Daily on Healthcare: Fighting against weight discrimination in the workplace

By | September 10, 2019

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THE FIGHT AGAINST WEIGHT DISCRIMINATION IN THE WORKPLACE: Retailers feature plus-size models. “Fat influencers” have seen success on social media. Doctor groups have framed obesity as a disease that goes beyond willpower.

But public attitudes about weight have become more negative, even though thin people make up the minority of the population, according to a recent study from Harvard University. People who are overweight or obese not only have emotional and physical difficulties after being bullied about their weight, but also suffer financial penalties. Research from the Rudd Center for Food Policy and Obesity at the University of Connecticut found heavier workers earn less than thinner employees, are less likely to get promoted, and are viewed as lacking discipline.

“Weight bias happens at virtually every state of the employment cycle, from being hired to getting fired,” said Rebecca Puhl, deputy director for the Rudd Center.

Michigan is the lone state with a law prohibiting discrimination on the basis of weight, and lawmakers in Massachusetts are seeking to follow along. A handful of cities, including San Francisco and Washington, D.C., also have such laws.

Despite the dearth of rules, the issue of weight discrimination in the workplace is gaining some attention from high-profile court cases. This summer, the Washington state Supreme Court ruled it was illegal under state law to refuse to hire someone just because of obesity, saying that employers were violating laws that prohibit discriminating against someone with a physical impairment. Over the years, waitresses and cheerleaders have sued against workplace rules on appearance.

Puhl from the Rudd Center thinks adding weight as a protected class would help to prevent discrimination and allow for workplaces to warn workers not to harass each other over weight.

“Adding weight legitimizes this as a form of discrimination, otherwise it makes it seem as though it’s OK to tolerate,” Puhl said.

Surveys published in the Journal of Obesity show nearly 80% of the public agrees. But under U.S. labor “at-will employment” laws, workers can be fired at any time and for any reason. Workers in unions are more protected, as are people who fall under protected classes, but some are more cautious about calls to expand the protections further.

“There is no question that, in our society, people are often judged unfairly on account of their weight or their looks, and I have a great deal of empathy for people who have been treated unfairly on that basis,” said Jennifer Braceras, director of the Center for Law and Liberty at the Independent Women’s Forum. “But I would caution lawmakers to think long and hard before creating yet another protected class.”

She added: “Historically, American anti-discrimination law has been used to prohibit and punish discrimination on the basis of immutable characteristics. It was never intended to eliminate at-will employment.”

Read more from my latest magazine piece.

Good morning and welcome to the Washington Examiner’s Daily on Healthcare! This newsletter is written by senior healthcare reporter Kimberly Leonard (@LeonardKL) and healthcare reporter Cassidy Morrison (@CassMorrison94). You can reach us with tips, calendar items, or suggestions at dailyonhealthcare@washingtonexaminer.com. If someone forwarded you this email and you’d like to receive it regularly, you can subscribe here.

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NEARLY 2 MILLION MORE UNINSURED UNDER TRUMP: The number of people without health insurance rose by 1.9 million people from 2017 to 2018, according to a report released Tuesday by the U.S. Census Bureau.

The total number of uninsured was 27.5 million, or 8.5% of the population, a 0.5 percentage point increase from 2017. The percentage of people that had private health insurance didn’t change significantly, while the percentage of people with government coverage declined 0.4 percentage points. The percentage of uninsured children under the age of 19 increased by 0.6 percentage points between 2017 and 2018, to 5.5%.

PELOSI DRUG PRICING DRAFT LEAKED: A six-page draft summary of the proposal from House Speaker Nancy Pelosi’s office, circulating among lobbyists, was obtained Monday by the Washington Examiner. A senior Democratic aide said the document was an out-of-date draft and that nothing has been distributed to the caucus as committees are discussing the proposal. Still, the aide didn’t specify which changes had been made. The draft plan would:

*Allow the secretary of the Department of Health and Human Services to negotiate the top 250 most expensive brand-name drugs, as long as they lack at least two generic alternatives. The government would set a price at no more than 1.2 times the average of what Australia, Canada, France, Germany, Japan, and the United Kingdom pay.

