Here is the question facing the businesses, workers and legislators in New York: "Do you really understand the problem you are trying to solve in workers’ compensation?"

The businesses say the high cost of workers’ compensation insurance is making it almost impossible to compete in the marketplace. It reduces opportunities to make a profit, hire new workers and all the other things that make businesses successful. The workers are being forced to give up rights to things like choice of medical care and are required to follow bureaucratic rules in order to receive the benefits they are entitled to under the law. And the legislators are caught in the middle with both constituents looking for results that save costs without taking away rights and benefits from the injured workers. 

What everyone is failing to see is that the real problem is not cost – it is duration; the time it takes to close the claim. Cost is just a symptom they keep treating to make the system better, but it is only getting worse. The challenge facing New York is that the span of time from when the claim is reported to the time the claim is settled and closed takes too long. This is what is driving costs to be so high. Unless legislators clearly understand that the problem is actually duration and stay focused on solutions that address duration, knee jerk reforms on costs will only exacerbate the problems.

According to the Work Loss Data Institute’s 2012 State Report Card, New York received an F, one of only a few states to receive such a grade. The report card measures states along five different outcome measures: incident rates, cases missing work, median disability durations, delayed recovery rate and key condition: lower back strain. What all of these measures are telling us is that New York is way behind other states when it comes to lost time from work and, more importantly, duration of the claim. 

Albany, we have a problem.

New York’s workers’ compensation system is broken. Layering on more complexity and more bureaucracy is not going to solve the problem.

What can you do to improve the care and satisfaction of injured workers? How do you get them back to work quicker which is what reduces duration and therefore cost?

Patient Choice of Medical Care – get the injured worker immediate medical care to start the treatment process as soon as possible. Don’t build layers of complex rules about who can and cannot provide treatment or where they can and cannot get their medications. The state licenses every doctor and pharmacy; if there is concern about the quality of care they provide, then there’s a simple solution: don’t give those doctors or pharmacies a license. If there is a concern about costs, control the rate they are charging with a fee schedule. Don’t add additional rules that would let insurance carriers such as American International Group control the processes and rates. We have all seen what AIG is capable of through the financial crisis it caused and the recent fines it received for avoiding taxes and assessments. Don’t let the pharmacy benefit managers, such as Express Scripts which was recently fined for not properly controlling the distribution of narcotics, dictate how an injured worker should be cared for in the state of New York. Are these the people you want to have complete control over the care of your citizens – really?

Why are carriers and PBMs fighting so hard to keep their exclusive position? Why don’t they want independent pharmacies to be able to participate in the process? As they say on Wall Street – those who make the rules, make the money.

Ken Martino is chief executive officer of Injured Workers' Pharmacy LLC, a mail-order pharmaceutical company located in Andover, Mass.