[Med-privacy] Fwd: [healthprivacy-news] Internal Wal-Mart Memo: Unhealthy Need Not Apply

[Peter Marshall]

Begin forwarded message:

From: "btossell@healthprivacy.org" <btossell@healthprivacy.org>
Date: October 26, 2005
Subject: [healthprivacy-news] Internal Wal-Mart Memo: Unhealthy Need=20
Not Apply
Reply-To: info@healthprivacy.org

Internal Wal-Mart Memo: Unhealthy Need Not Apply



As reported by the New York Times today, an internal Wal-Mart memo=20
presented to the company=E2=80=99s board of directors outlines options =
for=20
lowering health care costs.  The detailed proposals include excluding=20
unhealthy workers from employment and moving health care clinics=20
on-site in order to prevent employees from seeking emergency room and=20
other kinds of more expensive care.  The company is also considering=20
screening out unhealthy individuals currently employed by the world=E2=80=99=
s=20
largest retailer.



Wal-Mart=E2=80=99s internal memo not only raises issues of potential=20
discrimination under the Americans with Disabilities Act, it also calls=20=

into question whether the HIPAA Privacy Rule may be violated, and if=20
not, points to a major weakness of the law=E2=80=94in that it doesn=E2=80=99=
t cover=20
employers directly.  Since 2003, the Privacy Rule has prohibited health=20=

plans and providers from sharing identifiable patient data with=20
employers.  Thwarted by the new law, employers are resorting to=20
collecting health information directly from employees and job=20
applicants, acts that are not prohibited by the Privacy Rule.



This blatant act to screen out unhealthy workers certainly reinforces=20
consumer anxiety about employers using health information to=20
discriminate against them in hiring and promotion decisions.  A 2000=20
survey of Fortune 500 companies revealed that only 38 percent of=20
companies do not use or disclose employee health information for=20
employment decisions.  In fact, there is a long history of personal=20
health information being used against individuals by employers.  As a=20
result, many Americans are leery of being fully honest with their=20
providers, and, sometimes, avoid care altogether.



Acknowledging that people are shying away from certain care for fear=20
that employers will use their health information against them, IBM=20
recently announced that it is voluntarily banning the use of genetic=20
information for hiring decisions and for decisions related to health=20
care and benefit plan eligibility.  The Health Privacy Project has=20
consistently called for stronger protections for personal health=20
information, including genetic information, in the employment sector.