1-1banner
 
medpundit
 

 
Commentary on medical news by a practicing physician.
 

 
Google
  • Epocrates MedSearch Drug Lookup




  • MASTER BLOGS





    "When many cures are offered for a disease, it means the disease is not curable" -Anton Chekhov




    ''Once you tell people there's a cure for something, the more likely they are to pressure doctors to prescribe it.''
    -Robert Ehrlich, drug advertising executive.




    "Opinions are like sphincters, everyone has one." - Chris Rangel



    email: medpundit-at-ameritech.net

    or if that doesn't work try:

    medpundit-at-en.com



    Medpundit RSS


    Quirky Museums and Fun Stuff


    Who is medpundit?


    Tech Central Station Columns



    Book Reviews:
    Read the Review

    Read the Review

    Read the Review

    More Reviews

    Second Hand Book Reviews

    Review


    Medical Blogs

    rangelMD

    DB's Medical Rants

    Family Medicine Notes

    Grunt Doc

    richard[WINTERS]

    code:theWebSocket

    Psychscape

    Code Blog: Tales of a Nurse

    Feet First

    Tales of Hoffman

    The Eyes Have It

    medmusings

    SOAP Notes

    Obels

    Cut-to -Cure

    Black Triangle

    CodeBlueBlog

    Medlogs

    Kevin, M.D

    The Lingual Nerve

    Galen's Log

    EchoJournal

    Shrinkette

    Doctor Mental

    Blogborygmi

    JournalClub

    Finestkind Clinic and Fish Market

    The Examining Room of Dr. Charles

    Chronicles of a Medical Mad House

    .PARALLEL UNIVERSES.

    SoundPractice

    Medgadget
    Health Facts and Fears

    Health Policy Blogs

    The Health Care Blog

    HealthLawProf Blog

    Facts & Fears

    Personal Favorites

    The Glittering Eye

    Day by Day

    BioEdge

    The Business Word Inc.

    Point of Law

    In the Pipeline

    Cronaca

    Tim Blair

    Jane Galt

    The Truth Laid Bear

    Jim Miller

    No Watermelons Allowed

    Winds of Change

    Science Blog

    A Chequer-Board of Night and Days

    Arts & Letters Daily

    Tech Central Station

    Blogcritics

    Overlawyered.com

    Quackwatch

    Junkscience

    The Skeptic's Dictionary



    Recommended Reading

    The Doctor Stories by William Carlos Williams


    Pox Americana: The Great Smallpox Epidemic of 1775-82 by Elizabeth Fenn


    Intoxicated by My Illness by Anatole Broyard


    Raising the Dead by Richard Selzer


    Autobiography of a Face by Lucy Grealy


    The Man Who Mistook His Wife for a Hat by Oliver Sacks


    The Sea and Poison by Shusaku Endo


    A Midwife's Tale by Laurel Thatcher Ulrich




    MEDICAL LINKS

    familydoctor.org

    American Academy of Pediatrics

    General Health Info

    Travel Advice from the CDC

    NIH Medical Library Info

     



    button

    Friday, January 13, 2006

    Taken to Extremes: Some companies have taking to firing people for smoking - at home. There's an awful lot of hue and cry about our loss of freedoms at the hands of the Bush Administration, but it seems that there's much more loss of freedom at the hands of medicine. It's an example of medical advice taken to an extreme. Yes, smoking is bad for you, but it shouldn't automatically deprive you of the ability to make a living. And it leaves open the question of what they'll fire people for next - failure to walk two miles a day? Drinking too much caffeine?

    P.S. And you know, this would never be an issue if we had a system in which people paid for their own health insurance instead of relying on employers to provide it.
     

    posted by Sydney on 1/13/2006 08:48:00 AM 9 comments

    9 Comments:

    This is a question of bottom line not health advice. The company is private and can essentially hire or fire anyone it wants - as long as it is not discriminates against protected groups. If it didn't like women with ponytails it could've told women to stop wearing ponytails or be fired.

    Smokers is not a protected group and their medical costs are higher. So the guy is trying to control his costs. He has right to do it.

