“Alexa, you have some explaining to do.”
Guardian investigation reveals numerous cases of Amazon workers being treated in ways that leave them homeless, unable to work or bereft of income after workplace accidents
“Alexa, you have some explaining to do.”
Guardian investigation reveals numerous cases of Amazon workers being treated in ways that leave them homeless, unable to work or bereft of income after workplace accidents
Last week, some of my LinkedIn connections, as well as several other connections, learned of my recent hospitalization. The reason for this was not mentioned at the time, but I will tell you now.
Not having health insurance through an employer, and being denied renewal of a local county health care program, led to my going from Stage 4 to End Stage Kidney Disease.
The hospitalization last week was to place a catheter in me for peritoneal dialysis, and to repair an umbilical hernia.
My hospitalization was brought to light quite unexpectedly by my friend, Maria Todd. Maria’s sending best wishes for my speedy recovery and quick discharge from the hospital was much appreciated, and the warm words by others in response, and the thirty plus “likes” made me feel that people cared. For that. I am grateful.
But the events of the past month have brought home to me one very important point, given the current activity surrounding the so-called “repeal and replace” of the ACA, and the two Congressional bills that many consider doing more harm than good.
This nation needs Medicare for All.
There, I said it.
I know in the past, I have advocated single payer for others, but my illness has shown that anyone who loses health care for any amount of time, once they have reached adulthood, cannot go without health insurance.
This is what happens when men and women are removed prematurely from the workforce, for whatever reason, employer decides you are no longer wanted, economic downturn or just to eliminate positions that affect the bottom-line of the company, and are generally targeted to individuals in their 40’s, 50’s and early 60’s so that the company can save on health care costs for those employees, and so that younger workers can be hired to replace them.
This is not something new, and not related to automation and artificial intelligence disrupting whole industries, which is inevitable.
My initial view on single-payer was that if employers were no longer responsible for the health insurance of their employees, and they were guaranteed full coverage by the government, some of the job losses of the past decades would not have happened, and many talented men and women out of the workforce would be employed until their retirement.
If you don’t believe me, go to LinkedIn and read the many posts from such individuals who are still unemployed. One fellow in Texas even got turned down from jobs at fast food restaurants.
So, now it is personal for me.
I also know that many of you make your living from the health care system we currently have, and that some of you have expounded on why you think a single payer system is unrealistic.
I get it that your financial outlook depends on working in a broken, free-market system because it pays your salary, but healthcare was not supposed to be a business, nor was it supposed to marketed like any other commodity.
If you don’t believe me, read what Pope Francis said: “health is not a consumer good, but rather a universal right, and therefore access to health care services cannot be a privilege.”
But try telling that to Messrs. McConnell, Ryan, Paul, et al in Congress, and the current POTUS, all of whom want to eliminate medical coverage for millions of Americans they received under the ACA, cut back Medicare and Medicaid, and destroy Social Security.
Now that I will be receiving dialysis, and quite likely will qualify for disability, the prospect of not having those resources is very personal to me, and could literally mean my life.
Look in the mirror, then look at your spouse, your children, your parents, your neighbors, friends, etc. What do you think would happen to them if these programs were eliminated? Would you have enough money to care for them? Would you have money to pay for private insurance?
I lost my mother last month to dementia. She died on her 85th birthday in a nursing home some miles from my home (the home she and my father bought), but if the Republicans in Congress had gotten their way, and she had lived longer, I feared she would have been forced out of that nursing home, with no place to go, and would have been an even bigger burden to me.
So, I really don’t care if you are a Democrat, Republican, Independent, Libertarian, Socialist, Liberal, or Conservative, we all need health care at some point in our lives.
One of the friends I met here in Florida back in the 90’s died last July of a stroke. He was 73. He worked out, never smoked, had a good life, three kids, and like many of you, worked in Risk Management, as well as Human Resources, the legal profession, and served in Vietnam. But despite all that, he died prematurely, and went into involuntary retirement because he was in his 60’s. Luckily, his wife worked. But you get the picture.
We must all do our part to see that every American can get health care. Not just access to care, which is a Republican euphemism for being able to afford it, and if you can’t, too bad. But actual health insurance. Medicare for All.
Fellow blogger, Joe Paduda, today wrote a very prescient article about the impact the jobless economy will have on workers’ comp in the coming decades.
While the idea of driverless trucks may be something in the works, there are many factors working against it from becoming reality in the near term, and perhaps for many years to come. Laws and insurance requirements and what to do if the truck breaks down on a stretch of highway not easily accessible by repair trucks or miles from the nearest truck stop, will have to considered before driverless trucks put drivers out of work.
Yet, as Joe points out, manufacturing is already seeing a loss of jobs due to automation and higher productivity, which will lead to lower consumer costs, but will exact an even higher cost on the nation’s stability and will force politicians to come to grips with what to do with a permanently unemployed population, especially those in the service sector, who are being replaced, and will be replaced by automated cashiers, as well as those occupations tied to the workers’ comp industry.
