At least two separate, yet similar editorials ran in Tennessee publications this week lambasting the effort to implement Opt Out in the state. Both articles essentially contend that the Opt Out scheme being proposed holds “threatening consequences for the state, its business environment, businesses and workers.” 

Can't say I disagree with them.

One editorial appeared in the Knoxville News Sentinel (requires subscription), and the other in The Commercial Appeal. The News Sentinel piece was authored by Louis S. “Lou” Moran III, and the Commercial Appeal piece by Ron Gant and Portis Tanner. All three have close ties to the insurance industry. The editorials point out that recent workers' compensation reforms in the state have been in place less than two years, and already appear to be yielding excellent results. As they ably testify, The Workers’ Compensation Reform Act of 2013 was supported by business and labor leaders. It was approved by an almost unanimous vote in the General Assembly. And most importantly, it has yielded a 20 percent decrease in loss costs. With business booming and several major manufacturers expanding their footprint in the state, they simply ask the question, why fix what isn't broken?

More importantly, the authors delve into the deeper and less understood realm of the Opt Out scheme: pointing out that it is a one sided system offering a complete absence of claims transparency. Specifically, Gant and Tanner offer this regarding Opt Out:

Opt Out ought to concern the state’s business community and sound alarm bells for employees. Opt Out has threatening consequences for the state, its business environment, businesses and workers.

Opt Out is essentially an “injured workers” program that is based on limited and temporary benefits. All of the declared savings in the proposal are based on significant reduction of benefits to employees.

Businesses opting out of workers’ comp would create their own individual policies, driven by the guiding principle of employer cost savings. The current system of a uniform, established, transparent process to guide workplace injury would be discarded. (emphasis added)

In an Opt Out system, employers, at their own discretion, would set deadlines for employees to settle claims. Employers would handpick what injuries are covered, the benefits provided and select their employees’ physicians. One physician would review and make judgment on injury claims instead of the current four-physician panel system.

To those same points, Mr. Moran effectively argues this: 

At first glance, the “Opt Out” model might be perceived to be “pro-business” and congruent with Tennessee's conservative business climate. In reality, it is bad for business and potentially harmful to Tennessee workers and their families. 

I agree, and have expressed similar sentiments on the issue. 

Opt Out proponents ceaselessly tout the benefits of their plan, stating employees get faster medical care and heal faster than those under traditional comp. Heck, for all we know they sing louder and can play the piano better after a workplace injury too. You can practically envision animated blue birds chirping over their head, because everyone is so gosh darn happy. For all we know that may very well be true, but what they specifically do not tell us is how many employees are denied treatment based on ridiculously strict reporting requirements and other built in technicalities. They don't tell us because they don't have to. Anyone who wants to know can just pound sand. When all is said and done, Opt Out is a closed, 100 percent employer controlled system with no transparent reporting mechanisms. 

Anything they tell you, well, you'll just have to trust ‘em.

The authors also take an interesting point, leveraging local pride and trust in home grown solutions, by encouraging readers to “follow the money” when trying to decipher a reason for the attempt to uproot such a recently, and successfully it would seem, reformed system. They point to the Texas firm that has made it its mission to spread the word of Opt Out, facilitate legislation, and then sell employers their services when it passes. 

That same argument could be used against the authors and their industry; except that it has state oversight and a level of transparency on its side; something Opt Out lacks by intentional design. And they are right. Reforms in Tennessee seem to be going well. The economy is strong. Employment there is growing. Why change it now?

Let’s hope the voices of reason continue to strengthen in the Volunteer State. Everyone will be better off for the effort, except of course for the animated Bluebirds.

 

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