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Dell Takes Health Care Online 105

abb_road writes "Dell will announce today that it will begin offering employees an online system to track health care; the system, which will focus on insurance claims, doctor visits and prescriptions, is expected to improve employees' medical safety while reducing costs. The electronic records are expected to dramatically improve preventative care; employees will receive ongoing alerts for suggested and continuing treatment of health conditions. The system should also improve coordination among health care providers, especially when patients need to see multiple physicians. Other employers are expected to follow Dell's lead; the government 'has estimated that health IT can add $140 billion a year to the productivity of the $2 trillion health care industry.'"
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Dell Takes Health Care Online

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  • Old News (Score:4, Insightful)

    by thopkins ( 70408 ) on Monday April 10, 2006 @12:31PM (#15099736)
    This is nothing new, my health insurance has an online system and so do many others.
    • The difference/issue here is that its Dell who will be tracking this for employees... not the insurance provider. I would think there would be some privacy issues here? Dave
    • Re:Old News (Score:3, Insightful)

      by DavidD_CA ( 750156 )
      I'm thinking there may be more to this than just what some of our insurance carriers have today.

      I have PacifiCare and while it has a nice website that lets me do a number of things, it still leaves a lot to desire in terms of collaboration with all the parties concerned.

      If my dentist needs information, it still requires a phone call. Likewise, to book with my doctor, I have to call them or get called back. Bills are still sent via mail, and carrier-vendor communication is horribly archaic. Perhaps this s
    • Nothing New - This is nothing new, my health insurance has an online system and so do many others.

      I broke my clavicle last year and have been swamped with bills. I've been able to track my account on-line, which was particularly helpful in finding one bill sent to me wasn't sent to my insurer, first.

      Particularly distressing because when I was taken in to hospital I had my wallet with me and insurance card, which they took down. The depressing bit, however, is in a modern US hospital are many companies

      • I hear you on that one. My stepson was in a car accident with his uncle driving a few years back. He had no broken bones, but hit his head on the dash and got a bad bruis across his chest and stomach from the seatbelt. He was in the hospital for two days. Every doctor that walked by and saw his name on the clipboard sent us a bill. I refused payment on all of them as his uncle's car insurance should have paid, but it only had a $5,000 medical coverage, and all of the doctors walking by added up to over $12,
    • > This is nothing new, my health insurance has an online system and so do many others.

      Yeah, but this is Dell--if you die, they'll stick a restore CD in your mouth and have you back up and walking around in about an hour.
  • by Anonymous Coward
    Did you remember to floss?
  • by acidblood ( 247709 ) <decio AT decpp DOT net> on Monday April 10, 2006 @12:35PM (#15099753) Homepage
    employees will receive ongoing alerts for suggested and continuing treatment of health conditions

    Clippy pops up in the corner...

    `It looks like you have cancer. Would you like to book a session of radiotherapy?'
    • by Anonymous Coward
      or clippy: "I am sorry.. I cant allow you to watch more p0rn unless you take your medication for this week. This message is brought by your XXX Health Insurance, we care for you"
    • it sounds like you might be stopped up. would you like to order some metamucil?
    • by eviloverlordx ( 99809 ) on Monday April 10, 2006 @12:56PM (#15099883)
      Clippy pops up in the corner...

      `It looks like you have cancer. Would you like to book a session of radiotherapy?'


      More like: 'Dude! You're getting a colostomy!'
    • Aren't they (Dell) more likely to use an HMO? In which case Clippy would say:

      "It looks like you have cancer, but sorry, Dell cheaped out on you and all you have is an HMO. Would you like to get on the three-year-until-we-decide-to-help-you-or-not waiting list in the hopes that you die before we have to cover your treatment, saving shareholders precious cents, or would you like to take advantage of our low-cost assisted suicide option?"

      "[OK] [CANCEL]"
      • The only reason for a big business to use an HMO is because of the tax breaks and savings they've been granted by all the regulations that created the HMO monster. Look into the HMO Act of 73 for the damage created by federal "guidelines" that created the problems in health care we face today.

        Here [lewrockwell.com] is a link or two [lewrockwell.com].

        Dell is trying to do something to help their employees, but in the end it'll fail to help because all we'll see is another group of people trying to avoid taxes.
  • Denmark has a National IT Strategy on Healthcare [www.sst.dk]. I was able to talk to a delgate from Denmark many months ago about their projects. They have made some major acomplishments and had to deal with some difficult problems such as authentication.