If, as I reported yesterday, that 50% of all jobs will be gone by 2025, what do you do with those individuals who lose their jobs to machines and software?
It is a question that few have asked, and one that fewer have provided answers for. Also, what happens, as I also asked yesterday, if the 50% goes to 75% or higher?
The UBI is one idea floating around, but short of that, what else can we do to put permanently unemployed back into the workforce once technology makes them, in the words of that “Twilight Zone” episode, “Obsolete!”
It makes no sense, Joe states, to reform a system that won’t be around much longer. So, say goodbye to workers’ comp, say goodbye to claims adjusters, occupational therapists and physicians and nurses in same, pharmacy benefit managers, rehabilitation personnel, return to work specialists, case managers, utilization reviewers and bill reviewers, as well as underwriters and lawyers.
To quote Michael Corleone, in the Godfather, Part III, “just when I thought I was out…they pull me back in.” To blogging again, that is; not joining the Mob.
There is so much to catch up on in my absence, that I decided to apprise you, my loyal readers, of a subject I discussed earlier this year, the proposed Amendment 69 in the state of Colorado.
To refresh your memories, Amendment 69 (couldn’t they come up with another number?), also called “ColoradoCare”, was an attempt to create a single-payer system in the Rockies.
My previous three posts, “Colorado Gets Real on Workers’ Comp and Health Care”, “Colorado “Single Payer” in Health Care Industry’s Sights”, and “A Little Disruption is a Good Thing” outlined the plan for single-payer, the opposition to single-payer from the health care industry, and how it would be a good thing to have some disruption, especially in workers’ comp.
My writing on the subject also got the notice of a fellow writer, Katie Kuehner-Hebert, of Workers Comp Forum, a sister publication of Risk & Insurance magazine. Her article discussed whether the proposed amendment would be helpful or harmful for workers’ comp payers.
Last month, the voters in Colorado defeated the measure by a wide margin. On election night, at 8:30 p.m., with nearly 1.8 million votes counted across the state, the amendment was trailing 79.6% to 20.4%. Vote totals at 7 a.m., the next morning, with 86 percent of the vote counted, the measure continued trailing at roughly the same percentage or 1,833,879 to 467,424.
As reported in the Denver Post by John Ingold, throughout the campaign, the measure had polled better with Democrats than Republicans, and even in left-leaning Denver, the amendment lost by 2-to-1.
What does the defeat of the single-payer measure mean for the future of health care and possibly workers’ comp?
It means that until there is a nation-wide push for single-payer, state-specific measures such as Amendment 69 will either go down to defeat, or be scraped altogether, as happened in Bernie Sanders’ home state of Vermont. Amendment 69 was an attempt to get there, but as I followed up some weeks later, it was targeted by the health care industry, and never had a chance.
That brings me to my next topic. The recent political campaign that witnessed a misogynistic, egomaniacal, sexist, racist, Corporatist/Fascist bully and demagogue elected president, and a Congress of like-minded semi-demagogues.
Now this capitalist clown is appointing men to his cabinet who stand in opposition to many things the American people believe in, and one man, Representative Tom Price, R-GA , an ardent opponent of the ACA, is to be Secretary of the Department of Health and Human Services, the department which oversees the Centers for Medicare and Medicaid Services (CMS), who makes the rules for the health care law and the other medical insurance programs of the government.
Folks, that’s like putting the fox in charge of the hen house. Sooner or later, the chickens are going to be devoured, except it won’t be dead chickens lying around, but millions of Americans who will lose their health care newly won, and who may die because of it.
We still don’t know what will happen to the ACA after January 20th, because that man refuses to release his tax returns, refuses to commit to anything and goes off on tirades on Twitter to anyone who gets in his way. But I believe that this idiot and Congress will take away not only health care for millions, but eliminate Medicare and Medicaid, which is what Speaker Paul Ryan wants to do, but may be forced to back down once opposition gets wind of it.
Either way, health care in this country will get worse, not better.
That moron soon to occupy the White House has even nominated the CEO of a fast food chain to be Secretary of Labor. This guy, Andy Pudzer (or is it Putzer?, or just plain Putz?) wants to replace fast food workers with robots. Methinks he is one.
True, by 2025, it is predicted that 50% of all occupations will be replaced by automation, but the reason Pudzer wants to replace fast food workers with robots is so that the companies won’t have to pay living wages of $15 an hour to their workers.
I guess this putz would like to see workers thrown out into the street, especially younger minority workers who generally take these jobs to give themselves some work experience, and older workers left out of the changing economy.
You know what 50% less workers mean for workers’ comp? 50% less claims adjusters, physical therapists, durable medical equipment companies, pharmacy benefit management personnel, etc.
