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Obamacare could ease workplace health costs

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Assuming Obamacare emerges in good health from its political and bureaucratic malaise, what will it mean for the many who suffer from medical issues in the workplace? Is the pain worth the gain?

If you endure physical pain or emotional strain on the job, you have lots of company. The US Bureau of Labor Statistics (BLS) says disorders related to bones and muscles afflicted 164 per 10,000 full-time workers last year, up from 140 in 2011.

Meanwhile, emotional stress sidelines white-collar workers disproportionately, again according to a BLS study. The 1997 research shows that of 3,418 cases of “neurotic reaction to stress,” the median time away from work was 23 days.

Some jobs have unusual occupational hazards. Top professional golfer Fred Funk’s days of walking the fairway were threatened by severe arthritis. The pain finally drove the 56-year-old to get knee replacement surgery, which revitalized his career on the senior tour.

Country singer Mindy White, age 26, knows something about pain, and not just from songs of sorrow penned in her hometown, Nashville. Being onstage for long hours is tough on her hands, arms and feet, all subject to repetitive stress from playing instruments and the demands of performing on tour. She relies on natural treatments as an alternative to addictive prescription painkillers.

A study by the American Chronic Pain Association found that pain is the number one cause of disability in the U.S., and that it costs $294 billion annually in lost workdays and related expenses. In addition, the research says that common pain lowers workers productivity by about $60 billion every year. Ultimately, the consumer pays the tab in the form of higher prices for goods and services.

Whatever your workplace, Obamacare has the potential to make a positive difference, but it raises many unanswered questions.

On the positive side it promises to broaden coverage for some 30 million currently uninsured Americans. If you’re not covered or have minimal insurance, you may be putting off basic preventive measures that could keep you healthy -- and on the job.

A recent study from Johns Hopkins shows that adults living with pain worked less and earned less than their pain free counterparts.

Obamacare generally requires health plans to offer a number of free pain related preventive services including blood pressure tests, obesity counseling, depression and alcohol screening.

Mental health problems and substance abuse treatment must now be covered just like other physical condition and could reduce stress on the job.

Starting next year under Obamacare, employers can set up wellness programs to promote employee health under new guidelines to guarantee everyone has access to the benefits.

The goal is to lower workers medical costs -- for example by offering them incentives to lose weight or quit smoking, but without setting unfair standards making it difficult for some to participate. So far so good!

However, Obamacare contains some fine print about what preventive services are actually covered. For instance, check with your doctor to see if a test is preventive or diagnostic. If the screen actually shows that you have symptoms, you may have to pay for additional tests to confirm the diagnosis. You might also get stuck for an office visit co-payment to get your free preventive screen.

That assumes you get into see a doctor in the first place. We already face a shortage of an estimated 9,000 primary care physicians in the U.S., and that number is expected to grow to 65,000 in the next 15 years. The shortfall comes at a time when tens of millions become newly entitled to insurance benefits either under Obamacare or as Baby Boomers able to enroll in Medicare. Does that mean that patients can expect less or doctors have to work harder or both?

Obamacare seeks to “rationalize” treatment by improving quality and controlling costs. A more difficult task is managing patient expectations. As consumers we demand the most up to date technology, the latest breakthrough drugs, neonatal intensive care units at the beginning of life and compassion when we near the end.

While arguments about Obamacare often revolve around access, the debate should focus on changing our “help me” culture to one of embracing personal responsibility. For patients this means taking charge of your health by living within appropriate limits.

For physicians, Obamacare creates a new set of personal and professional challenges not the least of which is the unresolved issue of malpractice. At what point do you say to a patient in spite of potential liability, “that’s all I can do though I’d like to do more?”

According to the non-partisan Kaiser Family Foundation, the U.S. spent $2.6 trillion on health care in 2010. That’s an average of $8,402 per person. Fair to say, many question whether we’re getting our money’s worth. Under Obamacare, the system is under new management committed to reforms at every level. Still, in spite of Obamacare’s cost containment provisions, the Kaiser Family Foundation says health care expenditures will rise faster than national income “for the foreseeable future.”

We’ve opened the doors to the uninsured but do we have the surge capacity to meet the increased demand and the will to make hard choices? A big part of the answer will come at work, where maintaining good health should be job one.



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