The American Medical Association's (AMA) longstanding policy of opposing physician-assisted suicide may take a new turn when the AMA House of Delegates debates and votes on whether the association's Code of Medical Ethics should be amended, reports the Washington Post . "The reality is there are many more doctors in the AMA, but also outside the AMA, who have changed their minds about this," says New York University School of Medicine Professor Art Caplan. Although doctors, delegates, and others showed continued support for the status quo in an open forum on the AMA's website, public surveys indicate many Americans believe doctors should be allowed to help terminally ill persons end their lives. Supporters contend that physician-assisted death should be a choice for people who are already dying and want to end their suffering on their own terms, while opponents argue such assistance violates the profession's core tenet of doing no harm. Colorado delegate Lynn Parry says she will vote to reject the position of the AMA's ethics council to remain neutral, and ask it to spend more time "looking at what protections for physicians, and particularly for care recipients, would need to be in place" for the AMA to revise its guidance. "How we look at the universe is really driven by our personal belief system and, in large part, by our philosophies and religious beliefs, and that's as it should be," she notes.

Some large U.S. corporations are targeting increasing health insurance coverage costs by managing their employees' healthcare themselves, reports Reuters . For example, since 2017 Cisco Systems has been offering workers a plan it negotiated directly with the Stanford Health medical system, under which physicians are required to keep costs down by closely tracking about 12 health indicators to prevent costly emergencies, and keep Cisco employees satisfied with their care. Stanford receives a bonus if they fulfill these goals, or pays Cisco a penalty if they do not. On Cisco's San Jose campus is a special clinic serving as the first point of contact for many employees and their families. Cisco says costs for enrollees in the Stanford plan are 10 percent lower than the conventional coverage still used by most of its workforce. To increase enrollment in their healthcare plans, Cisco, Intel, and Boeing have offered incentives such as extra money for health savings accounts or reduced monthly premiums and co-pays. In January, Amazon.com, JPMorgan Chase, and Berkshire Hathaway announced plans to form an independent company to improve healthcare for their approximately 750,000 U.S. employees, sparking speculation that they would displace health insurers and other industry intermediaries.

The U.S. Office of Personnel Management (OPM) is recommending federal agencies promote employee wellness programs, noting "the connection from wellness to employee engagement and productivity is well established," reports FEDweek . "Both employees and agencies will benefit from reinforcing the importance of healthy living and a holistic approach to well-being through a variety of inclusive programs and services," OPM stated in a memo. "Employers have a tremendous opportunity to help their employees see the value of adopting healthier behaviors." OPM cited its recent Federal Workforce Priorities report, which listed such programs among those priorities and highlighted agencies' efforts to encourage employees and their families to live healthier and boost their physical activity. "In addition, other agencies collaborate and share ideas, post them on social media and reach more employees than ever before in an effort to motivate them to move and make healthy lifestyle changes," the office noted. "Agencies partner with healthcare providers and/or vendors for onsite blood pressure and body mass index checks that provide important information and raise individual levels of awareness." OPM encouraged agencies to support those objectives by "marketing available programs and services, offering a range of events and activities, such as health fairs, cooking demonstrations, fitness challenges/walks, and webinars."

Waist measurement can be an important habit in determining one's health, reports the New York Times . If the waist measures 35 or more inches for women or 40 or more inches for men, it is likely that their abdominal fat is dangerously high. Deeper belly fat that accrues around abdominal organs is metabolically active and has strong associations with serious diseases that include heart disease, cancer, and dementia. A study of 6,583 members of Kaiser Permanente of Northern California who were monitored for an average of 36 years found that those with the most abdominal obesity in midlife were almost three times more likely to develop dementia 30 years later than those with the least abdominal fat. A large abdomen also increased dementia risk in the women even if they were of normal weight overall and did not have other health risks related to dementia such as heart disease, stroke, and diabetes. Unlike the cells in subcutaneous fat, visceral fat secretes hormones and many other chemicals linked to diseases that commonly afflict older adults. One such substance is retinol-binding protein 4, which was found in a 16-year study of nurses published in Circulation to increase the risk of developing coronary heart disease. This risk most likely stems from the harmful effects of this protein on insulin resistance and development of diabetes.

"Hybrid" policies that combine long-term-care coverage with potential life-insurance benefits are transforming the long-term-care segment of the U.S. insurance industry, reports the Wall Street Journal . Limra estimates there were 260,000 purchasers of hybrid policies in 2017, versus 66,000 traditional long-term-care policies. Sellers of long-term-care policies originally targeted them to the U.S. middle class, arguing they would save ordinary families from depleting their savings, depending on children, or enrolling in the federal-state Medicaid program for the impoverished. These policies lost popularity after many insurers secured approval from state regulators for steep rate hikes. Today, many insurers are finding these policies most popular among the affluent, who are mainly buying the contracts to protect large estates. The federal government forecasts that 25 percent of Americans turning 65 between 2015 and 2019 will require up to two years of long-term care; 12 percent will need two to five years, and 14 percent will need more than five years. Aides and caregivers who provide round-the-clock care cost $131,400 a year, while private rooms in nursing communities surpass $100,000 in many places. Hybrids can be even more costly than traditional standalone products because they usually include extra features, such as a guarantee that premium rates will not increase. Hybrids also have a "return of premium" feature that allows buyers to recoup much of their money if they want out of the transaction, albeit with no interest.

