Health workers’ hands are tied

The ideas and innovators shaping health care
May 17, 2023 View in browser
 
Future Pulse

By Erin Schumaker, Carmen Paun and Ben Leonard

WORKFORCE

An emergency room is pictured. | AP Photo

Health workers often have to sign contracts barring them from quitting for rivals. | AP Photo

Noncompete agreements that protect businesses by making it difficult for workers to switch jobs are pervasive in health care, a congressional watchdog reported Tuesday.

That finding from the Government Accountability Office could buttress the Federal Trade Commission’s resolve to ban the contract provisions.

“The report addresses many issues that are of great importance and confirms the Commission’s preliminary determination that non-competes are an unfair method of competition,” Elizabeth Wilkins, director of the FTC's Office of Policy Planning, wrote in a letter to the GAO.

Why it matters: Hundreds of health care workers wrote to the agency this spring during the public comment period on the FTC’s proposed rule. They described difficulty changing jobs and consolidation in the health care industry they blamed on the lack of mobility.

But hospitals have asked the FTC for an exemption, arguing that forcing them to do without noncompetes would exacerbate existing workforce shortages and harm patients.

The report examined why health care employers say they need to bind their workers. The three top reasons were to:

— Protect trade secrets, intellectual property and proprietary information

— Prevent departing workers from taking clients with them

— Retain trained staff

On the Hill: Senators on both sides of the aisle are concerned about the effects of noncompetes on workers.

Sens. Chris Murphy (D-Conn.), Todd Young (R-Ind.), Elizabeth Warren (D-Mass.), Marco Rubio (R-Fla.), Ron Wyden (D-Ore.) and Tim Kaine (D-Va.) requested the GAO investigation.

“This report underscores how non-compete agreements suppress wages, particularly for low-income workers, and hinder our economic growth,” Kaine said in a statement.

Kaine touted the bipartisan Workforce Mobility Act, introduced in February, which would limit the use of noncompete agreements. Reps. Scott Peters (D-Calif.), Anna Eshoo (D-Calif.) and Mike Gallagher (R-Wis.) have introduced a House companion.

What's next? After reviewing the comments and the GAO report, the FTC will decide whether to finalize or make changes to its proposal.

 

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AROUND THE AGENCIES

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The VA hopes to eventually have a new electronic health records system at all 171 of its medical centers.

The Department of Veterans Affairs has renegotiated its contract with Oracle Cerner in an effort to right the troubled rollout of a new electronic records system, the agency confirmed on Tuesday.

The new contract aims to increase accountability by penalizing Oracle if the vendor fails to meet benchmarks. It also holds Oracle to higher performance metrics than the prior contract did.

The previous contract was set to expire this month.

Why it matters: Projected costs for the upgrade have ballooned, and flaws in the new health records system have endangered patients.

A July report from the VA’s inspector general found 1,134 reported patient safety events connected to the new system, including medical instructions that were lost. The VA recently told Ben that the system had played a role in “catastrophic” harm to six veterans, four of whom died.

In April, the VA said it was indefinitely delaying deploying the system to new sites.

Some lawmakers have called for additional accountability, while others want to shut the system down.

What's next: Senate Veterans’ Affairs Committee Chair Jon Tester (D-Mont.) said the contract renegotiation was “just the start of what’s needed to get this program working” and pledged to continue pushing his bill to boost oversight and accountability.

 

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WASHINGTON WATCH

House Foreign Affairs Committee Chair Michael McCaul (R-Texas) speaks with reporters at the U.S. Capitol Feb. 6, 2023. (Francis Chung/POLITICO via AP Images)

McCaul has bipartisan support for his bill to treat fentanyl like a chemical weapon. | AP

The House Foreign Affairs Committee thinks that treating fentanyl like a chemical weapon will help combat the scourge of fatal overdoses the synthetic opioid has caused.

The panel approved legislation by voice vote on Tuesday that seeks to add fentanyl to the chemicals regulated by the Chemical Weapons Convention.

That international treaty, which has been in force since 1997, the same year the Senate ratified it, prohibits the production and stockpiling of chemical weapons.

Committee Chair Michael McCaul (R-Texas), the bill’s sponsor, said his aim is not to ban the chemicals used to make fentanyl. But he wants to pressure China, where the chemicals are made, and to assist Mexico, where cartels mix the chemicals to create fentanyl, to disrupt the supply chain.

Why it matters: The bill is lawmakers’ latest attempt to act internationally to stem the flow of fentanyl into the U.S., where it’s become the top killer of people ages 18 to 45, and is responsible for 200 fatal overdoses a day.

China ended all counternarcotics and law enforcement cooperation with the U.S. last August, in retaliation for former House Speaker Nancy Pelosi’s visit to Taiwan, which China claims as its own territory.

Effect on health care debated: Reps. Joaquin Castro (D-Texas) and Sara Jacobs (D-Calif.) expressed skepticism about adding fentanyl to the convention because it’s a commonly prescribed painkiller.

But New York Rep. Gregory Meeks, ranking Democrat on the committee, assured them that he has worked with McCaul to ensure the classification of the drug under the convention would not hinder its legal use.

 

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