’s educational background, which centered on computer technology, culminated in earning a Masters of Business Administration (MBA); an Associate in Claims designation (AIC); and an Associate in Risk Management designation (ARM). He is a Chartered Financial Consultant (ChFC) and a licensed financial advisor. The NC Department of Insurance has certified him as an insurance instructor. He also possesses a Bachelors’ Degree in Actuarial Science.

LexisNexis has twice recognized his blog as one of the Top 25 Blogs on Workers’ Compensation. J&L has been listed in AM Best’s Preferred Providers Directory for Insurance Experts – Workers Compensation for over eight years. He recently won the prestigious Baucom Shine Lifetime Achievement Award for his volunteer contributions to the area of risk management and safety. James was recently named as an instructor for the prestigious Insurance Academy.

James is on the Board of Directors and Treasurer of the North Carolina Mid-State Safety Council. He has published two manuals on Workers’ Compensation and three different claims processing manuals. He has also written and has been quoted in numerous articles on reducing Workers’ Compensation costs for public and private employers. James publishes a weekly newsletter with 7,000 readers.

He currently possess press credentials and am invited to various national Workers Compensation conferences as a reporter.

James’s articles or interviews on Workers’ Compensation have appeared in the following publications or websites:

  • Risk and Insurance Management Society (RIMS)
  • Entrepreneur Magazine
  • Bloomberg Business News
  • WorkCompCentral.com
  • Claims Magazine
  • Risk & Insurance Magazine
  • Insurance Journal
  • Workers Compensation.com
  • LinkedIn, Twitter, Facebook and other social media sites
  • Various trade publications


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