Category Archives: health care

A Surprise Billing Law May Have Unintended Effects on Health Care

Posted on by

From today’s NPR News Online:

Patients are months away from not having to worry about most surprise medical bills — those extra costs that can amount to hundreds or thousands of dollars when people are unknowingly treated by an out-of-network doctor or hospital.

The No Surprises Act — which takes effect Jan. 1 — generally forbids insurers from dropping such bills on patients and, instead, requires health care providers and insurers to work out a deal between themselves.

Some observers have speculated that the law will have the unintended consequence of shifting costs and leading to higher insurance premiums.

Many policy experts told KHN that, in fact, the opposite may happen: It may slightly slow premium growth.

The reason, said Katie Keith, a research faculty member at the Center on Health Insurance Reforms at Georgetown University, is that a new rule released Sept. 30 by the Biden administration appears to “put a thumb on the scale” to discourage settlements at amounts higher than most insurers generally pay for in-network care.

That rule, which provides more details on the way such out of network disputes will be settled under the No Surprises Act, drew immediate opposition from hospital and physician groups. The American Medical Association called it “an undeserved gift to the insurance industry,” while the American College of Radiology said it “does not reflect real-world payment rates” and warned that relying on it so heavily “will cause large imaging cuts and reduce patient access to care.”

Read the complete story here.

Unions Fighting Vax Mandates Endanger Public Health & Economic Recovery

Posted on by

From today’s New York Times:

As New York pushes forward with some of the toughest and farthest-reaching vaccine mandates in the nation, thousands of health care workers in the state appear to be willing to be fired rather than get vaccinated.

So, too, do thousands of people who work in New York City’s public schools.

How sad that many of these vaccine holdouts are supported by their unions. Talk about a lack of solidarity.

For years, these unions defended the health and safety of their members. They fought for better wages and protected workers’ rights. They built the middle class. Now they are fighting state and city vaccine mandates aimed solely at keeping workers and communities safe and healthy. So much for the old union idea that an injury to one is an injury to all.

At least city and state government officials have the best interests of the public in mind, even if some in the labor movement have forgotten which side they’re on.

The state’s mandate, requiring vaccination of health care workers, went into effect at midnight on Monday. The city’s, which requires the same of all Department of Education employees, goes into effect at 5 p.m. on Friday. A court upheld the city mandate on Monday.

Some unions, like New York’s nurses’ union, took a reasonable approach, expeditiously negotiating over the vaccine mandate and fighting for other workplace safety measures related to the pandemic, like proper protective gear. Local 32BJ, a New York unit of the Service Employees International Union, which represents health care aides, janitors and many other lower-wage employees, has taken a similar approach and pushed hard to vaccinate its members.

But other New York unions have sought to stymie or delay the vaccine mandates. Some have argued that vaccination shouldn’t be a condition of employment at all.

Read the complete story here.

Families Harmed By SoCal Gas Methane Leak Reach $1.8 Billion Settlement

Posted on by

From today’s NPR News Online:

Thousands of families sickened and forced from their Los Angeles homes after the nation’s largest-known natural gas leak have reached a settlement of up to $1.8 billion with a utility, attorneys said Monday.

The settlement with Southern California Gas Co. and its parent company, Sempra Energy, will compensate 35,000 plaintiffs from the 2015 blowout that took nearly four months to control.

The Aliso Canyon blowout led to the largest-known release of methane in U.S. history and was blamed for sickening thousands of residents who moved out of homes near the San Fernando Valley to escape a sulfurous stench and maladies including headaches, nausea and nose bleeds.

The plaintiffs alleged personal injury for their illnesses and property damage to their homes. SoCalGas spent more than $1 billion on the the blowout — with most going to temporarily relocate 8,000 families. The utility has faced more than 385 lawsuits on behalf of 48,000 people.

Plaintiffs alleged they suffered personal injury and property damage after a natural gas storage well failed and uncontrollably released nearly 100,000 tons of methane and other substances into the atmosphere over 118 days.

SoCalGas said it would record an after-tax charge of approximately $1.1 billion this month and expects total settlement payments of up to $1.85 billion. The agreement is subject to about 97% of plaintiffs accepting it and could be reduced if fewer agree.

Matt Pakucko, founder of Save Porter Ranch, issued a statement repeating his call for the permanent shutdown of the facility, where natural gas is stored beneath a mountain in vacant, old oil wells.

“You can’t put a price tag on human suffering,” he said. “SoCalGas’ devastating blowout will never be behind us until the Aliso Canyon storage facility is shut down and the danger it poses to the community is permanently eliminated. We are nowhere near a resolution.”

Read the complete story here.

