Tag Archives: Joe Paduda

Why health care is consolidating and what it means for injured workers in Nebraska.

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Nebraska State Senator Adam Morfeld spearheaded the expansion of Medicaid in 2018. The Ricketts administration has yet to implement the expansion approved by voters

Health care is consolidating; hospitals are merging with other hospitals and hospitals are acquiring formerly independent medical practices. This consolidation is driven by the implementation of the Affordable Care Act. (ACA)

Health care consolidation is likely a net negative for injured workers in Nebraska. Injured workers ultimately bear the costs of increased medical costs under the ACA, while not enjoying the benefit of the Medicaid expansion under the ACA,

Why is health care consolidating?

The simple answer is that the Affordable Care Act (Obamacare) was a driving factor behind health care consolidation because its designers assumed health care consolidation would lead to lower costs. As Joe Paduda at Managed Care Matters points out, the overwhelming weight of the data about health care cost and consolidation has shown the opposite.

Consolidated health care systems function as monopolies in the communities they serve. In theory monopolies are supposed to be illegal. But as commentators like Matt Stoller have observed, judges and regulators have effectively gutted anti-trust law in the last 40 years with more or less bi-partisan consensus. Stoller also believes consolidation leads to more corporate crime, which in the world of workers’ compensation would mean fraudlent billing practices.

In my mind, the ACA’s creation of health care monopolies wouldn’t have been feasible if anti-trust law had not been defanged. Opponents of the ACA would have had grounds to challenge the ACA on anti-trust grounds as well as the other legal arguments they used to limit the effectiveness of the ACA.

What does health care consolidation mean for workers’ compensation?

Consolidated hospitals have the power to push up medical costs in workers’ compensation. Paduda points out this is particularly true in states, like Nebraska, that haven’t expanded Medicaid. Workers’ compensation is viewed as a cash cow for hospitals, particularly rural hospitals, that are hurting for revenue

For workers, I believe if workers’ compensation insurers have to spend more money on medical care, they are going to look to cut costs on the indemnity or disability side of workers’ compensation. In short, more money for hospitals and less money for injured workers. This may lead to more pressure to reduce workers’ compensation benefits in an economic downturn.

As I mentioned earlier, the consolidation of health care is partially the result of the Affordable Care Act. The ACA has had some positive effects on injured workers. A study of the ACA showed the shifting of injuries from health insurance to workers compensation.

Expanded health insurance, particularly if not tied to an employer, also allows injured workers to treat for work injuries that have been denied by workers’ compensation insurers.

Expanded health insurance also means that more workers’ will have relationships with primary care doctors and more control over their own medical care in a work injury. But in communities with limited health care choice, injured workers may be pushed towards employer-friendly occupational medicine doctors employed by that particular health care system. The right to chose a doctor becomes moot when there isn’t an effective choice of doctors.

The offices of Rehm, Bennett, Moore & Rehm, which also sponsors the Trucker Lawyers website, are located in Lincoln and Omaha, Nebraska. Five attorneys represent plaintiffs in workers’ compensation, personal injury, employment and Social Security disability claims. The firm’s lawyers have combined experience of more than 95 years of practice representing injured workers and truck drivers in Nebraska, Iowa and other states with Nebraska and Iowa jurisdiction. The lawyers regularly represent hurt truck drivers and often sue Crete Carrier Corporation, K&B Trucking, Werner Enterprises, UPS, and FedEx. Lawyers in the firm hold licenses in Nebraska and Iowa and are active in groups such as the College of Workers’ Compensation Lawyers, Workers' Injury Law & Advocacy Group (WILG), American Association for Justice (AAJ), the Nebraska Association of Trial Attorneys (NATA), and the American Board of Trial Advocates (ABOTA). We have the knowledge, experience and toughness to win rightful compensation for people who have been injured or mistreated.

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