Check out the latest Health Wonk Review posted by Peggy Salvatore at Healthcare Talent Transformation – it’s chock full of good posts and entertaining to boot: Health Wonk Review: Take Me To Your Leader – Egads!
And in a few other news items …
Can you offer unpaid internships? – Is your organization eligible to offer unpaid internships? If you are a profit-making entity, the answer is probably not. As part of its enhanced focus on employee misclassification, internships are one of the areas that the Department of Labor is examining. If your organization offers internships, you need to ensure you are in compliance with the Fair Labor Standards Act. DOL’s Wage and Hour Division has issued guidance: Fact Sheet # 71: Internship Programs Under The Fair Labor Standards Act. If your organization’s internship qualifies as a “training program” you may be an exception to the rule. The linked Fact Sheet lists 6 criteria which organizations can use to determine eligibility for training programs that would be allowed as unpaid internships.
While on the topic of compliance with wage & hour laws, here’s a list of other Fact Sheets, which looks like a good page to bookmark for reference.
Work comp trends – Work Comp Complex Care Blog recently featured series on “Big 3 Trends in Workers Compensation” as noted by the Total Medical Solutions vice president of clinical services, Kevin Glennon. There’s some good information, if you haven’t seen them: Part One: Obesity; Part Two Aging Workforce; and Part Three: Antibiotic-Resistant Infections
Lost tax revenue – The IRS estimates that across the country, $345 billion of tax revenue is lost each year to the underground economy. Check out Roberto Ceniceros’ post at Comp Time fro more on the topic: Notes on the underground economy
Safety is top labor issue – A new study by the National Opinion Research Center at the University of Chicago found that more than eight in 10 workers ranked workplace safety as their most important labor issue. Family and maternity leave was ranked as the second most important issue, followed by minimum wage, paid-sick days and time-and-a-half overtime pay. David Shadovitz offers more on the study at Human Resources Executive: Putting Workplace Safety First.
Healthcare costs – A recent survey of 466 large and midsize employers conducted by Towers Watson projects that employers’ health care costs will rise by 8.2% in 2011. According to the Employee Benefit News coverage of the survey, “Among survey respondents, 59% plan to implement significant or moderate health care plan design changes in 2011, and 67% plan to do so in 2012.”
Posts Tagged ‘employment issues’
Fresh other-worldly Health Wonk Review & other news tidbits
Thursday, September 30th, 2010Fire the Smokers! Tax the Fat?
Monday, August 17th, 2009Back in December of 2006 we blogged the story of Scott Rodrigues, a new hire of the Scotts lawn care company, who was fired after failing a drug test. No news here, perhaps, except that the drug in his system, nicotine is perfectly legal. Scott’s is self-insured for health benefits, so they have a vested interest in making sure that employees follow basic wellness practices.
On his way to a pre-placement drug test, Mr. Rodrigues chewed on Nicorette gum. He was trying to kick the habit. Ironically, the Nicorette may have triggered the positive finding for nicotine. Rodrigues was hired provisionally and then abruptly terminated once the test results were released.
Rodrigues brought suit in federal court for violation of privacy and civil rights. Judge George O’Toole has ruled in favor of the company. The judge found no violation of privacy laws, as Rodrigues smoked while walking down the street and in a restaurant parking lot. His supervisor spotted a pack of cigarettes on the dashboard of his truck. Would the judge have ruled for Rodrigues if the employer had peeked through a window to see him smoking at home?
O’Toole also rejected the notion that the firing violated a 1974 federal law that protects employee rights to benefits. O’Toole ruled that Rodrigues was not yet a bona fide employee and was working on the condition that he pass the urinalysis.
Jim King, a spokesman for Scotts, said the smoking ban has never been used to fire an “existing” employee. It is used solely to screen out applicants. Since the ban went into effect in 2005, the percentage of smokers among the company’s 7,000 employees has fallen to 7 percent from 28 percent.
[The Insider notes in passing that even as a “provisional” employee, Rodrigues was covered by workers comp from the moment he began working – indeed, while he was on his way to the drug testing lab.]
Whether employees can smoke or not depends upon the state they work in. A few states (e.g., Kentucky, Louisiana) explicitly protect smoker rights. Other states do not. It’s interesting that Rodrigues pursued his case in federal court, probably because Massachusetts laws offered no protection to smokers.
Is Obesity Next?
We all know that smoking increases the risk of illness and the cost of medical coverage. The same goes for obesity. So the next front in the battle to control the business side of medical costs may well be the bathroom scale. The New York Times magazine profiles the Cleveland Clinic, which has been upheld as a model for medical cost control. Two years ago, they stopped hiring smokers. Delos M. Cosgrove, the heart surgeon who is the clinic’s chief executive, would like to expand the hiring ban to include applicants who are obese.
“Why is it unfair? Has anyone ever shown the law of conservation of matter doesn’t apply?” Cosgrove states that people’s weight is a reflection of how much they eat and how active they are. The country has grown fat because it’s consuming more calories and burning fewer. Our national weight problem brings huge costs, both medical and economic. Yet our anti-obesity efforts have none of the urgency of our antismoking efforts. “We should declare obesity a disease and say we’re going to help you get over it.”
Should the Cleveland Clinic – or any other employer- decline to hire obese people, it will be interesting to track the results. Where obesity can be traced back to genetic or chemical issues – where it qualifies as a disability under the Americans with Disabilities Act- employers would be guilty of discrimination. If no such causes can be specified, employers may be on solid ground. (The unaddressed issue in these hiring practices, of course, is the loss of a vast pool of talented and often essential workers.)
A recent article in Health Affairs estimated the annual cost of obesity to be $147 billion and growing. That translates into $1,250 per household, mostly in taxes and insurance premiums.
The Fat Tax
Cosgrove is interested in an idea that some economists favor: charging higher health-insurance premiums to anyone with a certain body-mass index. Call it the Fat Tax. Another alternative might be taxing the calorie-rich foods that lead to obesity: just imagine paying a little surcharge for your large order of fries, your jumbo soda and your two-for-one pizza. That would be interesting, indeed! Just as smokers pay a tax-driven premium for their cigarettes, eaters would be taxed for their food addictions.
This is simply not going to happen. To be sure, fundamental wellness is the cornerstone of any plan to contain health care costs. But when the public good collides with the rights of freedom and privacy, individual rights will win out. Policy wonks may not like it, but citizens can eat whatever they damn well please. Lighting up after that supersized meal? Well, that’s one area where the public good pretty much trumps the private right.