Swine flu and US sick leave policy: the company we keep

I don't know if the rest of the world laughs at the US, but I feel quite sure they at least shake their collective heads when they hear how we lack one of the most important non-pharmaceutical measures against pandemic flu: paid sick leave. Of course only those countries with a policy of paid sick leave would be shaking their heads. It turns out, though, that's just about everybody:

The United States is one of only five countries in the world without a national policy on paid sick leave, Dodd said.

"We're in the company - and I say this respectfully of these countries - of Lesotho, Liberia, Papua-New Guinea and Swaziland. Those countries and the United States are the five that don't have paid sick leave," [Connecticut Senator Chris] Dodd said.

"Five nations, four of whom are struggling economies, barely surviving as nation-states, and the richest country in the world," he told a hearing in the Senate health, education, labor and pensions subcommittee. (The Independent [UK])

There are an estimated 57 million private sector workers without sick leave who are much more likely to go to work while sick or send their children to school when they are sick. The attack rate for this virus isn't know with certainty, but CDC is using a reasonable estimate of 10% of workplace contacts. It might be more or it might be less but it is avoidable. Dodd has introduced emergency legislation to require paid sick days for influenza, but it's not likely to pass nor is it any where near sufficient. Republicans have already announced their opposition on the grounds it would hurt an "already aching economy." I guess it's better that workers ache than some hypothetical business somewhere. But since businesses aren't people, they don't really ache. Just the people who work in them do.

And when they get sick, they aren't productive and they make others sick. If we toted up the lost productivity I'm guessing it would pay for sick leave many times over. But if it didn't? Wouldn't it still be the right thing to do?

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In 1st paragraph, I think you mean "...only those countries WITH a policy of paid sick leave"?

Mark: Of course. Thanks for pointing it out. I fixed it.

Agree Yes, this is the right thing to do.

Wrong, Mark go back to you 4th grade social studies text book and start reading.

And is it irony or just unfortunate circumstance that we have a particularly bad flu season during a particularly bad economic downturn. People are so afraid of losing their jobs, who can afford to call out sick and risk being labeled as unreliable?

Does anyone know if what this piece says is actually true?

And if it is true, how did this happen??

http://www.huffingtonpost.com/dr-nancy-snyderman/planes-vaccines-and-no…

Planes, Vaccines, and No EQ

When executives from the Big Three auto makers hopped their individual jets in November 2008 to fly from Detroit to Washington and throw themselves at the feet of Congress to beg for federal financial support, we all marveled at the disconnect...asking us for money while traveling in imperious style. And then they were taken aback with the public outcry.

Fast forward to November, 2009. Wall Street bailouts are the norm and fat corporate checks are back. The airplanes never really went away. So while Wall Street perks are percolating, guess what else those money mavericks have that you probably don't? They have allotments of H1N1 vaccine.

Here are some of the numbers:

Citigroup - 1,200 doses
Goldman Sachs - 200 doses
Morgan Stanley - 1,000 doses

Now look at what some of the New York City Hospitals received:

Memorial Sloan Kettering - 200 doses
Lennox Hill - 200 doses
NYU Medical Center - 300 doses

And the local universities:

Columbia University - 200 doses
NYU - 300 doses

The president of the United States has declared the H1N1 pandemic a national emergency. This move is supposed to give the federal government greater authority in coordinating doctors and emergency personnel during pandemics and in times of national security threats. You might also expect that the pronouncement would streamline getting vaccine into your doctor's office and not just into corporate medical clinics.

There are rules and forms of course to get your vaccine. The system is supposed to ensure that those who need it get it first. You remember who they are... pregnant women, young people under the age of 24, people with compromised immune systems and those caring for the very young or the very old. Hmmm. Doesn't sound like a Wall Streeter to me. Wall Street may be ground zero for an economic meltdown, but it is not ground zero for a viral pandemic.

You can put blame in so many places I'm not sure where to start... how the feds assign allotments, the NY Health department that didn't bother to use common sense or the financial institutions who jumped in the life boats while the needy were left on the sinking ship. Who cares about that inconvenient patient up the street when you have your private nurse with a syringe?

what a shame

Perhaps Sicko should be required viewing for this nation.

