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  • ACOEM Calls on HHS Secretary-designee Daschle to Address Critical Link Between Worker Health, Safety, and Productivity

    January 8, 2009

    Honorable Tom Daschle
    Department of Health and Human Services
    c/o President-Elect Obama Transition Team
    451 6th Street, NW
    Washington, DC 20001

     Dear Senator Daschle:  

    On behalf of the American College of Occupational and Environmental Medicine (ACOEM), I am writing to congratulate you on your selection by President-elect Obama as Secretary of the Department of Health and Human Services. I applaud the work you are doing to organize the new administration’s health care reform initiatives.

    We believe it is essential that health care reform, as part of economic reform, address the compelling link between the health, safety and productivity of America’s workers to our economy as well as to the health care system; and the critical need to invest strategically in preventive health care to empower the vitality of the United States economy.

    This strategy will provide a solid basis for guiding public policy in healthcare reform. Without a new emphasis on the health of workers, the United States’ health care system will be incapable of sustaining itself in the near future. The United States faces a stark reality: In the next several years, it will begin to feel the seismic repercussions of its flawed health policies, combined with massive demographic and economic trends. The transition of 80 million baby boomers into retirement age and a documented increase in chronic disease represent the arrival of a “silver tsunami” that will seriously impact the nation’s ability to remain productive and competitive in the global economy. All sectors of the health care system are drifting towards a fiscal and social waterfall – and we are approaching it more rapidly than ever.

    At this time of crisis in the financial capital markets, growth in the U.S. economy will come from investments in human capital – in a healthy and productive workforce. The creativity and productivity of the workforce will sustain organic growth in businesses since they cannot depend on growth based on investment in plant and equipment or through mergers and acquisitions.

    Moving the health agenda forward by focusing on prevention in the workplace and in the community has the added benefit of addressing the vital issue of America’s global competitiveness. Therefore, urgent action is required, focusing on a new prevention paradigm that values health as an investment to be leveraged rather than a cost to be justified. A healthy and productive workforce is inextricably linked to healthy people, healthy communities and a healthy economy.

    Preventive strategies that focus either on the individual or the individual’s environment can cost-effectively reduce adverse health conditions, preserve function, or enable employment. Health promotion, health education, hazard recognition, nutritional support, prenatal care, and immunizations are all examples of primary prevention strategies. Screening and early detection programs are secondary prevention strategies because they can identify and address problems at an early stage when prompt action can be curative or prevent progression. Evidence-based disease management, care management, disability management and return to work programs are tertiary prevention strategies because they can limit the destructive and disruptive impact of serious medical conditions on function in daily life and work, can protect or restore productive lifestyles, and can reduce future costs.

    There are four fundamental principles that we believe are critical for the Value of Prevention that should be considered in the economic stimulus legislation and in health care reform.

    • Build on the twin pillars of the community and the workplace: Invest in programs that promote primary, secondary and tertiary prevention in the workplace and in the community. Individuals do not leave the impacts of their personal health risks on the doorstep when they leave for work, just as they cannot leave the impacts of their workplace exposures when they return home.
    • Establish a clear national priority for investment in programs to assure a healthy, able, and available workforce: The prevention of disease, impairment, and disability on the working age population cannot be seen as discretionary. Spending on prevention must become a priority because evidence-based preventive services offer a return on investment.
    • Provide financial incentives to shift individuals and employers toward primary, secondary and tertiary prevention: Provide incentives for individuals to seek and employers to provide prevention (wellness, early detection and early intervention) programs. Incentivize prevention and health management strategies, including health promotion; addressing risk factors and early indicators to prevent progression to disease; preserving or restoring function; and protecting employability.
    • Provide funding to expand the supply of health professionals that are educated and trained in prevention: There currently is a shortage of health professionals needed to implement and provide integrated prevention strategies in the community and in the workplace.

    These principles are discussed in more detail in the enclosed ACOEM guidance statement, Healthy Workforce, And Healthy Economy: The Role of Health, Productivity and Disability Management in Addressing the Nation’s Health Care Crisis. 

    The American College of Occupational and Environmental Medicine (ACOEM) is the nation’s largest medical society devoted to promoting the health of workers, their families, and communities through preventive medicine, clinical care, research, and education. ACOEM represents nearly 5,000 physicians and other health care professionals specializing in the field of occupational and environmental medicine (OEM). ACOEM members practice in diverse settings including large industry with multi-plant operations, medium and small sized companies, private practice, hospital-based OEM programs, government agencies, and academia.

    ACOEM is a recognized leader among medical professional societies for its commitment to enhancing worker health and productivity; preventing work-related illness and injury; and advocating effective and outcome-oriented medical care. As a member of the American Medical Association’s House of Delegates, ACOEM works closely with other primary care disciplines, including family practice and internal medicine.

    Senator Daschle, a public investment in the health and productivity of working-age populations through a new preventive-based paradigm centered in the workplace is a public health imperative.

    In closing, ACOEM looks forward to working with you to enact comprehensive health care reforms. Please contact Patrick O’Connor, ACOEM’s Director of Government Affairs, if you have additional questions or need additional information. He can be reached at 202-223-6222 or by email at patoconnor@kentoconnor.com.

    Robert R. Orford, MD

    cc:           Honorable Edward Kennedy
                    Honorable Tom Harkin
                    Honorable Mike Enzi
                    Honorable Max Baucus
                    Honorable Charles Grassley
                    Honorable Henry Waxman
                    Honorable Joe Barton
                    Honorable John Dingell