    Dell isn't the first, and as each new project comes online new lessons are learned. I suspect there will be many more applications, in the near future, as information is invaluable in proper diagnosis and treatment in the modern medical system.
  • by monomania ( 595068 ) on Monday April 10, 2006 @12:44PM (#15099811)
    I'm always skeptical of blanket prescriptions for health care, or for what IT can and cannot do in the macroeconomic sense to solve a problem. For example, "the government 'has estimated that health IT can add $140 billion a year to the productivity of the $2 trillion health care industry.'" Is that indeed added to the 'productivity' of the industry, or is that added to the cost? The Dell implementation looks innovative (to a degree) and hopefully for them (and their employeees) will show a benefit; but I can already hear the chorus of those who have fought against real reform in the healthcare industry saying that the best solution is throw more IT at the problem. IT has never really worked any better than the proverbial money we used to throw.
  • by dakirw ( 831754 ) on Monday April 10, 2006 @12:44PM (#15099812)
    I'd be astonished if the employees ultimately benefit from these automated systems. The only thing that they'd get would be online access to their health records. The employers will say the employees benefit from getting health care in the first place. However, I'm a bit skeptical in this age of cost cutting that these tools won't be used to lump "problem" employees that use lots of coverage and force them into programs that would help the company save a bit of money. Is that legal? And how would the company get the information about the employee interactions with health providers - the insurance company, I'm guessing? It'd be an nightmare to get every doctor and pharmacy to plug into the system.
  • Call me crazy but I don't want my corporate business to "know" if/when/where I'm doing followup for my healthcare or what healthcare conditions I need follow up for.
    • I would call your atitude "prudent". Here, if no where else, people shoul0d be a wee bit suspect of having their most personal and sensitive information available via the web.
          Avaialble to...whom exactly? -is the question
      • by the_skywise ( 189793 ) on Monday April 10, 2006 @12:57PM (#15099890)
        If my health insurance provider wanted to provide a one-stop shop website where I could track that, that'd be good.

        It (theoretically) would provide me all the info I need and provide a gateway back to the company about what health information they could get on me.

        Putting the company in-the-loop for this is just a bad idea in terms of privacy. (Although I've been in companies where you had to paper file the insurance claims for doctor's visits through the HR department... though I don't know if that was required or just provided as a convenience)
        • There are strict laws in the US protecting your private health information from your employers. These systems are run by 3rd parties who are only allowed to report aggregate information back to employers. I've worked with these systems, and there is no way for an employer to see your private health information.
          • I have too and heard the file clerks joke and gossip about: "Ooo! I saw 3 cases of Herpes today alone! I wonder what club SHE goes to! tee hee hee" -pointing to the screen and the file on the unfortunate who must deal with our current intrusive health care system. Laws protect lawyers.....
            • Um no. You didn't. The only way these systems would ever get a chance at use outside of a developers desktop at big health CO, is if they are HIPPA compliant. And if they pass stingent security audits.
              • Yep. Hippa complaint. and yes...I have: Billing clerks, and nurses revieiwng claims, bills, med records. I know.. the usual view is: Put on a white lab coat and you are now above human foibles (except on Thursday which you have off to play golf). Actually, the back and forth in any billing center, physican's association, claims processing review or similar place would horrify Joe Q. if he heard it -oh, and knock the whole medical profession down a peg or three. which is not such a bad thing.
                • This discussion is about private records and one's employer, not health providers.
                  • Indeed it is. and that is exactly what I am discussing. Claims processing and bill review: conducted by HR departments, physican's associations (both of external and internal personel related claims), and the like. When you make a medical claim it is usually reviewed by: Your Insurer, the Doctor's billing clerk, your employer's HR department claims review department, and, in between these: If you are Union the Union may have a bill review department; if any of the funds are covered by any state or fe
  • Everyone is generally dissatisfied with healthcare in the US, and there lots of people who believe that the accountability that computerized records can enforce could really change things. Now the customers of healthcare (employers) have balloning costs and very little to show that the healthcare they are purchasing is actually effective.

    An obvious question is why proprietary medical software vendors have not addressed this issue already. Part of the reason is that there is no "Microsoft" in the industry
    • An obvious question is why proprietary medical software vendors have not addressed this issue already.
       