California should pass AB1119 to protect the work rights of family caregivers

Posted on by

From today’s Los Angeles Times:

As travel ground to a halt in April 2020, the janitorial staff at a hotel chain were furloughed. When business resumed, everyone was called back — everyone, that is, except the mothers.

In a pandemic layoff at another company, only two people lost their jobs — one was a new mother, the other was on maternity leave.

When a woman complained about insufficient COVID-19 protection at a warehouse distribution center, her bosses retaliated by rescheduling her, making it nearly impossible for her to supervise her children’s remote schooling and do her job at the same time.

We see discrimination against parents at the UC Hastings Law School Center for WorkLife Law during normal times, but calls to our hotline increased sevenfold as COVID-19 took hold.

It’s no news that workers are vulnerable because of the weakness of American employment laws, but it may be news that their family responsibilities may put them at greater risk.

Employers prefer “ideal” workers, the kind whose home lives don’t impose on workdays or require even occasional flexibility. The pandemic upended the notion that cookie-cutter rigidity is a work prerequisite, but it also gave some bosses cover to stick with the old mindset, as the workers who’ve been calling us discovered.

California is considering legislation that would push such employers into new thinking.

Assembly Bill 1119, now under committee consideration, would amend the state’s Fair Employment and Housing Act in two ways: It would make it illegal for employers to discriminate against people seeking, obtaining and holding work based on family caregiving responsibilities. And it would require employers to give regular caregivers — those with “direct and ongoing” responsibilities for children and other family members — simple accommodations, such as the right to arrive a few minutes late when school or childcare becomes unexpectedly unavailable, unless the accommodation imposes an undue hardship on the employer.

Read the complete article here.

Health Advocate or Big Brother? Companies Weigh Requiring Vaccines

Posted on by

From today’s New York Times:

As American companies prepare to bring large numbers of workers back to the office in the coming months, executives are facing one of their most delicate pandemic-related decisions: Should they require employees to be vaccinated?

Take the case of United Airlines. In January, the chief executive, Scott Kirby, indicated at a company town hall that he wanted to require all of his roughly 96,000 employees to get coronavirus vaccines once they became widely available.

“I think it’s the right thing to do,” Mr. Kirby said, before urging other corporations to follow suit.

It has been four months. No major airlines have made a similar pledge — and United Airlines is waffling.

“It’s still something we are considering, but no final decisions have been made,” a spokeswoman, Leslie Scott, said.

For the country’s largest companies, mandatory vaccinations would protect service workers and lower the anxiety for returning office employees. That includes those who have been vaccinated but may be reluctant to return without knowing whether their colleagues have as well. And there is a public service element: The goal of herd immunity has slipped as the pace of vaccinations has slowed.

But making vaccinations mandatory could risk a backlash, and perhaps even litigation, from those who view it as an invasion of privacy and a Big Brother-like move to control the lives of employees.

In polls, executives show a willingness to require vaccinations. In a survey of 1,339 employers conducted by Arizona State University’s College of Health Solutions and funded by the Rockefeller Foundation, 44 percent of U.S. respondents said they planned to mandate vaccinations for their companies. In a separate poll of 446 employers conducted by Willis Towers Watson, a risk-management firm, 23 percent of respondents said they were “planning or considering requiring employees to get vaccinated for them to return to the worksite.”

Read the complete article here.

Labor Secretary Says Gig Workers Should Be Converted to Employees

Posted on by

From today’s Forbes Magazine:

President Joe Biden positioned himself as the champion of the American worker during his campaign, as well as an ardent proponent of unions. On Thursday, Biden’s Labor Secretary, Marty Walsh, told Reuters that gig workers should be treated as employees.

This simple statement could become an existential threat to app-based technology companies, such as Uber, Lyft, Instacart, DoorDash and dozens of others that heavily rely upon gig-economy workers.

The tech companies are basically built on the backs of contract workers. However, these gig workers are not classified as employees. Without the designation, contractors don’t qualify for traditional benefits, rights and privileges that are afforded to full-time permanent employees.

This sector represents a significant part of the economy. About 55 million Americans work in the gig economy, comprising around 36% of the workforce. If the Biden administration decides to take action based upon Walsh’s plan, it could have devastating consequences. 

Walsh seeks to rectify the situation by reclassifying contract workers as “employees.” The labor secretary said, “We are looking at it, but in a lot of cases, gig workers should be classified as employees…in some cases they are treated respectfully and in some cases they are not and I think it has to be consistent across the board.” Based upon this news, shares of Uber fell as much as 8%, while Lyft took a dive by 12%. Doordash fell nearly 9% and Grubhub was down 3.3%.

There are concerns raised by opponents of the gig-economy structure who say, similar to Walsh, it doesn’t seem fair to workers. Venture capitalists, institutions and wealthy individuals have flooded capital into this sector. When the tech companies went public, the investors, CEOs and top executives reaped vast fortunes. Contractors serve as cheap labor. If they acquiesce to critics like Walsh, they risk losing multimillions or billions of dollars. 