BTW, Revere, do you have any new thoughts on the galloping increase of cases and/or hemorrhagic cases in Eastern Europe? Or why the silence from Mill Hill, CDC, WHO, etc????

Thanks.

This H1N1 thing is going to shine a spot light on all kinds of weaknesses in our "sick-care" system. The homeless and the uninsured are just as susceptible (if not more so) to the perils of this virus, yet these huge groups of people are invisible to the system. Granted, the uninsured can get a free vaccination (when all the Wall Streeters have been taken care of, of course), but what is happening for the homeless, does anyone know? If our predictions for H1N1 and respiratory failure and mortality should come true, the nihilist in me says that the system will fall apart at the seams. And good riddance, it needs to be rebuilt anyhow.
http://evimedgroup.blogspot.com/search/label/H1N1

And the whole sick leave travesty? Revere, you rightly point out that economy itself cannot feel pain, yet for decades now we have engaged in nurturing it well beyond our nurturing of the people. The Nanny state is nanny to the corporations, not its citizens! Here is a group that has been fighting for paid sick leave and equitable healthcare, now more than ever:
http://www.momsrising.org/

My husband works for an airline with such draconian policies regarding absenteeism that a sizable number of flight attendants (upwards of 25%) are on some sort of probation. So either they work while sick or they find a new job. And because they've been getting fewer hours per month, even the ones who aren't on probation may work while sick because they can't afford not to--frightening, isn't it?

The Railway Labor Act left airline and railroad workers quite extremely vulnerable to this kind of manipulation.

We may have a national policy on sick leave, and if one works for a government agency they may even get to use it, but for those who work in the private sector, there is no coherent policy. Working in both the private and public sectors for the last few years has afforded me the opportunity to use sick days when necessary for one job, BUT in my other job, taking time off means that my hours will be cut for the next pay period or longer as a reminder that it is impolite to take time off, even if ill.

And in the area I live, our provincial government has limited worker protection in labour matters. We have the weakest labour laws in all of Canada. Even our provincial government is struggling with what to do with people who are unable to get into the doctor if they have a suspected case of swine flu, so they are asking provincial government workers to swear an oath and promise they were sick if they had a prolonged period of time off.

Article here: http://www.edmontonjournal.com/news/Swear/2196785/story.html

I wouldn;t feel too badly, Revere, Canada is not nearly as kind as we advertise....unless you are a union or government employee with a permanent position.

From HRDC site------Sick leave
Definition:
Sick leave enables employees to take time off work when ill. It is not really leave for family obligations although it may sometimes be used as such.
In a nutshell, what is provided in labour standards legislation?
â¢Employees may not be dismissed, suspended, laid off or demoted when on sick leave in 6 juridictions (federal jurisdiction, Quebec, Yukon, Newfoundland, New Brunswick and Saskatchewan) and is unpaid.
â¢More information on your jurisdictionâs labour standards is available on Provincial Labour Departments websites or at the Employment Standards Legislation in Canada web page.
Considerations:
â¢Some companies offer employees, as part of their benefit plans, the opportunity to be off work for a set period of time for illness without loss of wages.
â¢Generally, some of these days may be taken each year without a medical certificate.
â¢If the employee needs to take a longer sick leave because of health reasons, he may be entitled to take longer unpaid sick leave. He may then be eligible for Employment Insurance sickness benefits or benefits from other compensation plans for work-related illness or injury.
â¢Some employees may allow their employees to use part of their banked sick leave for certain family obligations.
â¢Sick leave may also be combined with maternity leave if there are complications related to the birth of a child.

It is hard to believe that employers of reasonable competence do not realize that sick workers and/or the fact of more workers getting sick (from non-absent sick workers) will actually cut an organization's/company's productivity. And of course those workers' children, perhaps themselves sick but, whether or not, stuck in another day of school or childcare, to sicken or be sickened, too. I was a re-entry single mom once, desperately clinging to a bottom-rung job; what we are putting on real people, real children, when a worker or child is cik in such circumstances--is hell. Not to mention the effects on general public health.