      What about HL7? That's a standard, so are several of the other clinical, demographic and billing formats for electronic transmission.
       
      The problem with ballooning healthcare costs for most of the civlized world are due to demographic shifts and increasing malpractice insurance costs.
      • Show me System A that can talk to System B using HL7 and I will show you two systems that cannot talk to any other system in the world using HL7. HL7 is a weak standard. It might not be soon, there are lots of work to improve it...

        In a way you have made my point. There is no one company large enough to make HL7 into a solid standard.

        Also, while your comment regarding costs is true, it is also a massive oversimplification. What about drug costs, Fraudlent medical claims, uneeded CYA tests, and ineffecient pa
      • What about HL7? That's a standard, so are several of the other clinical, demographic and billing formats for electronic transmission.

        HL7 is very unwieldy for communicating between systems. It also does not scale very well. As for these other formats, you hit the nail on the head w/ "several". Take billing codes - ICD-9 is a standard, but it is revised every year or so. CPT covers the same procedure, but is a completely different standard. For Emergency Departments, you have DEEDS. There are too man
        • Reading through the comments in response to this, I have to now imagine we have quite a few health insurance geeks on slashdot Posting from work too! After all, it isn't very often one sees ICD9, CPT or even X12 in slashdot conversations.

          Go UCONN! :-)
      • What about HL7?

        Fine in theory but...

        WHO are you? Each company/ service (doctor, hospital, radiology, blood test, etc) has their own ID number for you. When the HL7 msg arrives, how do you marry up the msg with your account?

        IBM had a system which used very fancy algorithms trying to match things like name, sex, DOB, address, weight, height, and any other personal information it could find. The best the system could do was generate a confidence factor. There are lots of Smith, Wong, Mohammad in the world.

        If t
        • Each company/ service (doctor, hospital, radiology, blood test, etc) has their own ID number for you. EveWhen the HL7 msg arrives, how do you marry up the msg with your account?

          Every facility I've ever come across has an HIS which feeds the ancillaries the patient identifiers, the two main identifiers being a facility medical record number and a visit/encounter number. The ancillaries use those identifiers for clinical and billing functions, and not their own internally generated numbers.
          • Bad form to reply to my own post, but if you were referring to a scheduling or transcription system where the patient is seen at an affiliated physician's office before identifiers are assigned from the HIS ... then yes, those do present a problem. Though it is more procedural than system limited.
  • Good news and all, but Dell did have a keynote at Linuxworld and made some real interesting points in regards to virtualization. But no coverage on Appledot about it... C'mon guys!!
  • 1. Identify the employees generating the most health insurance liability. Something tells me it will end up as an undocumented factor in a performance review.
    2. Accelerate shifting the burden of medical care to the individual.

    Most Americans are quite happy to assume this burden with no benefit to them at all. They assume a huge liability in exchange for absolutely nothing.

    Socialized medicine might work some places, but the "S" word is derogatory in the U.S. and I don't see a good solution in either priva
    • 2. Accelerate shifting the burden of medical care to the individual.

      That works for me. I don't mind paying my own way, as long as they go ahead and bump up my salary since they aren't paying par of my healthcare expenses anymore. Unfortunately, they won't want to bump you up 100% of the cost, because they get a tax break for their sahre of the benefit. Also, your premium will go up for an individual plan versus a group plan. But hey, you are in IEEE or something, right? They have group plans.

      As for me, my
    • I worked at a company that was self-insured. During one of their meetings, the director said that sick or unhealthy employees didn't worry them - their expenses were predictable and easily planned for on a monthly basis. Their biggest issue was a young, perfectly healthy employee having a premature baby and causing a million dollar hit against the reserve fund. They were always happy when ski season was over so they could stop paying for the "healthy" people with their broken ankles and knee surgeries.
    • Socialized medicine might work some places, but the "S" word is derogatory in the U.S. and I don't see a good solution in either privatized or public health plans.

      Any form of socialism works best on small geographic areas where almost everybody believes in some sort of collectivism; that's why Western European countries hasn't dumped its socialist programs. However, it completely falls apart in very large nations (the USSR is a great example). It is much easier to convince 35 million people of the same

  • by TheMohel ( 143568 ) on Monday April 10, 2006 @12:56PM (#15099880) Homepage

    From TFA:

    Dell has offered limited electronic health records since 2004, but the upgrade coming Apr. 20 adds the ability for the system to automatically capture new information about treatments and test results, rather than waiting for the employee to enter the data manually.