While many people earn a livelihood driving cars, delivering food and offering creative services through on-demand companies, there is a dark side. The contractors work long, hard hours for little pay and no real benefits. Near-monopolies have been created that crush or drive out the competition. Look at what happened to the once-ubiquitous yellow taxi cabs when Uber came to New York City. 

Uber, Lyft, DoorDash, Grubhub and other similar gig-based companies are highly dependent upon independent contractors. They have a financial self-interest in classifying drivers or workers as contractors. This model enables corporations to avoid paying payroll taxes, FICA (Social Security and Medicare), disability, federal and state-level unemployment and health insurance benefits. They are not required to comply with minimum-wage laws nor offer vacation days. 

Read the complete article here.

Coronavirus: Retail workers ‘scared’ as cases surge during U.S. holidays

Posted on by

From BBC News Online:

They are calling for hazard pay, paid sick leave and better communication about outbreaks, among other things. The campaign comes as workers across the US have spoken out about condition and concerns over their health.

“Associates like me are scared,” said Walmart worker Melissa Love.

The workers rights campaign launched on Monday was organised by United for Respect, a workers rights non-profit that says it represents more than 16 million people across the US. Separately, the labour union UFCW, whose members include grocery and meatpacking plant workers, also called on employers to do more to protect staff.

“Simply put, frontline workers are terrified because their employers and our elected leaders are not doing enough to protect them and stop the spread of this virus,” UFCW International President Marc Perrone said.

“As holiday shopping begins this Thanksgiving, we are already seeing a huge surge of customer traffic. Unless we take immediate actions beginning this holiday week, many more essential workers will become sick and more, tragically, will die.”

Ms Love, a member of United for Respect who has worked at Walmart for five years, said on a call organised for reporters that she feared a rush of holiday shoppers could turn Walmart into a “super-spreader” hub.

“Working Black Friday this year comes with an obvious danger,” said Ms Love, who is based in California. “I do not believe Walmart should be trying to entice crowds into our stores on Friday and risk a super-spreader event.”

Read the complete article here.

Supreme Court ruling allows plan for religious limits to Obamacare contraceptive coverage

Posted on by

From today’s NBC News Online:

The U.S. Supreme Court on Wednesday cleared the way for the Trump administration to give the nation’s employers more leeway in refusing to provide free birth control for their workers under the Affordable Care Act.

The ruling is a victory for the administration’s plan to greatly expand the kinds of employers who can cite religious or moral objections in declining to include contraceptives in their health care plans. Up to 126,000 women nationwide would lose birth control coverage under President Donald Trump’s plan, the government estimated. Planned Parenthood said nearly nine in 10 women seek contraceptive care of some kind during their lifetimes.

The Affordable Care Act, better known as Obamacare, gives the government authority to create the religious and moral objections, said Justice Clarence Thomas for the court’s 7-2 majority. The Department of Health and Human Services “has virtually unbridled discretion to decide what counts as preventive care and screenings,” and that same authority “leaves its discretion equally unchecked in other areas, including the ability to identify and create exemptions from its own guidelines,” he said.

In dissent, Justices Ruth Bader Ginsburg and Sonia Sotomayor said the court in the past has struck a balance in religious freedom cases, so that the beliefs of some do not overwhelm the rights of others.

“Today for the first time, the court casts totally aside countervailing rights and interests in its zeal to secure religious rights to the nth degree” and “leaves women workers to fend for themselves” in seeking contraceptive services, they said.

Women’s groups condemned the ruling. The National Women’s Law Center said more than 61 million women get birth control coverage through Obamacare.

“The Supreme Court’s decision will leave their ability to receive this critical coverage at the whim of their employers and universities,” the group said. “This decision will disproportionately harm low-wage workers, people of color, LGBTQ people, and others who already face barriers to care.”

Read the complete article here.

Employer-Based Health Care, Meet Massive Unemployment from Pandemic

Posted on by

From today’s New York Times:

In the early months of 2020, Americans were engaged in the perennial election-year debate over how best to reform the nation’s health care system. As usual, the electorate was torn and confused. Polling indicated that a small majority of likely voters favored a new universal system that would cover everyone. But that support evaporated when it was made clear that any such overhaul would involve abolishing the private insurance market. At the time, nearly 160 million Americans received their health benefits through an employer, and the vast majority of them liked that coverage just fine — maybe not enough to sing about it, but enough to be wary of a potential replacement.

