Your source for the latest developments in workplace rights and employment law. "Today's Workplace" is the the blog (weblog) written by Paula Brantner, Program Director of Workplace Fairness. In each entry, Paula focuses on legal and political information relevant to employee rights and fairness issues in the workplace. Whether you're an advocate trying to stay on top of the latest case developments and workplace trends, or a worker wanting to follow and understand the issues, keep up to date here!
Wednesday, October 15, 2003
Every day it seems we hear about a new strike, and more often than not, the issue is not primarily wage increases any more. The central issue of many labor negotiations right now involves health benefits, and whether workers can rely on their employers to have most of their health care expenses covered by employer-provided health insurance plans, or whether cutbacks are going to enforce employees to assume a large share of rising health care costs. And whether workers are unionized or not, health care benefits are extremely important, and are likely to be the result of many more negotiations between employees or employers. In return, it's likely that employers are going to play more of a role in overseeing the health of their employees, and will implement more wellness programs that promote weight loss, exercise, and disease management. Is a workable solution in sight?
Grocery workers are on strike in Southern California, with health benefits, not wages, as the primary focus of the strike. (See New York Times article.) So are transit mechanics and sheriff's deputies in the same region, with health care also at issue. (See San Diego Union-Tribune article.) Last month, members of the United Auto Workers, in reaching agreements with the Big Three U.S. Automakers, accepted wage freezes and plant closings which in previous negotiations would have been unthinkable, but in return, were able to hold the line on their members' health care costs. (See New York Times article.) Workers who do get higher wages in labor negotiations often get those wage increases in exchange for greater health care costs, as was recently the case at Hormel. (See Kansas City Star article.)
As one labor expert noted, this is a trend that is only likely to escalate in the months ahead. "The underlying issue is the whole issue of health care costs," said Edward Lawler, a labor expert at the University of Southern California's Marshall School of Business. "Unless there's some change in legislation that completely redefines how health care gets delivered, I think we're going to see this time and time again as a labor issue." (See San Diego Union-Tribune article.) The same concerns were echoed by Greg Denier, director of communications for the UFCW, the union involved in the grocery workers strike. "This battle is growing nationwide. What's happening is that contracts are up across the country in different areas. The employers are dedicated to eliminating affordable health care for employees, so the national health care crisis is being played out on the picket line."
Rising health care costs have placed employers and employees in a financial bind: will employers absorb the costs, in the face of declining profits, or will they attempt to pass along some or most of the increase to their employees? All over, employees are being asked to pay higher co-payments coupled with reduction of coverage for prescription drugs and some medical services. And don't think they haven't noticed or don't care, either. A poll of workers last year found that health-care coverage is the most important benefit, outscoring compensation by a margin of two to one. For two-thirds of those responding to the survey, health coverage was a primary factor in their employment decision. Since two-thirds of the American public rely on their employers for health care, this trend is bound to affect million of American workers. (See CNN/Money article.)
Setting aside a drastic shift in how health care costs are paid, such as a government-sponsored universal health care program, how can policymakers even begin to address this vast problem? At every step in the process of providing health care, from doctors to HMOs, from insurers, to employers, to workers, someone is going to have to absorb the costs which have dramatically escalated in recent years. Health premiums for businesses have risen at a double-digit clip for four straight years, and a similar rise is expected in 2004. The surge has caused workers to pay, on average, 50 percent more in out-of-pocket expenses since 2000, according to a survey released last month by the Kaiser Family Foundation. (See Philadelphia Inquirer article.)
Will it ultimately fall primarily on the backs of the American worker, or will all of the entities involved cooperate towards a solution which keeps the model of employer-provided health insurance a viable one? One of the methods that various employers are exploring involves paying employees to shift insurance costs to a spouse's employer. This method shifts the burden of insuring a particular employee to a larger employer's plan, which may not be so dramatically affected by one employee's age and health status as that of a smaller employer's plan. The smaller employer pays the lower premium to the employee, who in term remits it to his or her spouse's employer for coverage. That method shifts the underwriting cost to the insurer, in essence, but of course, only works where an employee's spouse has adequate coverage. (See Philadelphia Inquirer article.)
