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  • ACOEM Congratulations New Secretary of Labor Solis/Urges Investment in New Preventive-based Paradigm Centered on Worker Health and Productivity

    March 2, 2009

    The Honorable Hilda L. Solis
    Department of Labor
    200 Constitution Avenue, NW
    Washington, DC 20210

    Dear Secretary Solis:  

    On behalf of the American College of Occupational and Environmental Medicine (ACOEM), I am writing to congratulate you on your confirmation as the Secretary of Labor. In your position, you will have the opportunity to emphasize the important relationship between health and workplace productivity as the Administration and Congress consider reform of the health care system.

    The health of the workforce is inextricably linked to the productivity of the workforce and therefore, ultimately linked to the health of the economy. This important relationship between health and productivity has significant implications for national health policy and should become a part of the nation’s health-reform debate.

    Continuing the status quo of current health care strategies in the workplace is not a sustainable option; the realities of the economic burden of health risks and health conditions, rising total costs and an increasingly competitive global marketplace require an urgent shift to integrated health and productivity improvement strategies. A strong body of evidence has emerged in recent years, offering employers proven strategies for more effectively managing the health of the workforce and recognizing the strong link between health and productivity.

    Chronic health conditions are on the rise across all age groups, and it is expected that in the near future, conditions such as diabetes, heart disease and cancer will cost employers heavily as they provide medical benefits for employees and absorb the costs of absence and of long- and short-term disability claims. Nearly 50 percent of Americans have one chronic health condition, and of this group, nearly half have multiple chronic conditions. One study found that more than 80 percent of medical spending goes toward care for chronic conditions.

    Another important issue is the link between poor health and reduced productivity. Research shows that on average, for every one dollar they spend on worker medical/pharmacy costs, employers absorb two to three dollars of health-related productivity costs. These costs are manifested largely in the form of presenteeism (a condition in which employees are on the job but not fully productive), absence and disability. Research has shown that in addition to common chronic conditions such as cancer, heart disease and diabetes, a host of other conditions – ranging from musculoskeletal/pain, depression, and fatigue to anxiety and obesity – are driving total health-related costs in the workplace.

    Employers, the ultimate purchasers of health care for the majority of Americans, spend approximately $13,000 per employee per year on these total direct and indirect health-related costs. Using U.S. Department of Labor statistics showing approximately 137 million non-farm employees in the United States, the overall annual cost impact on the workplace is an estimated $1.7 trillion.

    The impact of health conditions on America’s competitive position in the world is sobering: without a healthy, able and available workforce, the United States will find it impossible to thrive in an increasingly competitive global marketplace.

    The workplace offers unique resources and infrastructure for addressing these problems. In an environment in which health costs are skyrocketing, health promotion and health protection measures aimed at the nation’s workforce could have significant long-term impact, potentially saving billions in costs. Furthermore, the positive impact of reaching large populations through the workplace extends beyond those currently employed. Families of the employed, retirees and other beneficiaries could also benefit from integrated health and productivity strategies implemented by the nation’s employers.

    The fundamental philosophy driving the adoption of these strategies is that health is not only of great value to individuals and populations, but also of great value to business and industry. It is important for all employers – whether small, medium or large – to look beyond healthcare benefits as a cost to be managed and rather to the benefits of good health as an investment to be leveraged. Ultimately, a healthier, more productive workforce can help drive greater profitability for employers as well as a healthier economy for our nation.

    There are four fundamental principles that we believe are critical to the health and productivity of workers.

    • 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. Today, most of the investment is made in public and community health interventions, but only a small investment is made in workplace health interventions. Individuals do not leave the impact of their personal health risks on the doorstep when they leave for work, just as they cannot leave the impact 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, 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.

    Secretary Solis, 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 ensure the health, safety, and productivity of American’s workforce. 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 e-mail at patoconnor@kentoconnor.com.

    Robert R. Orford, MD

    cc:       The Honorable Edward Kennedy
                The Honorable Mike Enzi
                The Honorable George Miller
                The Honorable Buck McKeon