It also means that there will be more unease, anger, and maybe even violence. The kind of violence that has been avoided for decades, and that was predicted more than one hundred and fifty years ago by a certain German writer. And what if that 50% goes to 75%? What then?
One idea is to give these permanently unemployed a universal basic income (UBI), but with this Congress, that too will not happen.
There is an old Chinese curse that is appropriate now: “May you live in interesting times.” Interesting, possibly; dangerous, most definitely.
Last month, I told you that I was planning to shut down my blog because of my acceptance of a new position.
Unfortunately, some things were not meant to be, and while I was waiting until the new year to end the blog, I have decided to reverse course and keep it up and running, so those of you who have enjoyed my writing will have more to enjoy, I hope.
This still leaves me back where I was in October when I accepted the position, so if any of you have something in mind, let me know.
I am open to consulting with anyone. Resume furnished upon request.
Yesterday, I ran across an interview on Truthout.com by Mark Karlin. Mr. Karlin was interviewing the two authors of a new book, People Get Ready, by Robert W. Mc Chesney and John Nichols.
Mr. Karlin’s first question, answered by Mr. Mc Chesney, intrigued me and got me thinking of what is happening in workers’ comp, as well as what is happening in health care.
As I mentioned briefly in my last post, automation and artificial intelligence will have a significant impact on the future of workers’ comp, and this is emphasized in Mc Chesney and Nichols’ book. There have been other books and articles recently on the subject, so this is nothing new.
But what got me thinking is that Mr. Karlin addressed the main question the book raises — namely that the conventional wisdom has always been that the more advanced technology becomes, the more beneficial it will be for humans.
Mr. Mc Chesney responded that convention wisdom said that new technologies will disrupt and eliminate many jobs and industries, and that they would be replaced by newer industries and better jobs.
Mc Chesney also said that they argue the idea that technology will create a new job to replace an old one is no longer operative; nor that the new job will be better than the old one.
According to Mr. Mc Chesney:
“Capitalism is in a period of prolonged and arguably indefinite stagnation. There is immense unemployment and underemployment of workers, which we document in the book, taken from entirely uncontroversial data sources. There is downward pressure on wages and working conditions, which results is growing and grotesque inequality. Workers have less security and are far more precarious today than they were a generation ago; for workers under the age of 30, it is a nightmare compared to what I experienced in the 1970s.”
Likewise, Mr. Mc Chesney, continued:
“there is an immense amount of “unemployed” capital; i.e. wealthy individuals and US corporations are holding around $2 trillion in cash for which they cannot find attractive investments. There is simply insufficient consumer demand for firms to risk additional capital investment. The only place that demand can come from is by shifting money from the rich to the poor and/or by aggressively increasing government spending, and those options are politically off-limits, except to jack up military spending, which is already absurdly and obscenely high.”
Contemporary capitalism is increasingly seeing profits generated, he adds, not by its fairy tales of entrepreneurs creating new jobs satisfying consumer needs, (remember Mitt Romney’s ‘job creator’ line of bs?) — but by monopolies, corruption and by privatizing public services.
Finally, Mr. Mc Chesney states that:
“Capitalism as we know it is a very bad fit for the technological revolution we are beginning to experience. We desperately need a new economy, one that is not capitalistic — based on the mindless and endless pursuit of maximum profit — or one where capitalism has been radically reformed, more than ever before in its history. It is the central political challenge of our times.”
They are not the only ones arguing for such reform or revolution, Senator Sanders notwithstanding. In previous posts, I have mentioned the biopsychosocial theory, Spiral Dynamics, and the book by Said W. Dawlabani, MEMEnomics The Next-Generation Economic System.
Other authors such as Richard Wolff, and Robert Reich have written books about this subject, and like Mc Chesney and Nichols have reached similar conclusions. Yet, Dawlabani, accessing the Spiral Dynamics model, goes much deeper into why we got here and what we need to do to get out of it.
Such a future version of capitalism has been called by many different names that I have come across in the past decade or so. Natural Capitalism, conscious capitalism, and so on, to name a few. But the main point is as Mc Chesney and Nichols points out in their book, the technological revolution, rather than liberating humans and making our lives better, as Mc Chesney says in the interview, may have the perverse effect of reinforcing its stagnating tendency.
An issue related to automation and artificial intelligence and its impact on the future of work, is if we are all replaced by machines and software, how will people be able to live? How will the goods and services produced by automation be sold, and to whom? Only those who are fortunate to have employment in jobs that machines cannot do? Or will we have to go back to a time when money was only the purview of those who had it?
The answer to these questions have also been raised by those in the tech world, and one suggestion they have come up with is a national basic income (NBI), and naturally has already been shot down as a bad idea by those on the Right. I guess they really want people to be poor.
