INTERVIEW. AIDS presents a number of new challenges for US employers
The increasing incidence of AIDS among American workers has those in charge of the nation's businesses facing a series of new challenges, says management expert Judy D. Olian. Managers must now consider a host of AIDS-related issues, including relevant laws, insurance ramifications, employer-employee relations, and the concerns of workers who do not have the disease, not now considered medically curable.
Dr. Olian adds that managers should be compassionate toward employees with AIDS while applying work standards consistently to all employees.
Olian is an associate professor of management and organization at the University of Maryland's business school. Her specialty is human management resources: how organizations can better manage people.
The latest available statistics on employer practices regarding AIDS (Acquired Immune Deficiency Syndrome) are from a survey in late 1985 by the American Society for Personnel Administration.
The survey found that 9 percent of companies responding had an employee with AIDS and 6 percent did not know. Only 3 percent had written policies on dealing with employees with AIDS. The society is processing results from a new survey, expected to be made public in October.
The need for managers to deal with the issue of employees afflicted by AIDS is ``part of a trend,'' Olian says, in which ``the lines are becoming blurred, slowly'' between issues traditionally considered either work- or home-oriented. ``How people are feeling ... is becoming a managerial issue'' for reasons of management, law, or health.
Employers also are increasingly involved in the rehabilitation of employees who have abused alcohol or drugs.
An employer who learns that an employee has AIDS has three basic choices, Olian says: retain him on the payroll as long as he lives, keep him employed as long as he can work, or fire him when his work capacity drops. It is premature, she says, to know what the national trend is.
Current national law prohibits firing an employee diagnosed with AIDS if he is capable of performing his work, as he apparently comes under the Vocational Rehabilition Act, which protects the handicapped. This assessment is based on widespread interpretations of a Supreme Court decision five months ago of a case that involved a person diagnosed as having tuberculosis, which Olian calls the ``closest proxy'' thus far to an actual decision involving AIDS.
The engine that drives the decisions of many employers on how to treat employees afflicted with AIDS is the reaction of the insurance company that provides employees with health insurance.
That reaction, Olian says, generally is to try either to boost premiums substantially or to end the health-care coverage of an employee as soon as he is diagnosed as afflicted with AIDS, except in those states that forbid termination.
Olian says that ``is why there is such fear, among individuals who fear that they have AIDS, of having a test.''
Often information on that test is fed back to the employer; if the test is positive, ``the minute their employer finds that they're no longer capable of doing the job - they'll get fired.''
Olian says this whole situation actually ``isn't anyone's fault.'' Employers are often unable to bear the cost of substantially higher health-insurance premiums, which are traditionally paid in part by the company, and in part by individual employees.
And insurance companies may lack the resources to pay the full costs of AIDS care, estimated at between $150,000 and $250,000 for each of the untold numbers of people with the disease.
Earlier this month the Society of Actuaries estimated that paying the costs of health insurance for AIDS and related illnesses in existing insurance policies would cost the insurance industry $50 billion by the year 2000.
Further, the society estimated, future policies could add $30 billion to $60 billion to this sum.
If costs of the AIDS illness can be fully borne neither by the afflicted individuals nor employers nor insurance companies, what is the answer?
``It's essential,'' Olian says, ``that there be a social policy bailout'' by the nation. For one thing, she says, about half of all Americans who have developed AIDS are ``people living at the fringes of society,'' including those without health insurance.
Beyond this factor are the concerns about future cases in the US.
``With projections being that three or four years from now we're going to have 190,000 cases of AIDS, we have to confront the issue as a social problem,'' Olian says. ``There have to be broader solutions'' than trying to rely on employer insurance.