*Allow private health insurers to pay the lower price that the government negotiated.

* If drug companies refuse to negotiate or do not arrive at a price agreement with the government, then they would be fined the equivalent of 75% of the gross sales obtained the previous year from the drug in question.

*If a pharmaceutical company charges Medicare more than the negotiated price, or doesn’t offer the price to private health insurers, then the company would be subject to a monetary penalty equal to 10 times the difference. The plan also would penalize drug companies if they raise prices above the rate of inflation.

FDA PUTS JUUL ON NOTICE FOR ALLEGEDLY MARKETING TO SCHOOL KIDS: The Food and Drug Administration warned Juul against continuing to market to kids after teens said in Congressional testimony that a Juul representative told kids at a school presentation that the product is “totally safe.” Two teens speaking at a House Oversight Committee hearing in July said they heard the representative tell young students that they “should mention JUUL to his [nicotine-addicted] friend … because that’s a safer alternative than smoking cigarettes, and it would be better for the kid to use.” The FDA demanded that Juul send all scientific data the company has gathered to back up its claims that the e-cigarette is safer than smoking cigarettes.

Melania chimes in: First lady Melania Trump entered the e-cigarette fray with a Monday tweet, raising the possibility that they might be “an on-ramp” to nicotine addiction for kids. Trump said she is “deeply concerned about the growing epidemic of e-cigarette use in our children” as more and more kids take up e-cigarette use at young ages.

PURDUE PHARMA BUCKS STATE ATTORNEY GENERALS’ DEMANDS IN SETTLEMENT TALKS: Opioid manufacturer Purdue Pharma rejected settlement terms set forth by state attorneys general in talks to settle over 2,000 cases against the company. The Sacklers “refused to budge” on settlement terms after attorneys general demanded they pay states out of their personal wealth — $ 4.5 billion. State attorneys told The Hill and NPR Monday that the Sacklers’ decision to reject the terms has stalled talks and the company is expecting “imminent” bankruptcy filing.

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REVIEWING STATES THAT HAVE REFUSED TITLE X GRANTS TO PROTEST TRUMP ADMINISTRATION RULE: The Trump administration finalized a rule this summer for the Title X grant program that requires the “physical and financial” separation of family planning services and abortion services, and prohibits doctors from referring patients for abortions. Last week, Tampa Family Health Centers in Florida announced they are opting out of the grant program. Planned Parenthood dropped out of the program in August, relinquishing access to up to $ 60 million each year. Several states are following Planned Parenthood’s lead, choosing to drop out of the program and funding women’s health clinics with state money.

Illinois will forgo $ 2.4 million: Democratic Governor J.B. Pritzker announced on July 18 that he was pulling the state from the Title X grant program. “While I’m committed to bringing as many federal dollars to the state as possible, I refuse to sacrifice our values and allow vital care to lapse. In this state, we trust women to make their own health care decisions and will guarantee access to reproductive health care for all of our residents,” Pritzker said in June.

Washington will continue funding women’s health clinics without federal help: Washington state health officials announced in July the state would reject federal funds, and would use state money to support providers across the state. Democratic Governor Jay Inslee, state Attorney General Bob Ferguson, and Secretary of Health John Wiesman said on July 30 that the state must ensure “patient access to quality reproductive healthcare” regardless of federal rules and funds.

Vermont will forgo grants and rely on a contingency fund to keep clinics running: The state announced in August that it will reject grant money and instead rely on a contingency fund put in place in 2018 containing $ 759,560. Vermont Health Commissioner Mark Levine said the fund should keep Planned Parenthood clinics in the state up and running until June 2020.

TULSI GABBARD FAVORS THIRD-TRIMESTER ABORTION RESTRICTIONS: Democratic presidential candidate Tulsi Gabbard supports restricting third-trimester abortions, setting her apart from fellow Democrats in the race. She told Dave Rubin, host of “The Rubin Report,” that she believes abortions into the third trimester should be prohibited unless the mother’s life is at risk or she faces severe health risks. “I take a more libertarian position on this issue,” Gabbard said. “That government really shouldn’t be in that place of dictating to a woman the choice that she should make. I think that there should be some restrictions though.” When she entered politics in her 20s, Gabbard was staunchly anti-abortion but shifted her views upon entering Congress. She cosponsored the 2013 Women’s Health Protection Act which would remove governmental restrictions on abortion access and has made women’s issues a key part of her platform.

