ProPublica, the news organization that last spring electrified the workers' compensation industry with a series of scathing reports, has turned its sights on the world of Opt Out, and is reporting that, for employees subject to that system, things are not as Disneyesque as promoters would have us believe. The highly detailed report was published simultaneously on NPR. Looking at the article and the details the authors provide, it would seem that Opt Out is not the happiest place on earth after all. 

ProPublica reporter Michael Grabell tells me they “obtained and read all the plans that have been approved in Oklahoma as well as about 60 in Texas”. They also created an interactive database that is definitely worth looking at, as you can explore and compare the plans, proposed bills and state laws related to Opt Out. They conducted extensive interviews with Opt Out advocates, including Bill Minick, president of PartnerSource, as well as program opponents like venerable Oklahoma attorney Bob Burke. In addition, they “tracked down a number of injured workers whose employers had [Opt Out] plans to hear their experiences”.

Overall, it is likely the most extensive review ever conducted regarding this closed and opaque system – at least one not produced by the people who tout its benefits and profit from its growth.

I encourage you to fully read the article here. It clearly shows that all things are NOT created equal, and despite the hype, there are some tragic stories occurring behind the Opt Out veil of secrecy. With this system being seriously considered in other states, people need to know what its implementation may really mean for their state and it's workers. 

One of the biggest surprises for people will be the revelation of something that has been well known in private circles, but never before mentioned in the media. Many people are unaware that the medical director “charged with picking doctors and ultimately reviewing whether injuries are work-related” for many Opt Out firms is Dr. Melissa Tonn, an occupational medicine specialist who often serves as an expert for employers and insurance companies. Why is that potentially significant? Quite simply, Dr. Tonn is the wife of PartnerSource president Bill Minick, the guy who drove the effort to take Opt Out to Oklahoma, helped craft the laws, and then wrote the plans most OK Opt Out employers use. 

Critics say that Tonn “has a vested interest in PartnerSource making more money”. Minnick defends his wife's qualifications, saying she stands “on her own credentials as the former director of two hospitals' occupational health programs and as past president of both the Texas College of Occupational and Environmental Medicine and a national organization of physicians who evaluate disabilities.” He also indicated PartnerSource discloses the relationship in contracts, and client companies “can visit with whatever vendor they want to”. They do not have to use Tonn.

Fair enough. Employers who are saving a ton of money are fully informed and aware. I wonder if that relationship is clear to the injured workers whose lives are suddenly dependent on this arrangement?

Doesn't matter. Employees in that system really have no control over their situation regardless. 

To compound the issue for the Opters, columnist Peter Rousmaniere, who is not an opponent of Opt Out, issued a damaging letter of his own this morning in response to the ProPublica report. In it he details how injured workers' covered under Opt Out could see a reduction in benefits of up to 25% over traditional workers' compensation systems (You can read the letter here). Rousmaniere wrote it after reading the ProPublica report early Wednesday morning and circulated it as an email. He considers it an examination of one aspect of the Opt Out / workers' comp trade-offs that industry insiders would appreciate; though it is “probably hard for lay people to fully understand”. He told me via email that his paper “could not have been done” without ProPublica finding the ERISA plans, which, in his words, “Opt Out advocates have much to their detriment not made public over time”.  He also says it is part of his efforts to stimulate an informed debate.

And no matter what you make of Rousmaniere’s numbers, he really hit at the achilles heal of Opt Out; the secrecy and lack of transparency that all participants seem to insist upon. This is not new information, and in fact has been the single biggest point that cause many of us to oppose Opt Out to begin with. We suspect the emperor has no clothes, but we just are unable to see the emperor. If Opt Out employers recognize that, and develop real and verifiable reporting mechanisms, many of the critics of the system could be silenced. As long as, that is, the emperor really is clothed.

And finally, a public relations company hired by ARAWC, the Association for Responsible Alternatives to Workers' Compensation, sent me an email containing a statement that they asked be included should I run a story on the topic. Since I am nothing if not fair and reasonable, I will comply. In fact, I'll do better than that. I'll not only publish the statement, I will publish the requesting email, and will provide commentary on both.

No need to thank me. It is what I do. 

First, the email, from Courtney Blossey of Jones Public Relations:

Good morning,

As you may be aware, ProPublica’s Michael Grabell has published an article regarding The Option and opting out of state workers’ compensation. Should you choose to run the story, please also run our statement from the Association for Alternatives to Workers’ Compensation (ARAWC) Spokeswoman Brenda Barwick. 

We can offer you an interview with an ARAWC representative if you’re interested. 

Best Regards,
Courtney Blossey 

My comment on this email:

Ms. Blossey, the last time I checked ARAWC stood for “Association for Responsible Alternatives to Workers' Compensation”. However, I note in your missive that you call them the “Association for Alternatives to Workers’ Compensation”, omitting the word “Responsible”. Personally I find that a refreshing change, and applaud you for a dramatically honest approach in public relations.

Now, the ARAWC (excuse me, the AAWC) statement:

First and foremost in the ProPublica article that came out today, ARAWC cares about employees and their recovery. References to employees in this story not receiving care are truly tragic, and our innovative system can be a solution in every circumstance. ARAWC will continue to actively advocate for The Option to be implemented in a transparent manner in other states so employees across the nation are able to participate in a program that fosters better care and ensures a faster recovery process. It is important to note there have been  independent studies conducted on The Option and as an association we will openly distribute and share the positive medical outcomes achieved through our system. 

My comments:

It is interesting to note that the statement claims that “our innovative system can be a solution in every circumstance”. It is interesting because in the article, Mr. Minick was quoted as saying that “There's no occupational injury system that we've found yet that will provide perfect results in a 100 percent of cases”. It could just be a typo in the statement, but for an organization that prides itself on transparency and conciseness, I doubt it.

Thank you for clarifying that point.

Furthermore, the statement reads “ARAWC will continue to actively advocate for The Option to be implemented in a transparent manner”. Is that the same transparency intended when members of your organization supported the successful effort to “make confidential” all the information submitted in the application process in Oklahoma? No one may now review any documents or information submitted to the Commission for Opt Out approval (unless a court demands it). Was that the “transparency” to which you allude? Or do you mean the “transparency” where no claim data is available or will be discussed? Possibly both?

I'm just curious.

Also, can you clarify who funded the independent studies that you allude to?

And finally, I appreciate that you will “openly distribute and share the positive medical outcomes achieved through our system.” Unfortunately, that is not the only thing we are interested in. What the world really wants to know is the claim denial rate of your membership, particularly in comparison to what it was prior to opting out. Can you add that information as well?

We all would appreciate it.

So, it seems that Opt Out might be having a rough day on the public relations front. They might as well get used to it. ProPublica isn't done. That, and the continued insistence on privacy and silence will continue to dog Opt Out employers; this will only become more prominent as the system expands to other jurisdictions. In its current structure and form, a secretive Opt Out could become a victim of its own success, ultimately collapsing under its own public relations weight as its reach expands across the nation. 

To paraphrase an old adage – you can fool some of the people some of the time, but you can't fool all of the people in an ever increasing number of states. Ironically, in the end, Opt Out will probably be as bad for the employers who have embraced it as it is for the workers they employ. 


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