Some employers are focusing on "disease management," which is an effort to control the costs incurred by workers with serious chronic diseases, such as diabetes, asthma, and heart disease, as those workers often consume the overwhelming majority of health care expenses. Disease management programs are intensive case management programs that use individualized care coordination for high-risk patients with multiple or complex medical conditions. However, some critics claim that these programs have yet to show the desired results. (See Nashville Business Journal article.) Other employers are building wellness programs into every aspect of corporate life, from the design of their campuses to the speed of the building elevators. Some large corporations have deliberately designed key buildings to be at a great distance from one another, to encourage more walking during the work day, and have chosen slower elevators, designed to get employees to take the stairs more frequently. (See New York Times article.)
While all of these efforts to promote employee health and reduce health care costs are laudable, it still appears that employees are increasingly being asked to bear the brunt of increased costs. And while unionized employees have some leverage in negotiating health care costs as part of the larger contract with the employer, non-unionized employees have little ability to influence their employer's coverage decisions, especially as the economy limits workers' mobility and renders empty the threat to move to another employer with better coverage. If costs continue to increase, and those costs continue to be shifted to workers, a significant crisis is surely on its way, if not already here, that could shake the model of employer-sponsored health coverage to its very core.
Grocery workers are on strike in Southern California, with health benefits, not wages, as the primary focus of the strike. (See New York Times article.) So are transit mechanics and sheriff's deputies in the same region, with health care also at issue. (See San Diego Union-Tribune article.) Last month, members of the United Auto Workers, in reaching agreements with the Big Three U.S. Automakers, accepted wage freezes and plant closings which in previous negotiations would have been unthinkable, but in return, were able to hold the line on their members' health care costs. (See New York Times article.) Workers who do get higher wages in labor negotiations often get those wage increases in exchange for greater health care costs, as was recently the case at Hormel. (See Kansas City Star article.)
As one labor expert noted, this is a trend that is only likely to escalate in the months ahead. "The underlying issue is the whole issue of health care costs," said Edward Lawler, a labor expert at the University of Southern California's Marshall School of Business. "Unless there's some change in legislation that completely redefines how health care gets delivered, I think we're going to see this time and time again as a labor issue." (See San Diego Union-Tribune article.) The same concerns were echoed by Greg Denier, director of communications for the UFCW, the union involved in the grocery workers strike. "This battle is growing nationwide. What's happening is that contracts are up across the country in different areas. The employers are dedicated to eliminating affordable health care for employees, so the national health care crisis is being played out on the picket line."
Rising health care costs have placed employers and employees in a financial bind: will employers absorb the costs, in the face of declining profits, or will they attempt to pass along some or most of the increase to their employees? All over, employees are being asked to pay higher co-payments coupled with reduction of coverage for prescription drugs and some medical services. And don't think they haven't noticed or don't care, either. A poll of workers last year found that health-care coverage is the most important benefit, outscoring compensation by a margin of two to one. For two-thirds of those responding to the survey, health coverage was a primary factor in their employment decision. Since two-thirds of the American public rely on their employers for health care, this trend is bound to affect million of American workers. (See CNN/Money article.)
Setting aside a drastic shift in how health care costs are paid, such as a government-sponsored universal health care program, how can policymakers even begin to address this vast problem? At every step in the process of providing health care, from doctors to HMOs, from insurers, to employers, to workers, someone is going to have to absorb the costs which have dramatically escalated in recent years. Health premiums for businesses have risen at a double-digit clip for four straight years, and a similar rise is expected in 2004. The surge has caused workers to pay, on average, 50 percent more in out-of-pocket expenses since 2000, according to a survey released last month by the Kaiser Family Foundation. (See Philadelphia Inquirer article.)