STUDY: MANDATORY WAITING PERIODS INCREASE SECOND-TRIMESTER ABORTIONS: Introduction of a 2015 Tennessee law that mandated a minimum 48-hour waiting period to undergo an abortion caused a 62% increase in the share of abortions that happen after 12 weeks, when the second trimester begins, according to a National Bureau of Economic Research report. While abortions in the second trimester increased, the report suggests the total number of abortions fell by 6%. Women who have to wait a minimum of 48 hours between first and second consultations for abortion procedures could force them to put off the procedure due to a significant increase in costs associated with waiting, including additional visits to the provider, lost wages due to the required time off from work, transportation costs, and childcare arrangements. Waiting could cost the patient up to $ 900 and force her to undergo the procedure beyond a point at which a visit to the provider and the abortion itself would be less expensive.

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Note, though: Abortions declined, as sought by mandatory wait period advocates: Abortions declined 6% across the board, according to the study, even though second-trimester abortion rate has increased. An overall decreased abortion rate is what advocates and legislators on the state level hoped to see when they began enacting mandatory wait periods. A total of 27 states require women to wait anywhere from 18 to 72 hours between the first consultation with a provider and the actual procedure.

MEASLES CASES INCREASE, BUT AT A SLOWER RATE: The number of measles cases reached 1,241 on September 5, an increase of 7 cases from the previous week. While cases keep climbing, the rate is slowing. As of August 29, the number of cases had risen by 19.

FORMER USC GYNECOLOGIST SURRENDERS HIS MEDICAL LICENSE AMID SEXUAL ABUSE ALLEGATIONS: Former gynecologist George Tyndall gave up his license to practice medicine in California as he faces 29 charges of sexually abusing his patients at the University of Southern California gynecological clinic. Sixteen female patients accused him of sexually abusing them between 2009 and 2016 by touching them inappropriately and telling them it was medically necessary. After practicing at USC for 27 years, Tyndall was fired in 2017. He maintains that he is innocent.

The Rundown

The Washington Post Bloomberg to spend $ 160 million to ban flavored e-cigarettes

The Associated Press Alabama investigates 5 cases of lung disease tied to vaping

San Francisco Chronicle California limits vaccine medical exemptions as protests disrupt Legislature

Stat FDA rejects bid for a moratorium on opioid approvals as scrutiny of the agency heats up

Modern Healthcare Senate appropriators demand scrutiny of new liver distribution system

NPR Telepsychiatry helps recruitment and patient care in rural areas


TUESDAY | Sept. 10

Congress in session.

Sept. 10-11. Hilton Arlington. Medicare Advantage Product Design Innovations. Details.

9 a.m. 1789 Massachusetts Ave. NW. American Enterprise Institute event on “After repeal and replace: The Fair Care Act and the 2020 campaign plans.” Details.

10 a.m. 2123 Rayburn. Energy and Commerce Committee’s Health Subcommittee to hold hearing on bills to address rising maternal mortality rates. Details.

1 p.m. HVC-215. House Republicans to hold hearing on the Born-Alive Abortion Survivors Protection Act. Details.

WEDNESDAY | Sept. 11

9 a.m. National Press Club. 529 14th St. NW. National Pharmaceutical Council event on “Health Spending: Moving From Theory to Action.” Details.

THURSDAY | Sept. 12

8 p.m. Houston. ABC-Univision Democratic debate.

FRIDAY | Sept. 13

8 p.m. Houston. ABC-Univision Democratic debate.

Noon. Dirksen G-50. Alliance for Health Policy briefing on “What’s Next on Social Determinants of Health?” Details.

MONDAY | Sept. 16

12:30 p.m. 1789 Massachusetts Ave NW. American Enterprise Institute event on “If we cannot live with the individual mandate, can we cover enough lives without it?” Details.