Using the CDC Worksite Health ScoreCard to Promote Organizational Change

Purpose: To measure the impact of tying adoption of evidence-based worksite health promotion (WHP) interventions to annual organizational strategic objectives, as measured by the Centers for Disease Control and Prevention (CDC) Worksite Health ScoreCard (ScoreCard). Design: A prospective cohort study following Johns Hopkins Medicine (JHM) affiliates against industry-specific and large employer benchmarks from 2016-2020. Settings: JHM, the largest private employer in Maryland with facilities in Florida and the District of Columbia. Subjects: Twelve JHM affiliates representing over 40,000 employees. Intervention: A strategic objective was established annually based on the ScoreCard and organizational priorities. Measures: JHM affiliates measured their WHP efforts annually using the ScoreCard. CDC industry-specific and large employer benchmarks were collected for comparison. Analysis: ScoreCard data was assessed annually to measure deviations from CDC benchmarks, determine whether strategic objectives were met, and inform additional annual objectives. Results: JHM demonstrated improvement from 8.9 percentage points above industry-specific and 3.4 percentage points below large employer benchmarks in 2016, to 26.4 percentage points above industry-specific and 21.8 percentage points above large employer benchmarks in 2020. Conclusion: Large employers face unique challenges in implementing WHP programs. Our study suggests embedding health promotion in annual strategic objectives may alleviate these challenges by prioritizing the goal and ensuring adequate resources to be successful. There are however, some limitations on using benchmarking data for comparison.

COMING TOGETHER BUT STAYING APART: CONTINUITY AND CHANGE IN THE AUSTRIAN AND SWISS VARIETIES OF CAPITALISM

This chapter assesses institutional continuity and change in the varieties of capitalism in Austria and Switzerland. In the face of growing internationalisation, budgetary constraints and European integration, continuity and change have been determined by prevailing interest configurations and institutional limits in terms of public intervention and private governance. Hence, private employer dominance in Switzerland has fostered ra- pid change in areas where private regulation prevailed, such as corporate gover- nance, whereas institutional veto points have strongly limited change in areas where public intervention was necessary. By contrast, the larger scope of public intervention in Austria and its more majoritarian features have allowed more space for change in welfare reforms while the strong institutionalisation of corporatist institutions in labour market governance, for instance, has made it more resilient to change than Switzerland. In this respect, Austria and Switzerland provide good examples of how institutional change is dependent on the respective share of public regulation and private governance.

Expelling the “Sinister Vilgrain”

This article tells the story of the Congo-Brazzaville's nationalization in 1970 of the Société Industrielle et Agricole du Niari (SIAN) and its affiliate Société Sucrière du Niari. At the time of independence, the company, controlled by France's Vilgrain family, was the Congo's largest private employer. The SIAN episode is fertile ground for exploring the theme of postcolonial entanglements from a political-economic perspective. It especially illustrates how those entanglements created both obstacles to and opportunities for neo-imperial influence, just as they did for acts of sovereign independence. The article suggests that the complex, multifaceted interdependencies among France, the Congo, and the Vilgrain family insulated the effects of nationalization on the larger Franco-Congolese relationship while eventually providing a measure of compensation for the despoiled investors. Cet article raconte l'histoire de la nationalisation en 1970 de la Société industrielle et agricole du Niari (SIAN) et sa société affiliée SOSUNIARI par le Congo-Brazzaville. A l'indépendance la SIAN—une entreprise sucrière contrôlée par la famille française Vilgrain—était l'employeur privé le plus important du pays. L'affaire SIAN nous offre un terrain privilégié pour explorer le thème de l'enchevêtrement politique et économique des anciens et nouveaux pouvoirs dans la période postcoloniale. Elle illumine comment ces enchevêtrements fournissaient des occasions pour, et posaient des obstacles à, l'influence néo-impériale et l'indépendance souveraine. L'article conclut que l'interdépendance de la France, du Congo, et de la famille Vilgrain servait à isoler les effets de la nationalisation sur leurs relations plus larges tout en assurant, après un certain délai, une mesure non-dérisoire d'indemnisation pour l'investisseur spolié.

Nelson, Cole v. Young, and the Beginning of the Campaign against the Court

This chapter discusses the U.S. Supreme Court’s decisions during its October 1955 term. The flow of decisions in “Communist” cases became heavier in the 1955 term, with the Court handing down nine signed decisions. The nine decisions ran the gamut of government action against “subversives”: two contempt cases, one of them against a defense lawyer; a deportation and a denaturalization case; the Subversive Activities Control Board’s order directing the American Communist Party (CPUSA) to register under the Internal Security Act; one case each involving federal and state public-employee loyalty programs; a private-employer firing upheld by state courts; and the criminal conviction of Steve Nelson, a CPUSA official, under a state sedition statute.

Whistleblowing and the Bioethicist’s Public Obligations

Bioethicists are sometimes thought to have heightened obligations by virtue of the fact that their professional role addresses ethics or morals. For this reason it has been argued that bioethicists ought to “whistleblow”—that is, publicly expose the wrongful or potentially harmful activities of their employer—more often than do other kinds of employees. This article argues that bioethicists do indeed have a heightened obligation to whistleblow, but not because bioethicists have heightened moral obligations in general. Rather, the special duties of bioethicists to act as whistleblowers are best understood by examining the nature of the ethical dilemma typically encountered by private employees and showing why bioethicists do not encounter this dilemma in the same way. Whistleblowing is usually understood as a moral dilemma involving conflicting duties to two parties: the public and a private employer. However, this article argues that this way of understanding whistleblowing has the implication that professions whose members identify their employer as the public—such as government employees or public servants—cannot consider whistleblowing a moral dilemma, because obligations are ultimately owed to only one party: the public. The article contends that bioethicists—even when privately employed—are similar to government employees in the sense that they do not have obligations to defer to the judgments of those with private interests. Consequently, bioethicists may be considered to have a special duty to whistleblow, although for different reasons than those usually cited.

Health Insurance is Dead; Long Live Health Insurance

Upon the death of a king or queen, the proclamation “the king is dead, long live the king” announces a new monarch’s accession to the throne, preserving the sovereign order. As the Patient Protection and Affordable Care Act (ACA) is implemented, it is tempting to proclaim the reign of a new system of health insurance. But, will it preserve the old order or initiate a new form of governance? As states and insurers grapple with new rules and regulations being issued from the Department of Health and Human Services, the Treasury Department and the Department of Labor, one might believe an entirely new health insurance system is being built. Yet, the ACA is designed to preserve existing forms of public and private health insurance, such as Medicare and private employer group health plans, which will continue to operate much as they have in the recent past. What has changed is the role that insurance will play and how that will shape the way we think about health policy.

Public Health Insurance, Labor Supply, and Employment Lock *

We study the effect of public health insurance on labor supply by exploiting a large public health insurance disenrollment. In 2005, approximately 170,000 Tennessee residents abruptly lost Medicaid coverage. Using both across- and within-state variation in exposure to the disenrollment, we estimate large increases in labor supply, primarily along the extensive margin. The increased employment is concentrated among individuals working at least 20 hours a week and receiving private, employer-provided health insurance. We explore the dynamic effects of the disenrollment and find an immediate increase in job search behavior and a steady rise in both employment and health insurance coverage following the disenrollment. Our results are consistent with a significant degree of “employment lock”—workers who are employed primarily to secure private health insurance coverage.