Will it ultimately fall primarily on the backs of the American worker, or will all of the entities involved cooperate towards a solution which keeps the model of employer-provided health insurance a viable one? One of the methods that various employers are exploring involves paying employees to shift insurance costs to a spouse's employer. This method shifts the burden of insuring a particular employee to a larger employer's plan, which may not be so dramatically affected by one employee's age and health status as that of a smaller employer's plan. The smaller employer pays the lower premium to the employee, who in term remits it to his or her spouse's employer for coverage. That method shifts the underwriting cost to the insurer, in essence, but of course, only works where an employee's spouse has adequate coverage. (See Philadelphia Inquirer article.)
Some employers are focusing on "disease management," which is an effort to control the costs incurred by workers with serious chronic diseases, such as diabetes, asthma, and heart disease, as those workers often consume the overwhelming majority of health care expenses. Disease management programs are intensive case management programs that use individualized care coordination for high-risk patients with multiple or complex medical conditions. However, some critics claim that these programs have yet to show the desired results. (See Nashville Business Journal article.) Other employers are building wellness programs into every aspect of corporate life, from the design of their campuses to the speed of the building elevators. Some large corporations have deliberately designed key buildings to be at a great distance from one another, to encourage more walking during the work day, and have chosen slower elevators, designed to get employees to take the stairs more frequently. (See New York Times article.)
While all of these efforts to promote employee health and reduce health care costs are laudable, it still appears that employees are increasingly being asked to bear the brunt of increased costs. And while unionized employees have some leverage in negotiating health care costs as part of the larger contract with the employer, non-unionized employees have little ability to influence their employer's coverage decisions, especially as the economy limits workers' mobility and renders empty the threat to move to another employer with better coverage. If costs continue to increase, and those costs continue to be shifted to workers, a significant crisis is surely on its way, if not already here, that could shake the model of employer-sponsored health coverage to its very core.
Tuesday, October 14, 2003
It is rare to find unanimity in the U.S. Senate, and almost unheard of to find unanimity on a bill that benefits workers more than businesses and insurers. Yet it happened today in the Senate, which unanimously (in a 95-0 vote) passed the Genetic Information Nondiscrimination Act (S 1053), a bill that would bar employers and insurance companies from discriminating against people based on their genetic histories. And what may be the most virtually unprecedented development of all: the bill is also supported by the Bush administration. Even that might not be enough to guarantee action in the House of Representatives, this year, however, and that's a real shame. Once again, it may be up to how loudly workers speak out urging the House to take action this year on this bipartisan bill.
The scientific progress made in the last decade in mapping the human genome and identifying the source of many genetically caused illnesses and conditions makes it more important than ever to protect those who might be adversely affected by the disclosure of this information. As Dr. Francis Collins, head of the National Human Genome Research Institute, notes, "[genetic discrimination] could cause this wonderful revolution fueled by the genome project to actually be stillborn because people would be afraid of getting the information that otherwise be of great advantage to them for medical purposes." (See ABC News article.) Dr. Collins also characterized the bill, as quoted in the title to this blog entry, as "a bill for people with DNA," or a bill for everyone, which may explain at least in part, the bipartisan support. (See New York Times article.)
In short, the bill would bar health insurance companies from using genetic information to deny coverage or to set premiums, and would prohibit employers from using such information to hire or fire workers. Neither insurers nor employers could ask for genetic information or require people to take genetic tests. According to a more detailed summary prepared by the Senate's Health, Education, Labor & Pensions Committee, which originally heard the bill, the bill:
The bill was first introduced in the Senate in 1997 (1997 version) by Sen. Olympia J. Snowe (R-ME), and then was aimed only at health insurers. While the idea attracted the support of prominent senators such as Sen. Bill Frist (R-TN), now the Republican leader, and Sen. Tom Daschle (D-SD), the Democratic leader, the measure nonetheless languished for several years. Insurers objected to language that they said would prevent them from collecting information that could help them manage the health care of patients with genetic diseases, so that section was removed. While Republicans wanted to limit the bill to health insurers, Democrats wanted to see it expanded to include employers; it now includes employers.