Sorry for the poor substitute for sentence structure in #13. "It is hard to believe" *but clearly true*. I won't bother you with the other additions---but yes, Revere, thank you for bringing this whole topic up again!

Your telling me that cutthroat telemarketing outfits in India and the Philippines give paid sick leave? Somehow this seems unlikely. I've had friends tour these things and they sound like one drummer away from a slave-ship.

In Australia every worker gets 7 days sick leave a year. Sick leave is cumulative. If you don't take sick leave for five years, you will have 35 sick leave days up your sleeve. Sick leave can only be taken with with the written approval of a doctor or specialist. Workers can barter with employers over their sick leave entitlements, and can take cash in lew of sick leave, or use up their sick leave days for extra holidays. I believe that is how it goes.

So the assumption is that Americans transmit dangerous or disabling infectious diseases to coworkers at a greater rate than other nationalities, causing harm to our economy and resulting in injury and death. Is there any evidence for that? (Answer: No.)

In the real world people take sick leave when they're not sick, and they also work when they're sick despite having the right to take sick leave, because of all kinds of factors, including project deadlines, the desire not to impose on workmates, etc.

The most effective solution is to, when and only when there actually is a dangerous epidemic, get the word out that you need to be extra vigilant in not coming in. This in fact is what has happened with swine flu. By only doing this only when there is a real emergency, workers actually pay attention and comply.

I've had friends tour these things and they sound like one drummer away from a slave-ship.

It's not news that call centers often violate labor laws.

By speedwell (not verified) on 13 Nov 2009 #permalink

Everything comes with a trade-off. In Sweden we have quite generous sick leave policy (even though not as generous as it used to be). For some very surprising reasons (?), we also have internationally very high sickness absenteeism (despite having, according to most objective data, one of the healthiest populations). During the 1990s sickness absence increased dramatically and expenditures increased with 50%. The most common causes are musculoskeletal disorders (very difficult to objectively measure) and mental disorders (depression, âburn-outsâ etc). As someone pointed out, in the real world with these kinds of benefit systems, people tend to misuse them to a large degree as well. Polls in Sweden have showed that a large part of the population considers it OK to take sick-leave due to âsocial reasonsâ (i.e. depressed due to family reasons, relations and so on).

In 2007 we spent 27.1 billion Swedish kroner (approx. â¬2.5 billion) on sickness cash benefits. That is quite a lot for a very small country like Sweden.

There is no such thing as a free lunch Revere, this money has to come from something. It means less money for education, health care, private consumption etc. Just because a system is good for slowing down the swine-flu pandemic, does not necessarily mean it is a welfare improving policy. So no, I am not shaking my head. Perhaps the sick-leave system we have here in Sweden helps us in the current pandemic, but it costs enormous amounts of money each other year as well (but, with my marginal tax rate at 60% its nice to see the money spent, perhaps).

North Korea, China, with its secret jails, and Cuba to name a few have SICK LEAVE POLICIES??? PLEASE!!!

Nurses who work up close and personal with IMMUNOCOMPROMISED patients cannot afford to call in sick. About 1/2 of our paychecks pay for "benefits" (such as health insurance). And being sick is seen as weakness...And no sort of weakness (physical, mental, emotional) is tolerated from ICU nurses. At least 2 pts have been infected with H1N1 by HCW in my unit.

By anonymous (not verified) on 13 Nov 2009 #permalink

anonymous nurse--your post is important, and a frightening reminder of one terrible result of the skimpy sick leave that comes of having no national policy on this.

Revere, we, in the rest of the world, are not "shaking our heads"; we are flabbergasted. Are there any plans in the US to to forbid children working in mines and as chimneysweeps?

I work as a temp in Japanese Company. They held a meeting telling us not to come to work if we were sick. Someone ask if are jobs would be protected if we missed work for illness. The answer was no.

By Jim in Indiana (not verified) on 14 Nov 2009 #permalink

The US is ran as a 3rd world country. If the "conservatives" got what they really wanted this country would be nothing but billionaires and peasants. There would be no middle class. Everyone else just works to serve the interests of the rich elite.

When will those tea bagging morons realize that they have been duped into fighting for the very people who wish to screw them into the ground?