Reader Ali let me know about some dangerous legislation that is on the table right now that would nullify important worker protections on the basis of genetics and disability of workers and their families.
As I’ve discussed before on this blog, the Affordable Care Act (which, full disclosure, gave me the opportunity to have insurance by insisting that insurance companies stop denying me coverage based on my BMI) also had some problematic things, including Workplace “Wellness” Program provisions that allow workplaces to penalize workers for not submitting to invasive blood tests and mental health questions and/or not participating in “wellness” programs regardless of whether or not there was proof of efficacy.
The Equal Employment Opportunity Commission (EEOC) filed a series of lawsuits claiming that these screenings and their associated penalties are in violation of the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA)
Enter Senator Lamar Alexander (R-TN) and co-sponsors including Orrin Hatch of “dazzling display of hypocrisy” fame. These wellness programs are supported by companies that give Lamar money (like Blue Cross Blue Shield for example, one of his second largest contributors and the insurer involved in the EEOC lawsuit.) Now, Lamar can’t argue that these wellness programs aren’t in violation of the ADA and GINA, so he doesn’t try. Instead, he’s filed legislation to essentially stop these Acts from applying to workplaces. Because when civil rights protections may not be the best for corporate bottom lines, then the obvious solution is to suspend civil rights protections. Or wait, no… it should be the opposite of that, right? RIGHT?
His Senate Bill 620 is called the “Preserving Employee Wellness Programs Act. ” Apparently “Preserving Employee Bottom Lines Over the Civil Rights of Employees Act” just didn’t have the same ring to it. Basically, he is seeking to (retroactively) exempt workplace “wellness” programs from the protections of the ADA and GINA and thus stop the Equal Employment Opportunity Commission from being able to enforce these provision and protect workers civil rights.
So why is this a problem?
First of all, these screening programs are supposed to be voluntary, but the cost of not “volunteering” can be thousands of dollars (in the Honeywell Case about which the EEOC lawsuit was filed, it was around $4,000) So it’s only really voluntary for those who can afford $4,000 a year to take a stand for their own civil rights (at my house we call this getting “volun-told”) once again the poor are hit the hardest.
These programs measure things that are not completely within – and sometimes not at all within – people’s control, and in some cases require people to enter into programs on their own time (Weight Watchers meeting at lunch anyone?) that not only don’t have a track record of efficacy, but may not be in keeping with the person’s health philosophies or the plan that they and their doctor created. If they refuse, they can face monetary penalties.
These programs typically use BMI, a ratio of weight and height that isn’t a poor indicator of health so much as it its not in any way an indicator of health.
When we start messing with the acts that protect people from workplace discrimination on the basis of dis/ability and/or genetics we are at the top of a very steep slippery slope.
Not for nothing, but these programs don’t actually save any money (let alone make anybody any healthier.)
And the research itself is super sketchy for a lot of reasons.
The argument is that employees who lead “healthy lifestyles” shouldn’t have to subsidize those who don’t. Setting aside the fact that neither body size nor metabolic numbers can tell you someone’s lifestyle, I note that these programs don’t do anything about employees who participate in sports – including particularly dangerous sports – and are thus much more likely to cost the company money due to sports injuries. Apparently employees who don’t participate in sports are expected to subsidize those who do.
It seems to me that businesses aren’t necessarily looking at cost savings through employee “wellness” programs, but rather are looking at the fact that they’ll save thousands of dollars every time an employee stands up for their right to not literally turn their blood (and the blood of their spouses and children) over to their employer, not to mention making it easier to penalize employees for not meeting “wellness standards” that they cannot meet due to disability or genetics.
These protections were put in place on purpose, to avoid exactly the kind of discrimination that Senator Alexander and his buddies are trying to help businesses engage with this legislation.
So what can you do?
Ali’s created a petition that you can sign. (And thanks to Ali for her help with the research for this piece!)
You can also always write your congress people.
You can tell other people what is happening and encourage them to take action.
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These are the big “keep government out of our lives” guys, right?
Actually it’s “Keep government out of my life as I use government to beat you down so far that your existence need not trouble my unbroken high opinion of my perfect rightness.”
Petition signed, legislators contacted. Expect me to be a loudmouth about this one.
I’m tired of the “bad Samaritan” attitude: that those who aren’t X shouldn’t have to “foot the bill” for those who are X.
I don’t drive. Why should I have to foot the bill for injuries incurred by those who do? Heck, driving is inherently dangerous. These people bring it on themselves. Some drive every day, and many drive when too tired or distracted. When I’m a big CEO I’m goin to make sure those who drive to work—creating air pollution, noise, putting themselves and others and environment in danger, not to mention failing to get the healthy exercise they could get by walking or biking—pay through the nose by instituting Employee Self-Motive programs to reward those who don’t drive (whether to work or not) and penalize those who do.
