There is no shortage of work for those of
us connected with workers’ compensation and occupational health & safety
(OH&S). People continue to get hurt,
develop disease and even die as a result of work-related activity. Investigating injuries, adjudicating claims,
caring for victims and families while reducing and eliminating the causes to
prevent future occurrences are the obvious “reasons” behind what we do. Exactly how we organize and what we do vary
greatly with the jurisdictions in which we work. Virtually every developed and developing
nation has systems and organizations that deliver workers’ compensation and OH&S
services. So, what is the underlying “social
policy objective” each society is trying to address?
The ubiquity of workers’ compensation and OH&S
public policies reflect an underlying and universal social policy objective: to protect workers from work-related injury,
disability, illness and death in a compassionate and sustainable way that still
allows the economic activity and innovation necessary for societies to operate
and thrive. This social policy objective
recognizes that all human activity takes place in the presence of hazards to
the health and safety of individual workers. It also recognizes societal expectations that
a vibrant economy is desirable.
In deciding how to achieve this social
policy objective, legislators have a series of direct and indirect levers they
can adjust that will impact workers, employers, work activities and work
processes. These control mechanisms
cluster under the general headings of workers’ compensation and OH&S.
On the workers’ compensation side,
legislators can determine the scope of coverage—both who and what will be
covered. Making workers’ compensation
coverage mandatory imposes a cost on firms and an oversight obligation on
behalf of authorities. Premiums can be
modulated to achieve effects. Bringing
hearing loss into the scope of workers’ compensation, for example, increases
compensation costs and therefore premiums.
The increased premiums can provide an incentive for reducing noise
induced hearing loss in the workplace.
The same argument may be made for mental injuries and illnesses due to
stress and bullying. Bringing these
outcomes into the scope of workers’ compensation can certainly provide an
incentive for prevention. Experience rating (also called experience
modification) is another lever that can be fine-tuned to apply economic
pressure to firms with greater frequency or claims costs. To mitigate costs, greater investment in
prevention and rehabilitation/return-to-work and work accommodations are the
typical workplace responses. Other
incentives including retrospective rating, rebates and discounts for specific
prevention or RTW initiatives round out the control panel on the workers’
compensation side.
On the OH&S side, there are four main
levers: regulation, enforcement,
education/consultation, “prevention” promotion.
The regulation lever can be set widely or narrowly and adjusted towards
being more prescriptive or performance based.
All regulation has a cost in terms of the freedom of an enterprise to
extract economic gains from a process.
Whereas workers’ compensation policies will impose costs associated with
injuries to the firm, regulation on the OH&S side may increase production
costs but prevent injuries or exposures that would lead to workers’
compensation claims.
The enforcement lever can be set with
respect to intensity and severity. Who
gets inspected , how often and with what consequences (financial penalty, stop
work order, etc.) are the main policy desisions. The effectiveness of this control for
well-performing firms is really not an issue.
For poor performers who ought to know better, the enforcement lever will
only be effective if set to level where the expected cost of detection
(financial and reputational) of regulatory violation exceeds the expected value of gains possible
by violating the regulation.
The education/consultation control has little impact on high-performance
organizations (they already know and do what needs to be done). For workplaces who do not know or who have a new
or difficult safety or health issues, increasing resources and efforts in this
area can be effective.
Finally, the prevention promotion lever can
be set broadly or narrowly but lacks precision.
It is great for increasing awareness and shifting attitudes at a
societal or sectoral population (health care workers, welders for example)
level but requires sustained exposure to target audiences to achieve intended
results.
Those are the levers that legislators have
to achieve the social policy objective.
Legislators typically delegate the authority to set and adjust the
controls to commissions, statutory agencies or other bodies. Often, feedback mechanisms or oversight
agencies or reports are also mandated to determine the performance of the
system in achieving the social policy objective.
My own view is that these levers must be
operated in concert. The setting of each
control has an impact on the overall movement toward the desired
objective. Where the scope of what is covered
is wide and the percentage of employed labour force covered is high, it makes
sense to create statutory structures with the high degree of control over all
the levers that can impact the social policy objective.
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