Boston College Professor Alicia Munnell says her research adds credibility to concerns that millennials are lagging so far behind previous generations financially that their retirement may be imperiled, reports Politico . "A comparison of millennials with earlier cohorts when they were the same age shows that even though a higher percentage of both millennial men and women have college degrees, they are behind in almost every economic dimension," she notes. Reasons Munnell cites include millennials' entry into the labor pool during rough economic times. "Most ... were graduating from college during a period that included both the bursting of the dot.com bubble and the Great Recession," she says. "This experience appears to have been particularly hard on millennial men, who have labor-force participation rates below earlier cohorts." Finding good jobs also has been a difficult prospect for millennials, while meeting retirement goals is complicated by their limited access to retirement plans at work, their lower likelihood of being homeowners, and their greater probability of having to shoulder student loans. "However, the good news for millennials is that retirement is still a long way off," Munnell says. "A lot will depend on their future savings patterns, financial market returns and, particularly, how long they work."

National Labor Relations Board (NLRB) General Counsel Peter Robb has released a new Guidance Memorandum specifying how NLRB regional offices receiving claims of improper employment policies are to interpret employer workplace rules, reports Labor Relations Update . In the case of NLRB's decision in The Boeing Company , the board set up a new and more employer-friendly standard for the legality of employee work rules, requiring regional offices to no longer interpret ambiguous rules against the drafter or generalized provisions as barring all activity that could conceivably be included within the rule. The offices will now check whether a rule would be interpreted as prohibiting Section 7 activity, rather than whether it could conceivably be so interpreted. Before Boeing , employers had been less eager to ban employee conduct when crafting handbook rules out of concern that those rules could be construed as possibly infringing on Section 7 rights. Robb's Guidance Memorandum explains how certain types of workplace rules would fall within the three-category analysis the board espoused in Boeing . The memo offers a preview in how a regional office would prosecute a potential unfair labor practice charge brought by an employee or union. Robb noted regions will not interpret ambiguities in rules against the drafter, which should lead to fewer charges brought against employers in this area, provided employers follow Robb's advice when drafting their employee handbooks.

New U.S. Labor Department estimates indicated that 10.1 percent of Americans in May 2017 were on alternative work arrangements that could be classified as part of the gig economy, a decline from 10.7 percent in May 2005, reports Bloomberg . This slippage was mainly due to a decrease in the share of people identifying as independent contractors, which fell to 6.9 percent from 7.4 percent in 2005. Analysis showed that Americans 55 and older made up a higher percentage of independent contractors in 2017 versus 2005, suggesting baby boomers are accepting such positions. The labor-force participation rate among people 65 and older was 19.8 percent last month, compared with 15.2 percent in May 2005. Over 33 percent of independent contractors were 55 or older in May 2017, while the age group comprised less than 25 percent of workers in traditional arrangements. "This reflects the fact that the likelihood of employed persons being independent contractors increases with age," the department said.

The U.S. Department of Justice (DOJ) is asking a federal court to strike down key elements of the Affordable Care Act (ACA) and said it will not defend major provisions in the law, according to a brief it filed in a lawsuit brought by 20 state attorneys general. The provisions it is targeting include the bans on insurers denying coverage and charging higher rates to individuals with pre-existing health conditions, reports the Wall Street Journal . DOJ is also aiming to roll back limits on how much insurers can charge people based on gender and age. The move will likely rattle insurers, which are now setting rates for 2019 based on the belief that they must adhere to the ACA consumer-protection requirements. Some legal and health experts said the decision could destabilize markets. In its brief, DOJ said certain ACA provisions, such as banning insurers from denying coverage to people with pre-existing conditions, are invalid as of January 1 with the mandate-penalty repeal. The United States agreed with the plaintiffs that sections "must now be struck down as unconstitutional," the brief stated. DOJ did not say other aspects of the ACA, such as its expansion of Medicaid and its exchanges, should be halted.

The Social Security Administration's 2018 trustees' report predicts the Social Security Trust Fund will be depleted by 2034, so lawmakers are planning a series of hearings to examine proposed legislation to prevent this, reports ThinkAdvisor . The Social Security 2100 Act unveiled last April would boost both benefits and the payroll taxes that fund them, as well as change how cost-of-living adjustments are calculated. Social Security Chief Actuary Stephen Goss confirmed at a recent House hearing that the bill fortifies the Social Security Trust Fund so it has financial soundness throughout the 75-year forecast. Rep. Bill Pascrell (D-N.J.) said the bill "would raise benefits," and that a series of "good hearings down the road" would be held on the proposal. "I can't support any program that would cut benefits in order to solve the problem," he stressed. Goss concurred that resolving the viability of Social Security relies on "enacting something to make changes that will be necessary sooner rather than later." The Senior Citizens League says if passed, the bill would bolster Social Security benefits by basing COLAs on the Consumer Price Index for the Elderly, raising monthly benefits by 2 percent, setting up a new Special Minimum Benefit equal to 125 percent of the poverty line, delivering a tax cut to beneficiaries, applying the payroll tax to annual income over $400,000, and gradually increasing the payroll tax rate by 0.25 percent.