Labor Law Guy

What’s a QALY and What’s It Got to Do With You?

Posted in Random Musings by laborlawguy on August 19, 2009

Short answer to the second question: Plenty.

QALY stands for “Quality-Adjusted Life Year,” and it’s a concept used in British health care to determine if you’ll be allowed a certain treatment.

Say a certain operation will award you with one additional QALY, the National Health System (NHS) will pay up to £30,000 for that treatment. And no, QALY’s are not cumulative. If the treatment results in five QALY’s, you still get just £30,000 (a tad under $50,000) for your health care.

If that’s not enough to fund the operation, you get to live (or die) with whatever ails you.

The faceless bureaucratic agency that thus assigns death to British citizens goes by the impossibly oxymoronic acronym of NICE (National Institute of Clinical Effectiveness).

What’s all this got to do with you, an American?

Again the short answer: Plenty.

The reason for this is that Obama and his health care cronies/advisers are enamored of both QALY and NICE and will implement them here no matter how much they deny rationing of health care is under consideration. Just read the books by Obama’s main men in health care reform–Tom Daschle and Zeke Emanuel (yes, brother of Chief of Staff Rahm)–and you’ll see the heartlessness with which they intend to treat the elderly.

Except for their loved ones and themselves, of course, as they’ll set up a two-tiered health care system–one for the populace (we taxpaying scum) and the other for the high and mighty in government and their cronies: Nationalized, rationed medicine for us; privatized, gilt-edged care for them.

Change we can truly believe in.

A Sad Variation of No Room at the Inn Under Obamacare

Posted in Random Musings by laborlawguy on August 17, 2009

Thanks to someone named John David Lewis, I’ve been awakened to (and frightened by) another glorious feature of HR 3200, the House of Representatives’ so-called health care reform measure.

Under HR 3200, limitations on hospital readmissions will be imposed. Since a huge portion of the expense of running Medicare comes from hospital readmissions within 30 days of the first admission, the measure seeks ways to limit readmissions.

The solution? You won’t be readmitted unless enough people with the same diagnosis as yours have been released prior to your arrival at the hospital. The number of releases will be determined by a new health czar, and his/her decision will be above the law. You cannot sue or challenge any decision by the czar in court.

Let me give you an example. Joe has a heart attack on Nov. 1, and then suffers another one on Nov. 28. When he arrives barely alive at the hospital, a faceless clerk will check the records to see if enough heart attack patients have died or been released to justify Joe’s readmission.

“Sorry, Mr. Jones, but we can’t admit you yet. Can you wait until two more heart attack patients die?”

Of course, Joe may be one of those two himself.

Now, is this a grand system or what? The government will set quotas on hospital readmissions, and no one in the country (barring Congress, which would never interfere absent an open revolution by the citizenry) can challenge the system legally or administratively.

All decisions are final. Including the one that leads to your death on a gurney in a hospital lobby.

Medical-Industrial Complex Wants You to Be Abnormal

Posted in Random Musings by laborlawguy on August 14, 2009

An interesting opinion piece in the New York Times traces how the medical-industrial complex has been in cahoots for quite some time now developing new tests and devices and then forcing people to use them, with the goal, of course, of jacking up profits.

At the cornerstone of this campaign has been the definition of normal, as in “normal” health indicators such as, “We’d better check your cholesterol and blood sugar levels.” Along the way, the industry has succeeded in lowering the thresholds at which normal fades out and abnormal takes over. I remember a friend of mine who developed Type II Diabetes from gaining too much weight. He said his doctor told him that the upper limit of “normal” blood sugar levels used to be 140, but now it’s 100. Of course, he was well past both those figures, so it didn’t matter, but now it all starts to fit into a pattern after reading the NYT article by H. Gilbert Welch, M.D., entitled “To Overhaul the System, ‘Health’ Needs Redefinding.”

Here’s a sample:

It [the medical-industrial industry] develops diagnostic technologies able to find smaller and smaller abnormalities. So more and more of us are found to have damaged cartilage in our knees, bulging discs in our backs, and narrowed blood vessels throughout our bodies. And far too many are also found to have “spots” or “shadows” that are seldom significant but are said to be “worrisome.” So more and more of us have knee surgery, back surgery, angioplasty and more diagnostic investigation.

This all works well for the insurance industry too. I remember applying for health insurance a few years ago before my wife’s work-based insurance kicked in. I was declined for diabetes (hyperglycemia) because my blood sugar once tested at 107 (a freak result because I retook the test several times and it’s been down around 70 each time).

So who’s gaming the system? It seems to be a joint effort. Physicians order extra, unneeded tests for “defensive medicine” purposes. The device manufacturers and pharmaceuticals push tests and then drugs on patients who might not even need them. The insurance companies use the test results and the medicines we take to deny us coverage. And for our part, we consumers feel cheated unless our doctors order every test possible when we have the slightest little ailment.

Maybe what we all need is less health care. Now, there’s a novel idea, and of course, that’s exactly what we’re going to get if Obamacare goes through.

Sin Bins: Big Brother Is Alive and Well in the UK

Posted in Random Musings by laborlawguy on August 4, 2009

I came across a story that’s really hard to believe. It appears that the United Kingdom has a program called Family Intervention Projects, sarcastically dubbed sin bins, that monitor suspect families and their treatment of their children.

So far, so good, but look at the mechanisms they use: First they install cameras in the families’ homes to make sure the children go to school, eat properly, and go to bed on time. Then they send out private security guards for follow-up and corrective home visitations.

