The Americans with Disabilities Act and the U.S. health system.

Abstract

The Americans with Disabilities Act (ADA) of 1990 provides a strong weapon in the fight against discrimination by prohibiting the adverse treatment of qualified persons with disabilities. While the law begins to take effect during the summer of 1992, health care professionals do not yet recognize how it will affect the health care system. In this report I examine three areas of impact the ADA will have on the health care system. First, I show how the act affects the clinical freedom of health care professionals to choose whom they will treat. While the ADA prohibits health care professionals from discriminating against patients with disabilities, it does not guarantee that patients have access to the health care system. Second, I explain how the ADA significantly limits the ability of employers to require medical testing and medical examination. The ADA prevents employers from using medical tests as a basis for invidious discrimination against persons with disabilities, although it grants them wide leeway to restrict health benefit coverage for employees with costly medical conditions. Third, I explain how the ADA provides an effective review of communicable disease powers. I propose clear criteria for use by public health officials in the exercise of their compulsory powers such as vaccination, screening, and contact tracing. Phased implementation of the ADA began 1 January 1992. The ADA prohibits