Workers' compensation in the United States: high costs, low benefits

Studies suggest that income replacement is low for many workers with serious occupational injuries and illnesses. This review discusses three areas that hold promise for raising benefits to workers while reducing workers' compensation costs to employers: improving safety, containing medical costs, and reducing litigation. In theory, workers' compensation increases the costs to employers of injuries and so provides incentives to improve safety. Yet, taken as a whole, research does not provide convincing evidence that workers' compensation reduces injury rates. Moreover, unlike safety and health regulation, workers' compensation focuses the attention of employers on individual workers. High costs may lead employers to discourage claims and litigate when claims are filed. Controlling medical costs can reduce workers' compensation costs. Most studies, however, have focused on costs and have not addressed the effectiveness of medical care or patient satisfaction. Research also has shown that workers' compensation systems can reduce the need for litigation. Without litigation, benefits can be delivered more quickly and at lower costs.

The Impact of AIDS on Government Service Delivery: The Case of the Zambia Wildlife Authority

Background: The loss of working-aged adults to HIV/AIDS has been shown to increase the costs of labor to the private sector in Africa. There is little corresponding evidence for the public sector. This study evaluated the impact of AIDS on the capacity of a government agency, the Zambia Wildlife Authority (ZAWA), to patrol Zambia’s national parks. Methods: Data were collected from ZAWA on workforce characteristics, recent mortality, costs, and the number of days spent on patrol between 2003 and 2005 by a sample of 76 current patrol officers (reference subjects) and 11 patrol officers who died of AIDS or suspected AIDS (index subjects). An estimate was made of the impact of AIDS on service delivery capacity and labor costs and the potential net benefits of providing treatment. Results: Reference subjects spent an average of 197.4 days on patrol per year. After adjusting for age, years of service, and worksite, index subjects spent 62.8 days on patrol in their last year of service (68% decrease, p<0.0001), 96.8 days on patrol in their second to last year of service (51% decrease, p<0.0001), and 123.7 days on patrol in their third to last year of service (37% decrease, p<0.0001). For each employee who died, ZAWA lost an additional 111 person-days for management, funeral attendance, vacancy, and recruitment and training of a replacement, resulting in a total productivity loss per death of 2.0 person-years. Each AIDS-related death also imposed budgetary costs for care, benefits, recruitment, and training equivalent to 3.3 years’ annual compensation. In 2005, AIDS reduced service delivery capacity by 6.2% and increased labor costs by 9.7%. If antiretroviral therapy could be provided for $500/patient/year, net savings to ZAWA would approach $285,000/year. Conclusion: AIDS is constraining ZAWA’s ability to protect Zambia’s wildlife and parks. Impacts on this government agency are substantially larger than have been observed in the private sector. Provision of ART would result in net budgetary savings to ZAWA and greatly increase its service delivery capacity.

Making Sadza with Deaf Zimbabwean Women: A Missiological Reorientation of Practical Theological Method toward Self-Theologizing Agency among Subaltern Communities

Missiological calls for self-theologizing among faith communities present the field of practical theology with a challenge to develop methodological approaches that address the complexities of cross-cultural, practical theological research. Although a variety of approaches can be considered critical correlative practical theology, existing methods are often built on assumptions that limit their use in subaltern contexts. This study seeks to address these concerns by analyzing existing theological methodologies with sustained attention to a community of Deaf Zimbabwean women struggling to develop their own agency in relation to child rearing practices. This dilemma serves as an entry point to an examination of the limitations of existing methodologies and a constructive, interdisciplinary theological exploration. The use of theological modeling methodology employs my experience of learning to cook sadza, a staple dish of Zimbabwe, as a guide for analyzing and reorienting practical theological methodology. The study explores a variety of theological approaches from practical theology, mission oriented theologians, theology among Deaf communities, and African women’s theology in relationship to the challenges presented by subaltern communities such as Deaf Zimbabwean women. Analysis reveals that although there is much to commend in these existing methodologies, questions about who does the critical correlation, whose interests are guiding the study, and consideration for the cross-cultural and power dynamics between researchers and faith communities remain problematic for developing self-theologizing agency. Rather than frame a comprehensive methodology, this study proposes three attitudes and guideposts to reorient practical theological researchers who wish to engender self-theologizing agency in subaltern communities. The creativity of enacted theology, the humility of using checks and balances in research methods, and the grace of finding strategies to build bridges of commonality and community offer ways to reorient practical theological methodologies toward the development of self-theologizing agency among subaltern people. This study concludes with discussion of how these guideposts can not only benefit particular work with a community of Deaf Zimbabwean women, but also provide research and theological reflection in other subaltern contexts.