Friday, April 3, 2009

Money for Nothing, Kicks for Free

I’ve been reading the very interesting NY Times series about Workers’ Compensation in the state of New York. The general consensus is that the system is broken, but nobody can agree on how to fix it. My sense is that Workers' Compensation is not the problem. Rather, a widespread dislike of and scorn for workers is the problem. Consider, for example, how readily the courts and insurance companies and business owners and doctors assign blame to the injured workers themselves, who are widely perceived as wanting to get their money for free. One doctor was quoted as saying that 75% of the people on Workers’ Comp didn’t deserve it.

What’s really bizarre about this point of view is how many of those holding it profit from Workers’ Comp without doing much, if any, meaningful work. For instance, many of the fifteen Commissioners, whose job it is to review cases, work at home for a just a few hours a week. For this onerous task, they are paid $90,000 a year. At 10 hours a week, that comes out to about $180 per hour. Not bad when you consider that most are political appointees with no relevant experience in medicine or the law.

Even trained licensed professionals are in on the scam. One semi-retired doctor, hired to give independent medical assessments, performed as many as fifty examinations in a single afternoon. This means that he saw each patient for perhaps five minutes. He did not write down his findings. Rather, he ticked off boxes on a form and sent the form to an agency that turned his "findings" into a narrative which he then signed. He says he was paid about $100 per exam. That means that he was pulling in about $1,000 an hour. Of course his "work" was virtually useless. He cheerfully acknowledged that he couldn’t remember any detail of any case. And he admitted that he signed the narratives without reviewing them for accuracy as required by law. Apparently, he’d rather spend time with his wife.

I say his work was “virtually useless.” I’m guessing that it was extremely useful to the entity that paid for the exams, the insurance company, which used his “reports” as an excuse to deny claims and drag claimants through the courts sometimes for years.

Perhaps what is at work here (pun intended) is a psychological process called projection, in which an individual ascribes his or her own negative qualities to another person or group of people. If the reportage in these articles is correct, many of the people affiliated with the Workers’ Comp system in New York (and doubtless elsewhere), actively ascribe their own laziness, greed and dishonesty to the injured workers they are supposed to help.

I think that the dead give-away to this projection is the profound lack of compassion for, even hostility toward, the claimants, many of whom are suffering enormously, first because of their physical pain, second because of the emotional stress of being kicked around by the system, and third because of the social stress of not being able to work or have any money. One insurance company lawyer said that if he notices a claimant quietly sobbing in the courtroom, he automatically hires an investigator to follow him or her around, because he “knows” s/he is only trying to garner sympathy for a non-existent injury. And a doctor—a medical doctor—said that people should just go back to work in spite of their pain.

This scorn for workers seems to underlie the strategies that many employers have adopted to try to contain costs and discourage malfeasance. Some offer “bonus bucks” paid to all employees for a certain number of injury-free days. Other employers run a “bingo” game in which workers compete for a pot of money that grows with every injury-free day. According to one factory owner, the pots are large enough to be meaningful: up to $150. I think that's paltry. And I think that signifies scorn in a world that measures worth according to wealth.

By now, the solution to this mess should be obvious: long-term psychotherapy for everyone. Sure, it's not very practical, and it would take a long time. But wouldn't it be a healthier, happier world if the people with most of the money and most of the power owned up to their demons?

In the meantime, let's raise the minimum wage to something like $50 an hour. With no overtime and two weeks vacation, that comes out to about 100K a year, enough to elevate most Americans into the middle class. The opportunity to make that kind of money might even reduce the number of frivolous claims. Of course, to make such a massive wage increase mean something (and to avoid triggering inflation), we'd have to reduce wages and salaries everywhere else in the system. Let's start by capping executive compensation in all industries at about 250K and work our way down the ladder.


  1. Your comments are very perceptive, especially regarding the psychology issues. The design of the system could be to blame, but we have a different system in Canada and we have the same types of problems. (see )

    I believe it has to do with people who have power over others gradually falling into the illusion that their power is deserved somehow and that it must be because the people they have power over are bad. The actual level of false claims by injured workers has been studied and proven to be 0.01% in both Canada and the US. The figure of 75% stated by that doctor is simply wrong. But self-deluding, non-compassionate, narcissistic, psychopaths can be found in all professions, even medicine.

  2. Thanks, Puck. You are correct: the design of the system is flawed, of course. But I think those flaws reflect the biases of the people who design the system and are psychically, socially and economically invested in it.