Last week's catastrophic Chicago airport disaster (the one where I was trapped with a Kazillion other travelers after some mentally impaired moron with a severe case of cranial rectal inversion torched the Chicago Air Traffic Control Center because he was depressed they were making him move to Hawaii and causing Tin Pushers to scamper for their very lives grounding all air traffic and preventing me from getting home to shovel the litter boxes) was not a total loss it would seem. It turns out the thrust of unexpected travel disruption did in turn help further the cause of social science and workers' compensation cost management, and that cannot be a bad thing.

For one, it helped displace a long held yet misguided faith in the “One Beer per Bar” methodology.

As I indicated in an earlier dispatch, the disturbance in the travel force caused many of us to spend an unexpected night or two in hotels around the city. The way in which we spent those evenings varied a great deal. Some preferred to quietly meditate and search for deeper inner peace, while others amongst us went outward in search of deeper sausage pizza. And at least two from the group that were attending the same conference as I chose to embark on a Chicago bar crawl to help pass the evening hours.

These two men, both attorneys from the great state of Alabama, headed out with the admirable “goal of control”, vowing to only have “One Beer per Bar”. My sources tell me it did not end well. Several of their friends ran across them on their final stop, the hotel bar, where it became blatantly apparent that the “One Beer per Bar” rule had badly disintegrated at some point in the evening.

So why, you ask, did the “One Beer per Bar” rule fail so miserably? Well, first, it should be noted that those Alabama boys are not particularly known for their cipherin' skills, especially after the third bar or so.  Also, even for the best mathematicians, relying on a pre-set usage standard for a product that can impair your judgment when consumed is at best optimistic thinking.

So what does this have to do with workers' compensation? Well, not a thing, actually, but that is nothing a little visit to Bob's Cluttered Rubber Mallet Room can't fix. After all, our motto here is “Don't worry, we'll make it fit”.

In some ways the “One Beer per Bar” rule is not too dissimilar from the medically networked managed care fee for services model that we've wholly embraced over the last decade or two for our injured workers. You know the one; the system where we agree to pay the lowest contracted price for each standardized treatment – sort of a “One Price per Service” model.  This is the same system we deployed to control our medical spend that in turn has helped contribute to the explosion of medical expenses in our industry.

It seems somewhere along the path we became intoxicated with the concept and lost site of the original control mechanisms employed in the process. Seems many of us have trouble with our cipherin' skills. And when it comes to believing we are saving money by selecting the cheapest physicians, we have definitely let the system impair our judgment.

So, instead of a “One Price per Service” concept we should try to shift to an outcome based approach when it comes to medical care. We should dispose of the lowest fee mentality and reward doctors who are proven to perform, as quality of care and injury duration has suffered under our current medical model.

For comparative purposes, and so that Alabama based pub crawlers can have an accurate idea of what I am talking about, this concept would convert “One Beer per Bar” to “The Bar with the Best Beer”.  That should create an image of an improved pub crawl experience that parallels the improved medical treatment scenario I advocate.

Besides, that is as far as my rubber mallet can take me. Even an overactive imagination has limits – unless I am visiting my fourth bar.

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