Susi Lawrence asks about workplace bf support policies that could increase
female MD retention at a large HMO.
I totally agree that one place to make a big change in the breastfeeding
climate in the USA is to help more female physicians breastfeed their
babies--more happily and longer!
I suggest that the physicians you're in touch with should make a list of what
they would like. For many mothers, flexibility is the key...the option to
work fewer hours while their kids are young. This does pose a challenge to
employers, because if some employees are working fewer hours, the employer
needs to hire more people to cover the gap, and that's a cost to the
employer.
This is where having no universal national maternity benefits has left us:
business and workers have to pay the costs which would be shared by everyone
under a system that was supported by taxes. Businesses are often reluctant
to be more generous if that puts them at a disadvantage in relation to their
competitors. So workers (that is, families) pay the costs associated with
lack of breastfeeding or lack of advancement for working moms who work fewer
hours so they can breastfeed their kids.
If you don't know the book called "Advancing Women's Health: health plans'
innovative programs in breastfeeding promotion," written jointly by American
Association of Health Plans (AAHP) and Office of Women’s Health at DHHS and
issued last summer (2001), look for it at
<A HREF="http://www.4woman.gov/owh/pub/breastfeeding/">http://www.4woman.gov/owh/pub/breastfeeding/</A>
or download a PDF version (90 pages) at
<A HREF="http://www.aahp.org/">http://www.aahp.org/</A>
or read a press release at
<A HREF="http://www.aahp.org/template.cfm?template=/Search/SearchDisplay.cfm">http://www.aahp.org/template.cfm?template=/Search/SearchDisplay.cfm</A>!
The book describes the benefits that eight different plans provide to support
breastfeeding for their customers, and in the back tells how three plans
(Aetna, Humana, and Physicians Health Plan of Northern Indiana) support
breastfeeding for their employees.
Just for reference, the international standard in the International Labor
Organization's Maternity Protection Convention (not that a US HMO would care,
I suppose!) is this:
a) 14 weeks paid maternity leave, and six of that is "compulsory leave" to be
taken the first six weeks of the postpartum period (U.S. interests don't
like the word "compulsory," but that's the ILO's word. It is there to assure
that women are not forced back to work by their employers OR by their
families before they have had a chance to heal, to recover from giving birth,
and to establish lactation. Of course, in the US the system demands that
resident physicians and high school students get back to their work or
classes at TWO WEEKS, so compulsory leave is not an idea that falls on
fertile ground!)
b) additional leave if needed for medical reasons
c) cash benefits during leave at a level which ensures that the woman can
maintain herself and her child in proper conditions of health and with a
suitable standard of living
d) job protection while she is on leave--she can return to the same or an
equivalent job after her leave is over
e) non-discrimination--she can't be fired because she is pregnant, out on
leave, or for a period after leave, for any reason having to do with maternity
f) one or more daily breaks or a daily reduction of hours of work to
breastfeed her child, and
g) these breaks or the reduction of daily hours of work shall be counted as
working time and remunerated accordingly.
Now...I have to admit that only two countries have ratified this convention
since is was approved in June 2000. Still, this is the standard that has
been agreed upon. But the U.S.A. is noticeably uninterested in ratifying ILO
conventions. There are 184 or them, and the U.S. has ratified maybe...14.
I hope you're familiar with the information from Cigna. I'm still awaiting
publication of articles based on the study ULCA did in the late 1990s of the
cost-effectiveness of their employee breastfeeding support program, but press
releases back in 2000 said the company had saved $240,000 a year in reduced
health care costs for mothers and children, plus $60,000 annually in reduced
absenteeism, and needed to cover 62% fewer prescriptions for breastfed babies
compared to non-breastfed babies. This kind of savings might offset higher
costs of filling the gaps when lactating employees work fewer hours.
Good luck with this opportunity to take a step for HMO employees.
Chris Mulford
Co-coordinator, WABA Women and Work Task Force
Swarthmore PA (eastern USA)
***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