    So let me get this straight - this incredible new initiative is actually a lightly-used website, run by WebMD, that Dell employees have had for the past two years. And the newness is that the system can now "electronically" capture results. And Dell trumpets this in a major news release.

    We will set aside the interesting question of how (and whether) WebMD has convinced thousands of independent labs, as well as laboratory giants like LabCorp, to send results to WebMD. We will ignore the HIPAA regulations that will require patients to sign releases with anyone sending results to WebMD. We will overlook the balkanized, backward, and poorly-penetrated electronic medical records world in which these patients' doctors work.

    Even if all of these things were somehow not an issue, does anybody except Dell and WebMD marketing droids really believe that the only thing that was preventing this dramatic breakthrough from revolutionizing medical care for everybody was the lack of a stupid HL-7 interface?

    Oh, wait. Never mind. Check the last part of the article:

    The effort meshes with the federal government's plans to build a national health-information network that would keep electronic data on all Americans' care.

    Yup. Sure. Got it. Tinfoil hats meet blue-sky dreamers, and the result is ugly.

  • This whole thing is hubristic and silly, and has overtones of big-brother style snooping. Perhaps if America had a national health service, like the rest of the civilized World, companies wouldn't need to embark upon such ridiculusness in an attempt to lessen health insurance bureaucracy.
    • Free state health care rocks

      you get what you pay for
    • Perhaps if America had a national health service, like the rest of the civilized World, companies wouldn't need to embark upon such ridiculusness in an attempt to lessen health insurance bureaucracy.

      Oh hell no! Socialized medicine only works in small, collectivist countries (Western European nations and Cuba, for example). Socialized medicine won't work in a large place like the United States; it is much too big and the costs are too great to support that type of health infrastructure without heavy tax

      • I don't see why 250 million (US) is that much different to 60 million (UK).

        But actually, socialised medicine (like the NHS in the UK) doesn't work that well. Dirty hospitals, staff who frequently don't care, a blame culture, huge waiting lists, massive waste and politics. We are about to spend nearly $10 billion on the IT systems for this. Yes - $10 BILLION.

        I recently paid for some private consultations. I had to wait about 2 weeks to be seen or wait FOUR MONTHS to be seen on the glorious NHS (which inc

  • " the government 'has estimated that health IT can add $140 billion a year to the productivity of the $2 trillion health care industry.'"

    Excellent, and with an aging population and increasing cancer rates, the healthcare industry will grow even larger! Soon we'll be the busiest hamsters the wheel has ever seen!
  • I make and cancel doctor appointments, refill my prescriptions, and contact my doctor or a nurse ALL ONLINE. This news is silly.
  • This is called consumer driven health care....basically they entice you into doing preventative healthcare (physicals, health surveys, etc) in exchange for putting "healthcare dollars" in to your fund. This helps with offsetting the deductibles. Which are HUGE by the way, my family plan is 2k a year. It's all very web focused and they strongly recommend you managing your healthcare through the web. In fact one of the incentives that nets you $50 in your fund is simply registering on the provider site.

    I th
  • by jotok ( 728554 )
    Health care data is protected under US law and access to it is restricted to those with a specific need-to-know. I don't think it is very likely that anyone's employer has a compelling need to know anything about your health care other than "when" and "how much." They would surely use any additional data to make employment decisions, which is unethical at best, and in many cases already illegal (e.g. nobody should pass one of two equally qualified candidates just because one is in a wheelchair or has recu
    • Re:HIPAA (Score:2, Insightful)

      by TheMohel ( 143568 )

      HIPAA privacy regulations (there's a lot more to HIPAA than just privacy) don't for one second prevent you from consenting to the disclosure of your health care information to anybody you choose. It's not a "need to know" thing, it's a consent thing. Your consent to certain kinds of transfers (billing from your doctor to the insurance company) is obtained in writing, while your consent to others (your doctor talking to another treating physician) is implied. Your employer is completely free to solicit your

      • This is probably a more accurate interpretation of what HIPAA means. I still think that it would be unethical for your employer to request blanket access to your medical data in the first place, or to give any incentives for you to give it up, but I'll grant that it is not made illegal by HIPAA.