Business groups and insurers still object to the bill, however, which could doom its progress in the more conservative House of Representatives. One insurance group, the Health Insurance Association of America, called the bill "a solution in search of a problem." (See New York Times article.) However, according to Dr. Collins of the Genome Project, fears of discrimination already have deterred potential participants of genetic research projects. In two studies of breast cancer and one of colon cancer, one-third of the individuals who were qualified to participate ultimately declined after hearing that there was no federal law against such discrimination, he said. (See Los Angeles Times article.) More incidents like this are certain to occur without more legal protections for those who participate in such research.
While the bill easily passed the Senate, its fate is more uncertain in the House of Representatives. A similar measure, the Genetic Nondiscrimination in Health Insurance and Employment Act (HR 1910), has been introduced in the House by Rep. Louise McIntosh Slaughter (D-NY), and already has over 140 cosponsors. Even though enacting the Senate bill instead of the House provision would move things forward more quickly, the House may slow things down by requiring that the bill have hearings. This would mean the bill would not pass this year before Congress adjourns, which could happen as early as the end of this month. (See Washington Post article.)
Workers must speak out now to demand that the House take action on the Senate bill this year; otherwise, the bill will languish at least until Congress resumes next January, and most likely even later, given that 2004 is an election year. Ask your representative to push for a vote on the Senate version of the bill this year in our Action Alert, as the House needs to be reminded how important this bill is for both scientific advancement and the protection of workers from discrimination.
Stop Genetic Discrimination: Support The Genetic Information Nondiscrimination Act
More resources on genetic discrimination:
Genetic Alliance Genetic Discrimination Resources
Genetic Information and the Workplace Enacted State Legislation
ACLU Genetic Discrimination in the Workplace Factsheet
The scientific progress made in the last decade in mapping the human genome and identifying the source of many genetically caused illnesses and conditions makes it more important than ever to protect those who might be adversely affected by the disclosure of this information. As Dr. Francis Collins, head of the National Human Genome Research Institute, notes, "[genetic discrimination] could cause this wonderful revolution fueled by the genome project to actually be stillborn because people would be afraid of getting the information that otherwise be of great advantage to them for medical purposes." (See ABC News article.) Dr. Collins also characterized the bill, as quoted in the title to this blog entry, as "a bill for people with DNA," or a bill for everyone, which may explain at least in part, the bipartisan support. (See New York Times article.)
In short, the bill would bar health insurance companies from using genetic information to deny coverage or to set premiums, and would prohibit employers from using such information to hire or fire workers. Neither insurers nor employers could ask for genetic information or require people to take genetic tests. According to a more detailed summary prepared by the Senate's Health, Education, Labor & Pensions Committee, which originally heard the bill, the bill:
Protects against genetic discrimination from health plans and insurance companies:Supporters say the bill is long past due, given the advances in technology, including the mapping of the Human Genome and the development of tests that can predict whether a patient is vulnerable to a wide array of genetic disorders like breast cancer and neurological ailments like Huntington's disease. But many people shy from the tests that might save their lives or lead to major scientific advances, fearing the loss of health insurance or a threat to their work. Some companies have even started performing genetic testing on their employees, even in the face of much legal uncertainty about whether such testing is legal. Last year, Burlington Northern Santa Fe Railway paid over $2 million to settle claims with employees who after developing symptoms for carpal tunnel syndrome, were forced to submit to genetic testing. (See Reuters article.) The passage of this legislation would prevent such future abuses, and encourage the lawful use of testing to promote scientific advances and better health, rather than impede employees' employment and advancement.
• Prohibits health insurance plans from denying an individual enrollment in the plan because of individual's or family member's genetic information.
• Prohibits health insurance plans from charging higher premiums to individuals because of individual's or family member's genetic information.