What’s that? Some people live too far away to walk to work? Not my problem. They could get up a few hours earlier if they really cared. Some people are unable to walk or bike due to physical limitations? Well, they can pay the penalty like the rest of the lazy slobs.
Sounds a bit silly, doesn’t it?
I also meant to make the point that just because you aren’t sick, it’s just selfish to suggest that some who are deserve it and therefore are a drain on the system. People should have compassion, because everyone is “at risk.” Runners have heart attacks. Yogis get ankylosing spondylitis. To say some deserve public money and some don’t is to sit in judgement that no one should get to make.
Some people get cancer.
Here is a thought – do you realize that these programs don’t save money and are actually expensive? Ever heard of “number needed to treat”? Or “number needed to screen”? Look it up.
Here are a couple of examples for you. 1. The company in its brilliance decides to force everyone to have cholesterol checks. It’s a big company so they found some 500 employees with high cholesterol. Some of them are overweight, but many will not be, as for many people, actually most people, its genetics. So if for example, you’ll get 100 people who cannot reduce cholesterol with lifestyle measures, the only thing they could do is take statins. The average (and this include older people too with higher risk) number needed to treat for statins for primary prevention is here (it also shows side effects): http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/
So now do your math — how much money you save in 5 years vs how much you spend on treatment and side effects during these same 5 years.
2. Another example – mammograms. These wellness programs are keen on screening too. So you screen 1000 women for 10 years, you’ll prevent 2 deaths (and treatments of advanced cancer), but you’ll also get to pay for mammograms for 1000, false positive evaluations (about 300 or more – additional mammograms and about a fourth of those for biopsy), and you also get overdiagnosis (look it up) i.e. you’ll diagnose cases that look like cancer under a microscope, but will never spread if remain undetected. But if detected, they’ll get treated, right, so you end up paying for more cases of cancer treatment. Screening is actually very expensive.
I recommend looking up various interventions and see if they are cost-saving. When you don’t it don’t confuse cost-effectiveness with cost-saving because cost effectiveness simply means that the cost of quality-adjusted life year is less than 50,000. Now, this is important for the person whose life is saved, but we are talking others here, right?
Now, you may talk about lifestyle interventions being cheap, but they aren’t as people may just get knee injuries if they start running for example before they are ready. Incidentally – I am slim and exercise, but yes, I have high cholesterol. But my 10-year heart attack risk is 2%. I suggest you calculate if it’ll be cost saving to treat people like me with statins.
Every time I see stuff like this, I flash back to the book 1984 where everyone has to stand in front of their TV and exercise.
Not only that, but IIRC, they also played the execution of a fat man as comedy and were pleased with how easy it was to get the proles to laugh at it with the right framing and music.
I recall the old meme, “1984 wasn’t an instruction manual.”
I wonder if the return on investment also counts the money your employer is getting from you if you fail to be sufficiently “well”. My employer hosts wellness seminars regularly, and I’m sure they lose money on that. But will they continue losing money this year when they start charging us more for not participating?
Reblogged this on Anonymous Girl and commented:
Ugh. This is just beyond words. Giving your employer access to your medical records? Um, no. Maybe that works out great for the few people who don’t have any risk factors for any type of disease, but for those of us with a chronic illness, this is a disaster.
As a person with disabilities there is already so much discrimination around disabilities (even when it is technically illegal), the thought of reducing those protections even more is a bit terrifying.
Also so fucking sick of this “why should I have to subsidize people who are unhealthy?” bullshit. Because that’s how things work, suck it up and deal with it. I have no sympathy for folks who apparently think he fair solution is for people like me to just have the decency to die so they can save a tiny bit of money.
I’d gladly exchange my chronic conditions and the fre
bah, my computer f-ed up and posted too soon.
Meant to say I’d gladly exchange my chronic conditions and the frequent doctor visits, and medicals tests, and prescriptions I can barely even afford with insurance for good health and paying a bit more than my share into an insurance pool. Trust me, folks who are having to subsidize those of us with health problems still get the better end of that deal!
In Germany – as long as you are “officially disabled”, meaning you have gone through medical tests and received a paper for it with the % of disablement – you can go to court if rejected after an employment interview if you feel it was unfair. Then the employer has to proove that the candidate they picked was *better* qualified, because when *equally* qualified, the disabled person has to be employed. Also you can not easily fire someone with a disablement and they get easer access to early retirement funds. And guess what? People complain that it is “discrimination of the healthy” – so they don’t get a medal for “living healthy” blabla.
If it’s all about health, shouldn’t they just be happy that the genetic lottery favoured them?^^