Occupational and environmental medicine in the United States: A proposal to abolish workers' compensation and reestablish the public health model

被引:22
作者
Ladou, Joseph [1 ]
机构
[1] Univ Calif San Francisco, Sch Med, Div Environm & Occupat Med, San Francisco, CA 94143 USA
关键词
workers' compensation; public health model; policy; occupational medicine; national health insurance;
D O I
10.1179/oeh.2006.12.2.154
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
The workers' compensation model of occupational and environmental medicine Should be converted to a public health model. Occupational and environmental medicine, as a part of the public health infrastructure, Could play a much more substantive part in bringing about a national program to deal with occupational and environmental health. The workers' compensation insurance system could be discontinued at any time, but it will be vital to do so when national health insurance is adopted in the United States. Abolishing workers' compensation would remove the perverse incentives that currently, undermine the practice of occupational medicine. Medical care for workers should be provided by health care professionals who are not subject to influence by employers or insurers. Eligibility for benefits should not be determined by health and safety professionals. Wage-replacement benefits for workers should be determined by guidelines established by government and industry that prevent manipulation of health and safety professionals by employers and insurers. A nationwide comprehensive system to track work-related injury and illness, Superior to the current reliance on record's provided by employers and collated by government agencies, should be adopted. When unusually high rates of injuries, illnesses, and fatalities occur, government inspectors ought to respond and regulate the industry accordingly. Occupational health and safety professionals trained in public health can and should participate in these activities, but not when they are in the employ of industry or insurers.
引用
收藏
页码:154 / 168
页数:15
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