• Prohibits health insurance companies from basing premiums of a group health plan on genetic information of members (including family members) of the plan.
Keeps genetic information private:
• HHS privacy rules govern the use and disclosure of genetic information, except this bill also:
• Bans the use and disclosure of genetic information for insurance underwriting purposes.
• Bans the collection (i.e., requesting, requiring, and purchasing) of genetic information for purposes of underwriting.
• Prohibits insurance companies from collecting genetic information prior to enrollment in any plan.
Structure and Enforcement of Health Provisions:
• Creates a single federal standard for protection of genetic information, which does not exist today.
• Generally builds on the existing law framework under HIPAA. In doing so, this ensures that genetic
information is treated consistently with other health information and individuals, who face
discrimination, whether they are healthy, sick or disabled, have the same rights and remedies.
• The non-discrimination provisions are enforced in same manner as current law, however some
procedural protections are established for group health plan participants including the ability to seek
injunctive relief and to have retroactive reinstatement of coverage for violations. Penalties may be
payable to the individual or levied against the plan.
• The privacy provisions are enforced in the same manner as HIPAA privacy rules through HHS Office
of Civil Rights; with the same civil penalty and criminal enforcement structure.
Protects employees from genetic discrimination at the workplace:
• Prohibits the use of genetic information in employment decisions, such as hiring, firing, job
assignments, and promotions.
• Prevents the acquisition and disclosure of genetic information.
• Applies the same procedures and remedies as other forms of employment discrimination, such as race
under the Civil Rights Act of 1964 and disabilities under the Americans with Disabilities Act of 1990.
The bill was first introduced in the Senate in 1997 (1997 version) by Sen. Olympia J. Snowe (R-ME), and then was aimed only at health insurers. While the idea attracted the support of prominent senators such as Sen. Bill Frist (R-TN), now the Republican leader, and Sen. Tom Daschle (D-SD), the Democratic leader, the measure nonetheless languished for several years. Insurers objected to language that they said would prevent them from collecting information that could help them manage the health care of patients with genetic diseases, so that section was removed. While Republicans wanted to limit the bill to health insurers, Democrats wanted to see it expanded to include employers; it now includes employers.
Business groups and insurers still object to the bill, however, which could doom its progress in the more conservative House of Representatives. One insurance group, the Health Insurance Association of America, called the bill "a solution in search of a problem." (See New York Times article.) However, according to Dr. Collins of the Genome Project, fears of discrimination already have deterred potential participants of genetic research projects. In two studies of breast cancer and one of colon cancer, one-third of the individuals who were qualified to participate ultimately declined after hearing that there was no federal law against such discrimination, he said. (See Los Angeles Times article.) More incidents like this are certain to occur without more legal protections for those who participate in such research.
While the bill easily passed the Senate, its fate is more uncertain in the House of Representatives. A similar measure, the Genetic Nondiscrimination in Health Insurance and Employment Act (HR 1910), has been introduced in the House by Rep. Louise McIntosh Slaughter (D-NY), and already has over 140 cosponsors. Even though enacting the Senate bill instead of the House provision would move things forward more quickly, the House may slow things down by requiring that the bill have hearings. This would mean the bill would not pass this year before Congress adjourns, which could happen as early as the end of this month. (See Washington Post article.)
Workers must speak out now to demand that the House take action on the Senate bill this year; otherwise, the bill will languish at least until Congress resumes next January, and most likely even later, given that 2004 is an election year. Ask your representative to push for a vote on the Senate version of the bill this year in our Action Alert, as the House needs to be reminded how important this bill is for both scientific advancement and the protection of workers from discrimination.
Stop Genetic Discrimination: Support The Genetic Information Nondiscrimination Act
More resources on genetic discrimination:
Genetic Alliance Genetic Discrimination Resources
Genetic Information and the Workplace Enacted State Legislation
ACLU Genetic Discrimination in the Workplace Factsheet
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