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Employers reel from workers' insurance This year is no exception. Typical is the Senate's SB191, which attempts to prevent insurers from charging exorbitant rates. Insurance companies are usually cited as the culprits for high premiums by labor unions and lawyers who aid workers' compensation claimants. They are pushing the bill over opposition by insurers. Businesses, insurers and unions all back a bill to cap the fees charged by outpatient surgery centers, one of the few medical costs not controlled in workers' compensation. Surgery centers argue their costs will not be recouped under a cap proposed in a bill by Sen. Richard Alarcon, D-Sun Valley (Los Angeles County), who wants caps based on payments used by the federal government for services under Medicare. "The fee schedule being contemplated would basically make surgery centers not viable to treat work-related patients," said Dr. Glen Lau, owner with a group of other surgeons of Webster Surgery Center in Oakland. The centers have introduced a rival Assembly bill to create a more generous method of calculating what they can charge. Other legislation aims at reducing the number of medical visits. While medical costs in California are comparable to other states, Californians get more treatment. Overtreatment, business owners say. For example, in other states, a worker goes to a chiropractor an average of 15 times for each claim. In California, the average is 34 visits. Sen. Jackie Speier, D-Hillsborough, has a measure limiting workers' compensation patients to 15 one-hour visits to a chiropractor -- unless a medical doctor allows more. The doctor-approval requirement rankles chiropractors. Not surprisingly in the fractious world of workers' compensation, doctors also oppose Speier's bill because of their oversight of chiropractors and a ban on patient referrals to surgery centers in which they have an ownership interest. One of business owners' chief complaints is that there aren't enough controls on the costs of care or the amount prescribed for workers. "Our members hear a sucking sound from the middle of the system," said Martyn Hopper, a lobbyist for the National Federation of Independent Business. Regardless of what legislators do or don't do this year, insurers say rates aren't going to stabilize or fall any time soon. "Premiums aren't going to go down because now, for the first time, you're seeing premiums reflecting the actual cost of providing the product," said Mark Sektnan, a vice president with the American Insurance Association in Sacramento. "Until system costs are substantially reduced, there's not going to be any relief on the premium side."
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