    By Anonymous Anonymous, at 10:32 AM  

    There should be a 3 strikes your out rule regarding smoking. Getting kicked out of your health plan or even fired from your job is very serious. There needs to be a system in place to deal with such matters. Sure, I see it from the side of the payors and employers who offer insurance plans; however, I see it also from a social perspective. Kick this guy off of your plan or even worse, fire him, will only make matters worse without first having him go through a process (such as a smoking cessation program, etc.). Now that the guy is fired and the economy is terrible with jobs hard to come by (not sure of his field of work) he'll apply for state assistance and we'll all have to pay for his health care. Do you really think firing a person is going to "teach him a lesson" and actually quit smoking? Think again. Just take a look at the statistics for repeat offenders and our justice system. What a laugh.

    By Anonymous Anonymous, at 2:36 PM  

    I wonder how long it’s going to take for some lawyer to file a class action suit over this for failure to pay owed wages? As much as I dislike smoking and frivolous lawsuits, I almost want it to happen to Scotts.

    Consider this idea, if a company can tell you what to do (or not do), 24 hours a day, aren’t you really on the clock 24 hours a day? That would mean that you were entitled to 168 hours of pay a week, 232 counting time and a half for over time.

    Come to think of it, since they are under company orders 24/7, I wonder how much liability the company is now taking on for their employees’ actions off work property? I smell the possibility for more law suites.

    Seriously though, this is pure abuse. The Scotts ’ company has telling it’s employees what to do off company property when they are not paying them. I, for one, am going to stop using products and let them know why. Unfortunately, since most people won’t care (at least until their employer starts taking away a right they care about), Scotts’ and other companies will do what they want. And while it’s smoking today, it’ll be other things tomorrow.

    By Anonymous Anonymous, at 10:07 PM  

    I wonder how long it’s going to take for some lawyer to file a class action suit over this for failure to pay owed wages? As much as I dislike smoking and frivolous lawsuits, I almost want it to happen to Scotts.
    I am not a lawyer, but I saw a program on TV once about it and it featured interviews with lawyers. They said the employees don't have a case as they don't a written contract. If this was a government job or if the employees were members of a union - there might've been different rules. But an owner of a private company can hire and fire whom he wants - as long as he doesn't discriminate against a protected group e.g. he cannot fire somebody based on age, race, sex, but he can fire somebody for pretty much any other reason, including no reason at all.
    As far as somebody being uneployed as a result and having to collect government money - the job will simply go to somebody else who used to be unemployed. Net result to society is the same.

    We don't own our jobs. I've worked for 20+ years with the company that promised job security when I started. But they no longer promise anything. If they want to fire me tomorrow because people in India can do my job for 1/10 of my salary - they can do it. If they want to fire me because they don't like how I dress or smell or whatever, they can do it. They don't need to give a reason - "your position is eliminated" will work just fine. Even when employees have a real case - e.g. if I am fired and a younger person right out of graduate school is hired in my place - it is often very difficult to prove.

    Smoking is no exception. You don't like it - get a government job or choose a profession that has a union or create your own company. You can even create a company that only hires smokers and that competes with your old company.

    By Anonymous Anonymous, at 11:21 AM  

    Anonymous,
    I think that you missed my point. I was talking about a law suit on behalf of the people still working for Scotts', not the ones who get fired for smoking. They are doing work for the company 24 by 7 (not smoking), but are not being paid for it. If this legal theory were to be upheld, then it would be a violation of federal labor laws. (Well for the non-exempt employees.) It has nothing to do with contracts.

    Now I don't really think that anyone will try this tact, but it does illustrate a point. Under your way of thinking, it would be OK for a company to order it's employees to spend an hour a day (unpaid) exercising, or to vote a certain way, or to campaign for a certain candidate, or so on. All of these things could be in the interest of the company.

    The question is as a society if we want to tolerate having corporations dictate how people live their lives outside of work. On the clock, companies have every right to say if people smoke at work (I wish my employer would stop smoking on company property) or bring fatty food onto company property or what they wear to work or what languish they speak . Heck, if they want to make an hour of jogging part of the job, that’s fine as long as it’s done on the clock.

