The WBC health care plan and other medical issues
A health care plan for boxers: Sound too good to be true? That's because it probably is, writes Thomas Hauser.
Originally Published: March 28, 2008By Thomas Hauser | Special to ESPN.com
John Gurzinski/AFP/Getty ImagesIs help in the form of health care for fighters around the corner? Not just yet, apparently.Last month, a news release was circulated throughout the boxing community. Its headline (in solid capital letters with an exclamation point) read, "THANK YOU, JOSE SULAIMAN and the WBC!" A subhead informed readers, "WBC meets members' needs with health care plan." Not exactly. The plan provides for the partial payment of medical expenses incurred in conjunction with illnesses, accidents and other medical conditions. But it will not cover conditions related to boxing. That's a huge hole in the coverage. If a fighter needs medical care for a broken jaw, detached retina or other condition suffered as a consequence of the sweet science, he's on his own. That's like a health care plan for members of the military that doesn't cover combat-related injuries. How will one determine whether a condition is related to boxing? After all, there are gray areas. That determination will be made in the first instance by a claims examiner hired by the plan provider. Let's put the WBC-endorsed plan in perspective.
Glenn Davidow, an insurance broker based in Southern California, procures policies that groups (or individuals) need when they seek insurance. Davidow was approached by Jill Diamond of World Boxing Cares about the possibility of health insurance for boxers. He took the issue to the Consolidated Workers Association, which agreed to underwrite the plan. The CWA is not an insurance company. It's a corporation that offers lifestyle benefits such as discounted vacation packages and prepaid legal fees to small employers, church groups, trade associations and the like. In this case, the CWA is offering a "health care plan." Because of various state and federal laws, the offering is technically not "insurance." Plan participants will pay dues, not "premiums," to the CWA. Brad Wessler of Claims & Benefits Management Inc., is the administrator hired by the CWA. He will collect the plan dues and adjudicate claims for benefits. The one-page news release (which modestly referred to the WBC eight times) also states that the plan is open to "the entire boxing community." But that, apparently, is not the case. Davidow says, most likely, the plan will be limited to people licensed by a government athletic commission and their families. "We're not talking about a clearly defined membership group," Wessler says. "I don't think a final determination has been made yet as to who will be eligible to participate." Either way, the rationale for limiting the plan to "the boxing community" is essentially a marketing tool. Keep in mind, as far as the CWA is concerned, this is a for-profit venture (like selling discounted vacation packages). The WBC endorsement is significant primarily for marketing purposes. The program could be run just as easily with the endorsement of the Association of Boxing Commissions or another world sanctioning organization. There will be three coverage plans, each of which will offer a different level of benefits. Depending on the plan chosen, individual rates are expected to run from $97 to $195 per month with family rates ranging from $143 to $445 monthly. These rates have been set by actuaries based on the expected demographics of the insured group. A similar package could be put together for a lower-risk group (such as certified public accountants and their families), in which case either the premiums would be less or the benefits would be greater. Because the CWA is doing this to make money (nothing wrong with that), the benefits paid to plan participants will be limited, as they are under most insurance policies. That includes limits on the amount paid for each procedure, each doctor's visit and hospital stays of varying duration. Health care providers will be allowed to charge more than the benefit amount, and most of them will. By way of example, it's unlikely that the benefits paid will come close to covering the full cost of hospitalization. Plan participants will be responsible for paying the unreimbursed portion of all health care costs. But Wessler says that if a participant uses an in-network provider, the co-payment that he or she is responsible for will often be less than would otherwise be the case because the CWA has negotiated with in-network providers for reduced rates. With certain narrow exceptions, pre-existing conditions will not be covered for the first 12 months of a person's participation in the plan. The powers that be hope to launch the plan on June 1, shortly after it is presented at the NABF convention in Tucson, Ariz.
Thomas Lohnes/AFP/Getty ImagesA broken jaw, like the one suffered by Arthur Abraham in September 2006, wouldn't be covered by the WBC's health care plan.
As noted in a previous column, Juan Manuel Marquez suffered a terrible cut on his right eyelid in the ninth round of his March 15 fight against Manny Pacquiao. Afterward, Marquez's trainer, Nacho Beristain, could be seen on television packing what appeared to be a long, yellow string soaked in a liquid solution into the wound, covering the cut with Vaseline, and sending Marquez out for subsequent rounds. Keith Kizer, the executive director of the Nevada State Athletic Commission, said later that he'd been told the string was soaked in epinephrine (a legal coagulant) and that it had been removed from the laceration before Marquez left his corner for each round. Kizer subsequently learned that the packing had been left in the cut, but said, "Our primary concern is the safety of the fighter. There's no rule against leaving something like that in a cut, so it's at the discretion of the ring doctor and the commission whether or not to allow it." Michael Schwartz, the president of the American Association of Professional Ringside Physicians, who is widely recognized as a first-rate ring doctor, takes a contrary view. When apprised of the NSAC's position, Schwartz told ESPN.com, "That's ridiculous. It's totally absurd. It shocks me. Any time there's a foreign object in the eye, you're increasing the danger to the fighter. If a cut is bad enough to warrant doing something like that, the ring doctor should stop the fight." The Nevada Annotated Code does not specifically state that it's illegal to place a foreign object inside a cut and leave it there during a round. But a little common sense is in order. • Can a cornerman legally put a butterfly bandage on a cut between rounds? • Can a cornerman legally suture a cut between rounds? • Can a cornerman legally leave packing in a fighter's nose and send him out for the next round? • What if a string packed into a laceration dangles out during a round and gets into the fighter's eye? Come on, guys. Referees require a fighter's corner to wipe extra Vaseline off a cut. And Nevada is telling the world that it's all right for a fighter to come out with a foreign object packed into a laceration? The core problem here is that the Nevada State Athletic Commission has a policy of refusing to admit that it ever makes a mistake. That might be good spin politics, but it's lousy regulation, because without correction, bad decisions become standard practice. It's precisely because Nevada is a leader that the NSAC should call a halt to the practice of allowing foreign objects to be packed into lacerations between rounds. The appropriate response now would be to say, "It shouldn't have been allowed to happen before, and we won't allow it to happen again in the future." Thomas Hauser is the lead writer for Secondsout.com. His most recent collection of boxing columns -- "The Greatest Sport of All" -- has been published by the University of Arkansas Press. He can be reached by e-mail at email@example.com.
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