The Affordable Care Act debate reminds me of arguments in favor of and opposed to the coordination of occupational health and safety (OH&S) protections with worksite health promotion programs.
Regardless of how split the nation and the Supreme Court are on the issue of mandated health insurance coverage, whole people will keep working for entire companies, not parts of them.
And whether or not employers offer their employees personal health insurance coverage, they will still be on the hook for workers’ compensation costs, which have a direct correlation with injury and illness prevention and overall workforce well-being.
The rational for “wholeness” is thoroughly discussed in three influential white papers compiled by the National Institute for Occupational Safety and Health (NIOSH).
In one of the papers, on The Economics of Integrating Injury and Illness Prevention, prominent economists Darius Lakdawalla, Robert Reville and Seth Seabury (all formerly affiliated with the non-profit policy analysis organization RAND Corporation) discuss how employers might be expected to respond to certain provisions of the Affordable Care Act.
On one hand, they suggest that expanded employer-provided health coverage could “increase the incentives of employers to invest in health promotion.” In addition, they note that integrated OH&S and health promotion efforts could receive a boost from an apparent trend for employers to penalize/reward employees for health-related behaviors that are linked to chronic disease, such as smoking.
On the other hand, if employers react to the insurance mandate by dropping healthcare coverage, they would be less motivated to invest in integrated programs because they would not be directly carrying the healthcare cost burden. In that case, “some kind of public policy intervention would likely be required in order for integration to be successful,” the economists theorize.
They conclude that “while the potential benefits and challenges to integration change as the institutional environment of healthcare in the United States changes, the fundamental principles remain sound, and the model can be extended to represent whatever institutional framework emerges.”
Originally written in 2004, the papers in the compendium were updated by their authors and published by NIOSH to mark the first anniversary of its Total Worker Health™ program in June. As its name implies, Total Worker Health supports research to discover the best ways to break down stubborn euphemistic “silos” and connect disparate OH&S and health promotion functions to enhance overall worker well-being and business performance.
In releasing the papers, NIOSH Director Dr. John Howard said the federal government’s leading OH&S research organization believes that integrating the protection of worker health and safety with evidence-based health promotion will be a key strategy for building a strong economy on the foundation of safe jobs and healthy workers.
The papers should be thought-provoking for any employer who is interested in forging stronger alliances among health, safety, environment, risk management and human resource professionals in their organizations.
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