    I personally don’t think that this sort of behavior should be tolerated from companies. Now being of a libertarian leaning, I would favor boycotting companies like Scotts over government action, but I doubt that enough people will care to make one effective. Having health insurance bough directly by people instead of employers would help take away some of the incentive for this kind of abuse too.

    Still, that opinion and a couple of dollars will get you a cup of coffee….. if your employer isn’t conducting urine tests for caffeine this week.

    Oh, and by the way, I have worked for both private and government employers, and this sort of thing happens in both environments.

    By Anonymous Anonymous, at 4:47 PM  

    From Anon 11:21:
    Under your way of thinking, it would be OK for a company to order it's employees to spend an hour a day (unpaid) exercising, or to vote a certain way, or to campaign for a certain candidate, or so on.
    Actually, I didn't say that I liked what this company was doing; only that they have a legal right to fire anybody. But you are right, I missed your point of your post. After I read it and read the article again, I agree with you.

    One other thing that buged me about this article is that they require health assessment from web MD mentioned and make people discuss the results with counselors. This is scary because this assessment asks questions that are private.
    The company I work for used to have a non-smoking rebate - they would give a small amount of money to people who don't smoke or "promise" to quit. I don't smoke, so I was fine with it.
    Now they changed it to "healthy living rebate" in which you use the WebMD assessment, get feedback from the website - they claim it is private - and specify some dates by which you fix "problems". If you do it you get some money. The thing that bugs me about the whole thing is that "healthy living" includes "doing recommended screening tests". And webMD questionnair doesn't appear to use USPTF recommendations, but more stringent ACS recommendations.
    This bothers me because 1) whether or not someone has tests and what the results are(asked on the is private 2) screening has benefits and risks and the decision should be individually and not because of money 3) most screening is not cost-effective, so it doesn't make sense for company to have a stake in it - that is beyond paying for it 3) if at the moment they simply provide incentives, tomorrow they may start forcing people - since it is obvious that powers-that-be don't do math well enogh to know it is not cost effective. When I read the article and saw this health assessment from webMD and had somebody discuss the results, I started to wonder if this company will be forcing people to do tests next - although this will probably be illegal.
    At any rate, you do have a point here.

    By Anonymous Anonymous, at 7:09 PM  

    If people had to pay for their insurance completely .. I pretty much believe rates would have to go down..because people would be going without health care.. we pay 210 every two weeks for health insurance for two people starting jan 1 (along with whatever my husbands employeer pays).. the only reason this is remotely a good price is my chronic health conditions.. one more raise in rates and I will be forced to relay on my Medicare alone which wont even begin to cover costs IF I can find doctors that take it.. many in this area have stopped accepting it to due to the low rates paid. and yes I think the employer will eventually be sued.. we have one in courts now where employees were fired for having firearms in their cars on company property. lol.

    By Anonymous Anonymous, at 11:13 PM  

    OK, your rate is pretty low - maybe because you have medicare. A single 50-year old friend of mine who is a dental assistant could only find the insurance for $400 a month. And that's not the best one, althought not the worst one either. The only reason she can afford one is that her employer agreed to pay half. Now $400 a month is a bit difficult for a dental assistant especially considering that it is impossible to rent anything here not even a studio for under $900. That is you can find a studio - a one bedroom would be over $1200.
    A big advantage of employer-sponsored insurance is that at least in case of large corporations like mine, they get a group rate. Also, some corporations provide their own insurance.
    With a large group you are not likely to see insurance going up if a few people get really sick. Whereas with individual insurance, you may see a rate hike when you get really sick - exactly when you need the insurance. It is also a better deal for insurance companies as they have a group where the majority of people is healthy.

    By Anonymous Anonymous, at 10:48 AM  

    re:anon@2:36pm

    you really think you have a justice system?

    By Anonymous Anonymous, at 3:30 PM  

    Post a Comment

    This page is powered by Blogger, the easy way to update your web site.

    Main Page

    Ads

    Home   |   Archives

    Copyright 2006