Although the immediate future of healthcare reform remains uncertain, it is clear that significant long-term improvements to American healthcare will require effective methods of controlling healthcare costs that go beyond those currently being proposed. The United States lags behind many European countries in health, spending much more of its GDP on healthcare while posting worse health outcomes, largely due to the increased prevalence of preventable chronic conditions. This article exposes an important but often ignored component of European preventive healthcare: the law of workplace health and safety, which imposes on employers the positive duty to identify and prevent harms to workers’ health. In France, this duty is carried out through a comprehensive system of occupational medicine, required by the Labor Code, requiring all employees to be examined by a workplace doctor on a regular basis. The workplace doctors make individual and policy recommendations to employers to minimize risks to employee health, and monitor the workplace to identify and address these risks. To optimize the doctor’s ability to protect employees’ health, the law protects the doctors’ independence from the employer through the formalization of medical ethics rules and special procedures for firing the doctor. The French model of occupational medicine as public health policy demonstrates the importance of integrating a more robust law of workplace health and safety into the project of healthcare reform. This insight is particularly relevant to current U.S. practice, as employers are increasingly establishing onsite workplace medical clinics focusing on preventive medicine to reduce healthcare costs. The French model cannot easily be transplanted on American soil, but it highlights the public health potential of employer-provided onsite clinics. To control costs and improve health outcomes, a new direction in healthcare reform should include the revitalization of workplace health and safety regulation.
- healthcare reform,
- comparative public health policy,
- employment law,
- workplace health and safety
Available at: http://works.bepress.com/julie_suk/3/