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Industry Insights

Paduda: The Danger of Assumptions

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The older I get, the more I understand the value of experience. Convenient, huh?

Joe Paduda

Joe Paduda

The counter to that is one also learns, often the hard way, that assumptions — usually based on “experience” or “common knowledge” — can be dangerous indeed. The following are a few of the assumptions I’ve held at various times that turned out to be wrong.

  • More workers’ comp claims happen on Monday because workers hurt over the weekend wait till Monday to file so they can cheat the system.

Well, if there is a correlation, it is tiny. The National Council on Compensation Insurance did an excellent study last fall looking at the impact of the Affordable Care Act on claims and determined that Monday claims have the highest claims share.

  • People without health insurance are more likely to file work comp claims.

Nope. In fact, the best research I’ve found — from Rand — indicates the opposite is true. That is, workers whose employers do not provide health insurance are less likely to file work comp claims.

This may be due to the employer-employee relationship. Employees who perceive their bosses to be more benevolent may be more likely to file claims, as they don’t think they will suffer retaliation.

  • People always act in their own self-interest.

This one is a bit more complicated. Generally, it is true. The key is how one defines “self-interest.” External entities can often convince people to act against what is their true self-interest via effective messaging.

Poor white farmers joining the Confederate military to preserve a system that kept them desperately poor is one striking example. The anti-vaxxer campaign is another.

What does this mean for you?

Be ready to give up long-held beliefs in the face of solid evidence. It’s OK to admit you’re wrong.

Joe Paduda is co-owner of CompPharma, a consortium of pharmacy benefit managers. This column is republished with his permission from his Managed Care Matters blog.

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