But this idea should be kept on the back burner for now, as given the political climate in this country, that idea will be dead on arrival. Yet, while many have acknowledged what Mc Chesney, Nichols and others have said is happening, the other side — namely the current Speaker of the House and others in his party, have doubled down on their stubborn adherence to the rantings of a two-bit novelist, Ayn Rand and Ayn Randism.
Which brings me to the other point I wish to discuss, and that bears on what happens in the overall economy at large.
If automation and artificial intelligence will lead to elimination of many, if not all jobs, and if that will require a new economy as Mc Chesney and Nichols, and others have argued, what does that mean for the health care industry that seems to be going in the opposite direction?
Even before the enactment of the ACA, health care has become more centralized, bureaucratic, consolidated and more profit-driven than ever. The ACA in many ways has accelerated this process, and the direction it is headed is towards a more consumer-driven form of health care, and one where large hospital systems have integrated physicians and insurance services into their business plan.
The move among some physicians and physician practices towards concierge medicine, also is a sign that health care is moving towards a more capitalistic health care, in that it creates two classes — those who can afford concierge medicine, and those who cannot.
The transition to a new economy will not happen overnight, and may not happen for some time, especially if the forces aligned against it remain strongly opposed to reform. But if the health care system collapses, as I mentioned previously in articles last week, then along with the stagnation of capitalism generally, there will be an opportunity to move in that direction in health care as well.
Calling for ‘Medicare for All’ now with firm opposition to anything that spends government money or has a social benefit other than producing profit for a few, is only a waste of time and a con job.
There are only two ways an economic system and its attendant political system changes; by revolution or evolution. One is violent and bloody, the other happens because the old is replaced by the new so seamlessly that no one gets too emotional when it happens. An election does not do that, especially when the opposition is headed toward fascism.
That issue is for another time and place, and the rest of Mc Chesney and Nichols’ book discusses the current presidential campaign. I wanted to discuss the dichotomy between where capitalism is headed and where health care is headed, and at some point, health care will have to fall in line with the new capitalism.
I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.
Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp.
I am also looking for a partner who shares my vision of global health care for injured workers.
I am also willing to work with any health care provider, medical tourism facilitator or facility to help you take advantage of a market segment treating workers injured on the job. Workers’ compensation is going through dramatic changes, and may one day be folded into general health care. Injured workers needing surgery for compensable injuries will need to seek alternatives that provide quality medical care at lower cost to their employers. Caribbean and Latin America region preferred.
Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: email@example.com.
Will accept invitations to speak or attend conferences.
Transforming Workers’ Blog is now viewed all over the world in 250 countries and political entities. I have published nearly 300 articles, many of them re-published in newsletters and other blogs.
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Now that my company has left from the weekend, and my recent job interview came and went (did not get the job), I want to catch up on two items from yesterday that caught my attention, and will impact the future of workers’ comp.
The first item comes from Joe Paduda.
Joe’s article, “What Job?” asks the question, “what job will injured workers return to?”, and states that many of the high-injury rate jobs that drive a lot of work comp premiums and services won’t exist in ten years, and a lot of low-injury rate jobs will disappear as well.
One industry that Joe sees as suffering jobs disappearing is the trucking industry, where the replacement of long-haul drivers with autonomous driving will leave many without employment. The trucking industry employs 3.5 million drivers and pays $40,000 a year.
Along with the loss of trucking jobs, are those jobs that depend on, and support the truckers and the trucking industry such as people who work at truck stops, wait staff, hotel staff, and mechanics.
To further the discussion, Tom Lynch, in Workers’ Comp Insider.com writes that artificial intelligence is going to bring change on a monumental scale.
According to Tom, “I suggest it is not hyperbole to predict that we are on the verge of an epochal change, something like a kind of mass extinction, and what’s going extinct is an enormous number of jobs. This change might be even more significant than humanity’s evolution from an agrarian to an industrial economy.
Tom mentions a report that Joe cites that suggests up to 47% of jobs run the risk of going the way of the Woolly Mammoth by 2025.
It is highly controversial and its conclusions have been hotly debated.
Even so, Tom says that the most conservative naysayers agree that the figure is at least 16% (but that figure doesn’t take into account the jobs that the AI revolution will create, estimated at about 9%, for a net job loss of 7%).
Regardless, he says, millions of jobs will be lost.
The next item is from Stephanie Goldberg of Business Insurance.
Stephanie reported that the Oklahoma Workers’ Compensation Commission unanimously ruled that the state’s opt-out law is unconstitutional.
The commission ruled that provisions of the Oklahoma Employee lnjury Benefit Act are “inoperable,” unconstitutionally depriving injured workers of equal protection and access to the court, according to Ms. Goldberg.
The ruling is immediately appealable to the state’s Supreme Court, so if they uphold the ruling, it would leave Texas as the one and only state with an opt-out option. Tennessee has not voted on the law this year.