        My worry in this case is that I think it could enable unfair discrimination on the basis of health; and if there is anything that I have learned about corporate America, it's that if they can screw people over, they
        • I still think that it would be unethical for your employer to request blanket access to your medical data

          I agree. Unfortunately, there's no general agreement on this point from HR organizations.

          Corporate America foots the bill for health insurance. Insurers will do anything they can to reduce payouts, but I'm not as worried about direct discrimination because it will attract the attention of too many people if it becomes egregious.

          I'm far more worried about employer nanny-ism: my health care decisions are,

    • I wonder if Dell INdia could provide HR with information since India is not governed by US laws.

      Most us companies look for psychological problems and learning dissabilities as they affect job performance.

      Wasn't it a few years ago here on slashdot where a post suggested employers maybe interested in MRI scans as a condition of employment to insure no candidate has a learning dissability?
  • by nido ( 102070 ) <nido56.yahoo@com> on Monday April 10, 2006 @01:48PM (#15100219) Homepage
    If someone else is paying for my healthcare, why should I care what it costs?

    For example, when my grandmother was dying of cancer, Medicare and her supplemental picked up 95+% of the tab. Her doctor sent her to a nutritionist at first, as a way of acknowledging the mountain of research that proves nutrition is an important part of health. Grandma later said, "she wanted me to eat 5 servings of vegetables a day. She's CRAZY!" The doctor never mentioned nutrition again, and stuck to the high-tech/high-cost treatments he'd been trained in. She died after six months, after having spent $50k+ of other people's money.

    A year ago I started seeing a Doctor of Osteopathy in the Cranial Field [osteohome.com] for some Osteopathic Manipulation. He works from a home-office, has an answering machine for an assistant, answers all his own messages, and basically does everything himself. He gives me a receipt that I can submit myself for insurance reimbursment, if I so desire. He doesn't accept insurance because a) he'd need an employee to handle the billing b) his practice is full regardless c) many insurances are likely to disallow his kind of therapy, or pay him pennies on the dollar.

    In January I decided to see a homeopathic M.D. to see if there was something I could do about my cold hands. After taking an extensive history, he decided that my autonomic nervous system was probably out of balance, and injected me with novocain (same as what dentists use to numb the mouth) in a couple locations. He also gave me a couple of homeopathic remedies, and some fish oil/vitamin E at the next visit. I'm out $400 or $500 for his services, and am totally pleased with the results. He doesn't bill insurance either, also because it's not worth his time.

    If I'd gone the conventional route, my insurance would've had to spend $2000 or $5000 on diagnostic tests (an MRI goes for $1000, and CAT scans aren't cheap either), $20,000 on hand surgery/whatever, and I still would've had the problem. As it is, I've spent approx $5,000 with the D.O., and I'm totally satisfied because the treatment program works.

    Health Insurance should be carried for accidents, because you never know when you might have a $40,000 medical bill (like me, 8 years ago: a helicopter flight, a plane flight, a cat scan or two, 10 days in the hospital, etc...). But we should all pay our way, for the costs associated with living.

    Modern Medicine has evolved with almost univeral insurance coverage, so our doctors have the mindset of "if cost were no object, what would I do?" (this is not a concious thing, but a mindset that gets passed from generation to generation of medical professionals) Which explains why there are so many $60,000 heart bypass surgeries being done, even though some researchers say that bypass surgery belongs in the medical archives [discover.com], because it is almost universally incompatible with the patient's long-term outcome. I clipped a story from the paper a few weeks back about a guy who died in his 50's, 3 weeks after having a bypass operation. Re-plumbing the heart while ignoring the rest of the vascular system seems like a foolish way to go about attaining health. But it makes the heart surgeon wealthy, so why should he do anything else?

    See also:
    100 years of Medical Robery [mises.org]
    Real Medical Freedom [mises.org]
    • In January I decided to see a homeopathic M.D. to see if there was something I could do about my cold hands. After taking an extensive history, he decided that my autonomic nervous system was probably out of balance ...

