Edited by David S. Clark
Chapter 19: Preventive Health at Work
Julie C. Suk* 1 INTRODUCTION The delivery of preventive healthcare is a central challenge for overall healthcare reform in the United States. Much more is spent on healthcare providers and delivery in the US than in most other countries, but US health outcomes are much worse, in significant part due to the cost of treating chronic disease. European countries have done much better than the United States on this score. The American healthcare crisis has invited comparative perspectives, as many US reformers seek to learn from, and perhaps import, successful European models. This chapter exposes one important but often ignored aspect of preventive healthcare in European countries: the integration of preventive medicine into employment law. In France, for instance, the law requires every employer to provide a workplace doctor, who performs regular checkups on each employee, identifies workplace health risks and makes policy recommendations to the employer to protect employees’ health. As American employers begin to experiment with onsite preventive health clinics, what might they learn from the French experience? Rather than proposing a transplant of French or European workplace health services on American soil, this chapter explores the reasons why such a transplant would flounder, not only politically, but also legally. The purpose is to develop a critical perspective on the wide range of social and legal factors that impede preventive health services in the United States. 2 2.1 THE FRENCH LAW OF OCCUPATIONAL MEDICINE Origins French law has required every employer to have a médecin du travail,...
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