Israel Reflections 2017–Treating Terrorists and Other Medical Challenges

Television camras and microphones surround Dr. Ofer Merin dressed in doctor's scrubs.One other new visit this year was with Dr. Ofer Merin, a commander of the Israel Defense Force (IDF) Medical Field Unit and emergency room doctor at Shaare Zedek Medical Center in Jerusalem.   As student Margo Clark notes, his roles often require both flexibility and understand beyond our immediate biases.

Dr. Ofer Merin is the Chief of the IDF Field Hospital, which travels to different countries to offer assistance in times of need. One example of the IDF Field Hospital’s greatest accomplishments is its ability to be the only field hospital from a foreign country to help the Japanese people after they were devastated by a tsunami. Their success comes from the amount of flexibility and understanding that Dr. Merin and his team work under. Rather than pushing their own system, Dr. Merin and his team worked under and around Japanese law. Under Japanese law, it is illegal for a foreign doctor to treat a Japanese citizen.  The team was flexible and put the Japanese people first. Their flexibility is exemplified by their assisting and enabling Japanese doctors to treat the large number of Japanese people who were in need. By foregoing their egos and putting understanding and flexibility first, Dr. Merin and his team were the only foreign field hospital team to be allowed to help the Japanese people.  Here is a MSNBC news report showing the IDF work in Haiti from 2010.

Dr. Merin’s flexibility and understanding is continually shown in his additional role as the Deputy Director of the Shaare Zedek Medical Center. This center is known for simultaneously treating terrorists and the victims of their attacks. It is excessively difficult to imagine how hard it must be to treat a terrorist. However, Dr. Merin understands the consequences of both treating and not treating terrorists and being beyond reproach as far as bias towards his patients. As a doctor, he is an example of following the Hippocratic oath and doing no harm under stressful conditions where many would be tempted to be biased and fail their duties as doctors. His example is important because if he can work without bias towards terrorists, doctors everywhere should use his example to attempt to work without any sort of bias.

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Children’s Hospital Chief Says Her “North Star” Is Good Health for All Kids

When Peggy Troy returned to the Milwaukee area about eight years ago to become president and CEO of Children’s Hospital of Wisconsin, she was struck by the disparities in children’s health she found. She had been a hospital executive in Memphis and expected that things were better overall in Milwaukee. But when it came to medical issues affecting thousands of children in high-poverty neighborhoods, that wasn’t really the case. The disparities in Milwaukee’s central city were some of the worst in the nation.

Since then, Troy has been a central figure in accelerating the efforts by Children’s and many community partners to improve the overall health of children in Milwaukee and throughout Wisconsin. While the national reputation of Children’s for its medical work has continued to rise, the mission statement for the institution goes beyond delivering care for patients. It is to make Wisconsin’s children the healthiest in the nation.

That broader mission was Troy’s focus during an “On the Issues with Mike Gousha” program at Marquette Law School on Thursday.  

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That Extra Incentive

Most of us are familiar with wellness programs—programs sponsored by our employer or health plan that try to incentivize us to eat healthier, sleep well, and get more exercise.  If you’re anything like me, it helps to have that extra push or incentive, especially around the holidays when sweets abound, to stay on track—or at least, to not stray too far from health goals. Most of these programs have the added advantage of lowering health care costs, both by providing financial incentives to reduce immediate costs to the individual employees and by boosting the overall health of the employees as a whole, which could reduce future health care costs.   However, extensive technical regulations and recent litigation by the AARP make implementing health and wellness programs increasingly tricky for employers.

Title II of the Genetic Information Nondiscrimination Act of 2008 (“GINA”) and the regulations promulgated by the U.S. Equal Employment Opportunity Commission (the “EEOC”) thereunder, generally prohibit “an employer [from] request[ing], require[ing], or purchas[ing] genetic information [which includes an individual’s family medical history] with respect to an employee or a family member of the employee.”  42 U.S.C. § 2000ff–1(b). However, there is an exception for wellness programs, as long as employers jump through a set of hoops. 29 CFR § 1635.8(b)(2).  While not without its own problems and excesses, the exception in the EEOC regulations at least allows employers to provide incentives to those employees willing to participate in employer-sponsored wellness programs.

The AARP doesn’t like this whole “incentive” idea to begin with. It recently filed a lawsuit against the EEOC in an attempt to vacate the regulations entirely.  AARP v. U.S. Equal Employment Opportunity Commission, No. 1:16-cv-02113 (D. D.C. 2016) (hereafter the “AARP Complaint”).  This actually might not be a bad idea, except for the fact that the AARP thinks that the regulations do not have enough hoops.  In fact, the AARP would prefer that the regulations abolish any permission for any incentives or penalties to induce participation in employer-sponsored wellness programs. The AARP alleges in its complaint that all employer incentives or penalties to induce participation in employer-sponsored wellness programs violate Title I of the ADA and Title II of GINA.  AARP Complaint at 3. 

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