Wednesday, February 04, 2015

Hand washing should be optional

I couldn't make this up, from the Washington Post:

Sen. Thom Tillis (R-N.C.), at the end of an appearance Monday at the Bipartisan Policy Center, volunteered a story about “his bias when it comes to regulatory reform.”

Tillis said he was at a Starbucks in 2010 talking to a woman about regulations and where businesses should be allowed to opt out. His coffee companion challenged him, asking whether employees there should be required to wash their hands.

“As a matter of fact I think this is one where I think I can illustrate the point,” he recalled telling her. “I don’t have any problem with Starbucks if they choose to opt out of this policy as long as they post a sign that says we don’t require our employees to wash their hands after leaving the restroom. The market will take care of that. It’s one example.”

Here's the video version.

I think we should extend this to hospitals, nursing homes, and the like.  After all, the market will take care of that, too.  A few extra cases of c. diff and people will run to the competition.



cheryl said...

Excellent strategy for transparency.

Sign: "We don't bother to fix our mistakes."

"We never pay attention to reaction."

"This car has not been tested for safety."

Anonymous said...

The point that he was making is that government regulation is not necessary in this instance because no reasonable business would ever opt out of such a policy, and if they ever tried then they would be publicly castigated.

There are lots of situations where this wouldn't be the case - for example, where a business has a financial incentive to do the wrong thing - you need government regulation there. But this isn't one of them.

The notion that you need the government to prescribe the proper conduct in every situation is very silly, and the fact that of course businesses should make employees wash their hands is not a proper case for why you need Big Brother to step in.

beverly said...

Anon 12:40, I beg to differ. There are plenty of businesses ('reasonable' being in the eye of the beholder), including some restaurants I have been in, who would not bother to require hand washing for their employees. Even now I suspect they put up the sign in the bathroom and then wash their hands of the matter, so to speak.

That's the entire point, of course, is that different people have different views of what is 'obvious.' Vaccines, anyone?

Anonymous said...

Beverly - let's assume that's all true. 100% true.

What exactly is a government regulation going to do about it?

If a restaurant already has the sign in the bathroom, but you think in their heart of hearts they don't really care... then what? Are you going to have a government agency put cameras in the bathroom and monitor them remotely? Force all food service employees to attend seminars where they drill it into their heads?

I don't understand how you can advocate for a law without looking at what actual, real-world impact it will have. With all due respect, it's cognitively lazy. Saying "people should do x" is totally separate from legally mandating it and putting a regulatory structure in place to somehow force or monitor their compliance.

Laws are not a public relations tool or a statement of what people ought to do. You pass laws to fix problems. Laws involve government employees actually doing or enforcing something. If you're refusing to look at what happens when the rubber meets the road, you're sticking your head in the sand and tilting at windmills.

Paul Levy said...

Story from Bloomburg:

In North Carolina, as in several other states, hand washing regulations are more complicated and expansive than the ‘Employees Must Wash Their Hands Before Returning to Work’ sign above the bathroom sink. They dictate how to wash your hands (10-15 seconds with warm, running water), where employees can wash their hands (in a designated hand washing sink, not a sink used for food preparation), what kind of soap you can use (FDA approved), and what to use to dry off your hands (disposable paper towels or a hand dryer).

Not everyone will follow the regulations, but at least there’s a standard for health officials to enforce. Under Tillis’s example, if an employee washes his hands for 5 seconds, uses no soap and cold water, and dries his hands off on his jeans, hasn’t he washed his hands? Maybe, but that’s certainly not safe for consumers, as several salmonella outbreaks over the years have shown.

In 2013, an All American Grill in Tillis’s home state gave a hundred people salmonella. The health department identified several health violations that could have contributed to food cross-contamination, including the fact that the hand washing sink was out of paper towels and soap, and didn’t have sufficiently hot water, all factors that “could serve as a deterrent to hand washing or render it ineffective,” according to the department. In that situation that market didn’t take care of the safety risks—100 ill guests and employees did.

beverly said...

Anon, the answer to your question is simple - if there's a law and there is a violation, then the place is shut down. No law, it can do what it wants till enough people get sick and die that it's noticed. You want your child to be the index case? How far are you going to go with this? I am afraid it is you who fails to see what happens when the rubber of no public health meets the road of mass illness.