I’d be laughing at this silly joke except it’s not a joke but a reality and a Big Brother nightmare at the same time. Some 2,000 families have already participated in (be subjected to is more apt) the program, and now Children’s Secretary Ed Balls wants to expand the outreach (stranglehold would be better) to another 20,000 families.

The program is designed to reduce the number of children drawn into crime.

There must be a better way. Waterboarding, anyone?

Saudi Family Takes Its Genie Nemesis to Court

Posted in Random Musings by laborlawguy on July 21, 2009

A family living near the holy city of Medina in Saudi Arabia has filed suit in Shariah court against a genie it alleges has been harassing them.

Typical genie harassment involves threatening voicemails, stealing their cell phones, and throwing rocks at them at night when they leave the house.

The court is investigating while a local charity has relocated the family to a different house.

Genies are also called jinn in the Islamic faith and are a theme within the Koran itself.

Read about it here.

Meanwhile, the court is set to impose the granting of three wishes to the family. It’s not clear if the granting genie will be portrayed by Robin Williams or Barbara Eden.

Hawaii Passes Its Own EFCA

Posted in Random Musings, State Labor Law by laborlawguy on July 20, 2009

Over the veto of Governor Linda Lingle, Hawaii’s legislators have enabled card-check unionization and, copying the federal Employee Free Choice Act (EFCA) even further, mandated contract arbitration if no labor agreement is reached within 110 days.

Hawaii thus joins four other states with their own mini-EFCAs: New York,  New Jersey, Illinois, and Oregon. However, these state laws pertain only to intrastate businesses, which limits their scope. The federal EFCA could change all that.

Now that Congressional negotiators seem to have rescinded the majority card authorization provision from the EFCA, it appears that labor’s goal all along has been the mandatory arbitration provision to force a contract on newly organized businesses. Absent this provision, employers can stall and stall until the union loses its legitimacy without a contract and just disappears.

EFCA lives on and could be exacting a costly toll on American business sometime soon through mandated employer-union contracts. If you can’t beat ‘em, then legislate and arbitrate them into submission.

HELP Bill Will Help Employers Drop Health Insurance

Posted in Federal Labor Law, Random Musings by laborlawguy on July 6, 2009

Gee, talk about an incentive to drop out of providing health insurance for one’s employees, how’s this:

The Senate’s oxymoronically (or just moronically) named HELP Committee just reissued its health care redesign that includes an employer “play or pay” mandate. So what does an employer have to pay if he doesn’t provide insurance? A whopping $750 per family or $375 per individual–per year!

I could easily see many employers dropping their plans and telling their employees to sign up for the new so-called “public option.” They’d be saving a ton and shedding themselves of administrative heartache.

However, the HELP (Health, Education, Labor and Pensions committee) bill also extends Medicaid to people earning up to four times the federal poverty level–about $43,000 for a single individual and $88,000 for a family of four ($54,000 and $108,000 respectively for Alaskans).

I’d say that within the next couple of years, if this bill passes, a great majority of Americans will be on either Medicaid or the public option. In other words, just a legislative move or two from what the Obamacrats really want, which is “Medicare for all” (at least until you get too old to work when rationing will set in to save the system money).

Shocking News: Lose Your Job, Lose Your Life

Posted in Random Musings by laborlawguy on July 2, 2009

Losing one’s job shortens one’s life by up to a year and a half, according to recent studies. A job loss also often results in stress-related health conditions such as diabetes and hypertension.

The effects of job loss occur whether the loss came as a result of targeted layoffs, company closings, or individual terminations.

Another finding is–here’s the double whammy!–that periods of financial instability, often associated with unemployment, also lead to increased mortality.

While we’re having a go at health care, maybe we should focus on death care reform at the same time.

Sorry, just a bad joke as I think back over my own experience with job loss(es) the past decade or so.

Milton Could’ve Sued Lumbergh for Retaliation

Posted in Random Musings by laborlawguy on July 1, 2009

Comes word from the Second Circuit Court in New York that Milton, the putative star of 1999′s iconic movie Office Space, could’ve sued boss Lumbergh and prevailed on grounds of retalation for relocating him to the basement.

Read the court’s rationale here, and view Milton and Lumbergh below:

Top Ten Regulations OSHA Gets Questions About

Posted in Federal Labor Law, Random Musings by laborlawguy on June 26, 2009

Here’s a list of the top ten enquiries sent by e-mail to OSHA about its regulations. The agency keeps tabs both by e-mail and phone enquiry, so a notation in parentheses shows the phone rank and regulation link:

  1. Powered industrial trucks (1910.178, #3)
  2. Sanitation (1910.141, #4)
  3. Hazard communication (1910.1200, #2)
  4. Bloodborne pathogens (1910.1030, #1)
  5. Personal protective equipment, general requirements (1910.132, #5)
  6. Medical services and first aid (1910.151, #6)
  7. Ergonomics (no OSHA standard, not on phone list)
  8. Electrical, general requirements (1910.303, not on phone list)
  9. Respiratory protection (1910.134, #8)
  10. Air contaminants (1910.1000, #7).

Stolen shamelessly (but with attribution) from Safety News Alert, which also notes:

“The two questions in the top-10 list of questions received by phone that aren’t on the e-mail list are about indoor air quality (no OSHA standard) and permit-required confined spaces (1910.146).”

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