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KEMPER EXECUTIVE URGES RICHMOND INSURANCE GROUP TO COUNTER CLINTON ADMINISTRATION HEALTH CARE PROPOSAL

 RICHMOND, Va., Sept. 9 /PRNewswire/ -- The chief executive of a major insurance organization urged his industry to campaign to preserve the safety incentives of workers compensation insurance in any new health care delivery system, according to Kemper National Insurance Companies.
 Speaking to the Greater Richmond Chapter of the Society of Chartered Property-Casualty Underwriters at a meeting on Sept. 8, Gerald L. Maatman, chairman and chief executive officer of the Kemper National Insurance Companies, said that while a definitive health care reform plan has not yet been formally introduced by the Clinton Administration, early reports indicate some planners are considering integration of the medical portion of workers compensation insurance into the new system.
 "Under this scheme, workers compensation insurers would remain responsible for paying workers indemnity costs -- the wage replacement they are allotted under their state's workers compensation system, while medical claims arising from work-related injuries would be handled by the Clinton health care plan," he said. "This has come to be known as integration of workers compensation into the health care system. It might be better described as the disintegration of a system that, over the last 80 years, helped to significantly improve the safety of the American workplace by providing employers with strong economic incentives to prevent accidents and get injured workers back on the job."
 Maatman pointed to a number of specific flaws in fully integrating the two systems. One would be unfair rates. "Employers with good safety records and those who have workplaces that are death traps will pay the same," said Maatman. "In an increasingly competitive world, companies that spend money on safety will be at a competitive disadvantage compared to those who don't. As far as I'm concerned, this is enough of a reason to dismiss this idea as ridiculous."
 Maatman also said that "Workers compensation is intended to be a disability management system, of which medical care is just one element. Effective case management for an injured worker often requires investments that might not make sense to a health insurer bent on minimizing medical costs."
 Also, workers compensation presents special problems that are better met by insurance carriers more familiar with workplace injuries and illnesses, Maatman said. "Repetitive-motion injuries, such as carpal tunnel syndrome, back injuries associated with lifting and traumatic injuries resulting from industrial accidents are commonplace for workers compensation insurers, but may be relatively rare for general health insurers, who are generally geared more to dealing with various acute and chronic illnesses," he said.
 Another problem with integrating workers compensation into a single health care system involves the co-insurance payments and deductibles that have been reported to be part of President Clinton's reform plan. "If workers compensation medical is fully integrated into the plan, will workers have to pay these costs, ending the long-standing principle that work-related injuries are a first-dollar responsibility of the employer?" Maatman asked.
 Maatman added that "There is a way to make workers compensation mesh with the kind of health care delivery system envisioned in the Clinton proposals. It's simply a matter of coordination rather than integration."
 A coordinated approach, he said, would preserve the current system's strong incentives for safety and effective case management, but requiring workers compensation insurers to purchase medical care for injured workers from one of the accountable health plans envisioned by the Clinton planners. These health plans would be groups of health care providers linked in a sort of preferred provider organization.
 Maatman said the Clinton package also could be the vehicle for enacting a number of desirable reforms that could cut costs and bring greater uniformity to the workers compensation system. "For example," he said, "workers compensation carriers would welcome the opportunity to participate in the standardized electronic data system for billing and claim settlement that has been suggested by the administration, cutting wasteful overhead costs."
 Maatman noted the Clinton plan could also override state barriers to effective utilization review and bill auditing. "If this reform results in realistic medical malpractice reform, in uniform treatment protocols and usable outcomes measurements, and in increased fraud penalties, workers compensation will benefit along with the larger health care system.
 "Finally, if employee choice of medical provider is limited to practitioners at an accountable health plan certified as proficient in handling workplace injuries, the plan will provide the economic benefit to business that the administration is seeking.
 "I urge all of you to learn more about this issue, and to express your opinions to your employees, to your clients, to your trade and professional organizations and, most importantly, to your representatives in Washington," he added.
 Kemper National is the 13th largest property-casualty insurer in the country. It had 1992 sales of $3.1 billion and operates in all 50 states, the District of Columbia and many foreign markets. It is the seventh largest workers compensation insurer in Virginia.
 -0- 9/9/93
 /CONTACT: Patrick J. Gould of Kemper National Public Relations, 708-320-3422/


CO: Kemper National Insurance Companies ST: Virginia IN: INS HEA SU: LEG

MP -- NY014 -- 0215 09/09/93 10:10 EDT
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Date:Sep 9, 1993
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