Then came the pandemic of the century. And the highest level of unemployment since the Great Recession. And the most concentrated wave of job loss in the nation’s history — more than 40 million Americans filed new unemployment claims between mid-March and late May. It will take time to ascertain the full impact of those losses on the nation’s health insurance rate, but an early survey from the Commonwealth Fund is not encouraging: 41 percent of those who lost a job (or whose spouse lost a job) because of the pandemic relied on that job for health insurance; 20 percent of those people have not managed to secure alternative coverage.

Nothing illuminates the problems with an employer-based health care system quite like massive unemployment in the middle of a highly contagious and potentially deadly disease outbreak. For one thing, uninsured people are less likely to seek medical care, making this coronavirus that much more difficult to contain. Also, people with chronic or immune-compromising medical conditions are particularly susceptible to this new contagion — which means the people most in need of employer-sponsored health benefits are the same ones who can least afford to return to work at the moment.

“The pandemic has amplified all the vulnerabilities in our health care system,” says Drew Altman, president of the nonpartisan Kaiser Family Foundation, including “the uninsured, racial disparities, the crisis of unmanaged chronic conditions and the general lack of national planning.”

As dire as the crisis is, though, it’s also an opportunity to look at health care reform with fresh eyes — and to maybe, finally, rebuild the nation’s health care system in a way that works for all Americans, not just the wealthy and the well employed.

The first step will be acknowledging the problems of our current system. If American health care were its own country, it would be the fourth largest in the world by gross domestic product. The nation spends an average of $3.5 trillion per year on health care — more than Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain and Australia combined — and still loses more people to preventable and treatable medical conditions than any of those countries do.

In other words, America has created the most expensive, least effective health care system in the modern world, and the most vulnerable Americans have been paying for that failure with their lives since long before the coronavirus came to town.

Read the complete article here.

How COVID-19 turned a spotlight on weak worker rights in the U.S.

Posted on by

From today’s Harvard Gazette:

As the economy reopens after the COVID-19 shutdowns, businesses are taking a varied, often patchwork approach to ensuring health and safety for their workers, and much uncertainty persists regarding employers’ obligations and employees’ rights. The Gazette spoke with labor law experts Sharon Block, executive director of the Labor and Worklife Program, and Benjamin Sachs, the Kestnbaum Professor of Labor and Industry at Harvard Law School (HLS), about how the pandemic has turned a spotlight on the lack of clear workplace protections in general, and in particular for women and people of color, who were disproportionately represented among those deemed essential. Block and Sachs recently co-authored a report urging that U.S. labor law be rebuilt from the ground up. On June 24, they will release the report “Worker Power and Voice in the Pandemic Response.”

Q&A: SHARON BLOCK AND BENJAMIN SACHS

GAZETTE: What do you think the COVID-19 crisis has revealed about working conditions in the United States?

BLOCK: What it has revealed is something that many of us have known for a long time, but it’s been revealed in a much more urgent way, and it is how tattered our social safety net is in this country. That plays out in in a number of ways: for example, how inadequate our supports for workers are in terms of unemployment insurance. Just look at the desperate circumstances now more than 40 million workers have found themselves in. That’s been the reality for many low-wage workers, not on a mass scale, but that’s been their lived experience, even throughout a time when we thought we were in an expanding economy. The other side that has been exposed is that for workers who have been deemed essential and have worked throughout this crisis, how little protection they have in the workplace to be able to stand up for themselves, to say that their conditions are unsafe and they’re not being paid adequately for the important work they’re doing. On all sides of the social safety net and the ability of low-wage workers to have a decent life, what we’re seeing in myriad ways is how the system has failed workers.

SACHS: I would just add how weak the protections are for workers who stand up and demand safe, healthy, and fair working conditions, and how easy it is to fire workers who do that. It has also shown how badly broken our system of labor law is, which is to say that our system doesn’t give workers a voice so that the only recourse workers have is to take to the streets, and how little opportunity they have for an institutional structure of communication and demand-making. The other thing that Sharon and I would like to stress is how the crisis is being borne disproportionately by workers of color and women, which is another failing of our labor market and our system of labor law.

GAZETTE: Why are workers of color and women bearing the brunt of the coronavirus crisis? What role do the labor market and the labor law system play in it?

BLOCK: This is the result of the broken safety net we have. These are workers who are deemed essential, but the law has not treated as essential. They don’t have basic rights or the law doesn’t adequately address their situation. For lots of low-wage workers who are in these essential industries, the current labor law is particularly broken. They really have almost no real access to being able to act collectively and have the law recognize that and thereby give them power to affect their situation at work. As Ben said, they are predominantly workers of color and women, and that’s a big piece of why this pandemic has hit them so hard. We’re really seeing this connection that a lot of people intuitively knew, but hopefully more people understand now, which is that it is hard to separate economic issues and public health issues and issues of physical well-being. It’s not an accident that most people who are getting sick are poor or paid low wages.

Read the complete article here.