      Isn't "homeopathic M.D." an oxymoron? As long as we're throwing links around here are some about homeopathy:

      Homeowatch (cousin of Quackwatch) [homeowatch.org]
      The Skeptic's Dictionary [skepdic.com]

      And if you want to spew anecdotes, when my dad was in his early 60's he could barely walk across a room without being o

      • Say what you will about homeopathy, my experience is that it works well. There's even good research supporting its efficacy - see 13 things that do not make sense [newscientistspace.com] (linked to from /. some time back), #4 Belfast homeopathy results:

        MADELEINE Ennis, a pharmacologist at Queen's University, Belfast, was the scourge of homeopathy. She railed against its claims that a chemical remedy could be diluted to the point where a sample was unlikely to contain a single molecule of anything but water, and yet still have a h

    • Well it seems you are a perfect candidate for the "new" HRA and HSAs that the health insurance industry is going on about. Each person gets a small account that they can use however they wish.

      With HSAs, which are US Federally qualified, you can deduct any expense that falls within IRS 213(d). Which means you can deduct chiropractice, homeopathic, eyeglasses or even massages. But the faster you deplete your account, the faster you are on your own to pay the other bills until the catastrophic coverage kicks i
      • So few people are going to willingly accept being responsible, once again, for buying decisions regarding their healthcare.

        Mostly because we are barely qualified to make them, not having medical degress, and exposed to half-guessed medical opinions from competing clinicians with conflicting financial interests.
    • Manipulation and homeopathic "medicine" often "work" because of the placebo effect.

      If such treatments really worked (in double-blind, scientific tests) then they would just be called "medicine" without any qualifiers.

      You're right: spending big money on treating people who are days from death may not be a good use of economic resources. But referring them to quacks is certainaly NOT the solution.
      • You bring up a good point here. Thousands upon thousands of research trials have proven beyond a shadow of a doubt that placebos are powerful medicine. But you can't patent a placebo and sell it for $100/pill, so the placebo gets shelved in favor of more profitable treatment options.

        While pharmaceuticals have their uses, the primary effect of the overdosing of America is to make the pharmaceutical companies wealthy at the expense of the people's health.

        I myself did many, many things that could be qualifie
        • I do not believe that many physicians would forgoe recomending inexpensive treatment in favor of more expensive treatment simply because it is more profitable for their peers. I also do not believe that universities would refuse to study less expensive treatments for diseases simply because there are no patents to be had. I know both physicians and reasearchers personally.

          Anecidotal evidence (such as you presented) means almost nothing to a scientist. Especially if this evidence comes from someone selling s
          • I do not believe that many physicians would forgoe recomending inexpensive treatment...

            That's because the philosophical model they were trained in is inaccurate. M.D.s are trained that a patient needs something done externally to fix the problem - surgery, drugs, etc. Still's philosophy was that 'a body will fix itself if the impediments are removed'.

            Anecidotal evidence (such as you presented) means almost nothing to a scientist. Especially if this evidence comes from someone selling something (in this ca
            • I didn't say "I've never heard the term, therefore it must be con artistry." I merely stated that it made me suspicious of con artistry. If it were medically significant, it seems terribly odd to me that so few people test for it. If your doc publishes a paper "how to measure and treat shock," and it is peer reviewed and found to be useful, I bet everyone will be doing it soon. But... he has published no such paper. Why keep this to himself? If it could help the world, he is a royal jackass for doing so.

              I d
  • My company began doing this several years ago. The entire program is "voluntary", however if you do not participate - you miss out on substancial health insurance discounts on the monthly premiums. In other words - its best to participate from a financial standpoint. At first, many employees were outraged at the invasion of privacy. Participation involved a yearly physical performed on-site at your office by "trained" medical technicians. Blood samples are taken for the various tests which are to give eac
    • Good. Very good. Stay healthy (eat right/exercise etc) and you will save money. I think that is an excellent motivator. Think about it for a minute. If enough organizations do this, and people on a whole get healtier then the cost of insurance should go down because they aren't paying out nearly as much. Then the companies can fight back and say to the health insurance people: why are we paying so much? I like this idea.
  • So this program will help keep me healthy...

    Until I get really sick, and then Dell (since they have all my records) can fire my ass before I get too expensive! Schweet!!
  • by koan ( 80826 )
    Yeah....cancer, ok this employees got cancer lets slate him for lay offs as soon as possible.
  • There are so many conditions that will preclude one buying cheap personal medical insurance, that I want to minimize errors getting into my "official medical record". Borderline-high blood pressure is common exclusionary consdition. Out company used a self-assesment form that asked employees to answer what the employee may have perceived a certain condition rather than a doctor diagnosis.

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