With the stroke of a pen, Gov. Tom Wolf ended—for now—the annual effort to “change the way medical treatment is administered under the workers' compensation system” by vetoing Senate Bill 936. Over the last few years, the Republican-controlled legislature has been trying to pass various pieces of legislation targeting health care under the Workers' Compensation Act. Originally, there was a push to implement “evidenced-based medicine” standards, which is a statistical method to treat injured workers that removes medical decision making from doctors in favor of a “cookbook”-style approach reportedly in line with successful outcomes. This most recent attempt at altering the workers' compensation medical landscape would have ostensibly helped control the opioid crisis and reduced costs to the workers' compensation system by implementing a prescription drug formulary.

In the rosiest of terms, drug formularies provide for a pre-approval process for prescription drugs that are authorized by the FDA or otherwise “demonstrated to be effective” and offer an authorization process for other medications that a doctor may deem necessary. The bill vetoed by Gov. Wolf would have directed the Department of Labor and Industry to select a nationally recognized, “evidenced-based drug formulary” for treating workplace injuries. Detractors of the formulary bill point out that it would interfere with the relationship between doctors and patients by making it nearly impossible for doctors to decide what medications to prescribe and by limiting treatment options available to injured workers. Of course, both sides agree the main beneficiary in all this would be the insurers who would enjoy lower prescription drug costs.

It is curious that this bill was moved through the legislature along party lines, with only Republican support. What could be more anathema to the conservative mindset than unelected government bureaucrats dictating to doctors and individuals what they can and cannot utilize in achieving positive medical outcomes? What conservative has ever supported government mandates to private industry about the kinds of products that can be utilized in a free market? When has the Republican Party ever supported policies which increase bureaucracy on small businesses in the medical services industry, driving some doctors from the practice entirely? As it is, the ability for an injured worker to receive quality medical care is often dependent on a claims adjuster's willingness to accurately convey the payability of prospective treatment to a health care provider. Adding another layer of bureaucracy would seem to be against conservative orthodoxy.

If this debate sounds familiar, it is. Except, the roles were reversed. Most of the arguments now employed by Democrats against SB 936 were originally coined by conservatives in the decade-long battle over the Patient Protection and Affordable Care Act, commonly referred to as Obamacare. When panels of unelected bureaucrats were thought to be intruding in the medical decisions of doctors for their patients, it was conservatives that were opposed. Now, even deep-red county Republicans no longer seem to be concerned with the doctor-patient relationship. Likewise, Democrats, who generally view oversight and regulation to be the essence of good government are now champions of the free market and individual liberty. Anyone concerned with the influence of special interests in politics would do well to study the ongoing battle to “reform” the Pennsylvania workers' compensation medical system.

While gubernatorial candidate Scott Wagner has called Wolf a coward for vetoing SB 936, which was opposed by many of his donors, it is hard to make that case since the governor's veto accompanied with it executive actions designed to limit the excesses which the bill sought to curb. Wolf stated: “My administration is taking these steps to limit overprescribing of opioids to injured workers, limit expensive opioid-based medications, and combat the potential for opioid abuse without rationing health care for millions of workers who could be injured on the job or severely limiting treatment options for workers and their doctors beyond opioids. My priority will always be to ensure injured workers, including our police, firefighters and laborers, have access to quality health care.”

While the executive actions do not deal as directly with the opioid crisis and the potential for misuse and abuse of prescription opioids within the workers' compensation system as supporters of SB 936 would like, suffice it to say, imposing a draconian regulatory scheme on injured workers is not the answer, either. Just ask the opponents of Obamacare.

Christian Petrucci, of the Law Offices of Christian Petrucci, concentrates his practice in the areas of workers' compensation and Social Security disability. He also counsels injured workers in matters involving employment discrimination and unemployment compensation benefits.