Free Markets and H1N1

In a free market, companies should be allowed to decide whether or not to offer paid sick leave to employees. At the margin, employees who value paid sick leave will flow to companies that offer it and employees that don’t won’t; also at the margin, companies that offer paid sick leave will be able to pay their employees a little less in other forms of compensation. Everything works out for the best.

Unfortunately, not offering paid sick leave creates a classic externality: People go to work even when they’re sick, infecting their co-workers (or customers); employers internalize some of that cost (co-workers), but not all of it (co-workers going home and infecting their kids, who then go to school — because their parents can’t stay home to take care of them — and infect their classmates, etc.). I’ve written before that we are far behind the rest of the developed world in requiring paid sick leave.

Now is when it will hurt us. The New York Times has an article today titled “Fears That Lack of Paid Sick Days May Worsen Flu Pandemic.” (Economix has related data on who gets paid sick leave — public sector workers, people at big companies, and the highly-paid.) I’m not sure why they decided to throw in the word “may.” We know that at the margin some people with H1N1 are going to work when they shouldn’t. We know that H1N1 is highly contagious (5.7 million Americans affected so far). We may not know how many more people are getting H1N1 because of our non-policy on paid sick leave, but it can’t be zero.

Of course, you can count on the business lobby to deny that there is a problem:

“‘The vast majority of employers provide paid leave of some sort,’ said Randel K. Johnson, senior vice president for labor at the United States Chamber of Commerce. ‘The problem is not nearly as great as some people say. Lots of employers work these things out on an ad hoc basis with their employees.’

“According to the Bureau of Labor Statistics, 39 percent of private-sector workers do not receive paid sick leave.”

Vast majority?

There’s another dimension to this, too. Economix says this: “In both the private and the public sector, low-wage workers are far less likely to receive paid sick leave than high-income workers, touching off fears that front-line workers at fast-food restaurants or child care centers might be spreading their illnesses.”

That’s an interesting interpretation: the problem is that readers of Economix, who presumably do not work in fast food restaurants or day care centers, might catch H1N1 from a fast-food worker or their child’s day care provider. No, it isn’t. The problem is that our non-policy hurts the poor. Rich people can stay home when they are sick or when their children are sick, which means the rate of transmission in rich communities will be lower. Poor people can’t, so the rate of transmission in poor communities will be higher. This is obviously a simplification; there are poor people with paid sick leave, and rich people without it (many small business owners, for example). There are also communities that include rich and poor people. But in the absence of public policy not only do we have a negative externality, we have one that disproportionately affects the poor.

By James Kwak

53 responses to “Free Markets and H1N1

  1. we are far behind the rest of the developed world in requiring paid sick leave

    Interesting. Are the U.K., France, Spain, Italy, and Japan part of the “developed world”? Or do only the socialist Nordic states count?

    It is not at all obvious that paid sick leave has anything to do with whether people stay at home when they are sick. A paid sick day is a day off from work, period. In my experience, working both in a place that offered paid sick leave and in the same place without paid sick leave (after it was bought by a Japanese company), nearly everyone treats their sick days like any other day off. That is, they think of it as a resource which they can spend whenever they like by “calling in sick”.

    In other words, sick days and time off in general are fungible.

    So with all due respect, show me some evidence. Plot the spread of H1N1 — or any other illness, any year — for each country as a function of the number of “sick days” mandated by its government.

  2. “Lots of employers work these things out on an ad hoc basis” Claaaaaaaaaaaaaaaasic. I bet most of those conversations are mostly one-sided and end with a “Yes sir”. I have a friend of a friend, works as a nurse. She called in sick and the hospital pressured her to come in to work. Like REAL pressure.

    H1N1 doesn’t really scare me (deaths are always sad, but I don’t think the numbers are that far off from the standard flu deaths). I think of it as kind of like a practice run for something more serious. I think we get a C- on the practice run, so looking to the future it’s concerning. The Public awareness campaign by Secretary Sebelius has been quite good, but Moms waiting in line to give their children shots has been a major problem.

  3. One of my first jobs was with Kaiser doing medical research, often in support of developing a health care delivery system. My health care was fully paid for (I did pay $10 for a pair of glasses because the frames were expensive). When I was not feeling well, I would go straight to the clinic (as on duty employee went to the front of the line), they would take care of the problem and send me home if they considered me contagious. They are one of the largest, and cheapest health care providers in California with one of the highest quality ratings. Seems to have worked out well for them. To understand how to deliver high quality affordable health care, Kaiser is a fascinating study.

  4. I don’t want to turn this into a “Kaiser is great thread,” but I want to second your suggestion that Kaiser is a model system. Kaiser’s comprehensive, health-first approach is amazing and wonderful.

    After 35 years of Blue Cross, various PPO plans, and no coverage, I simply cannot believe just how good Kaiser is. I – literally – get personalized reminders to refill prescriptions, take tests, and go for preventative care. Each of my doctors can see quickly all of my records and what other docs are doing. And, I have never had such complete explanations or doctors who spent as much time spent with me as at Kaiser.

  5. Agoraphobic Kleptomaniac

    The Googles work, but let me help:

    http://www.mcgill.ca/files/ihsp/Contagion_Nation.pdf

  6. And how is that paper responsive to my point? It appears to do nothing more than restate James’s own post to which he linked.

    To reiterate my point using smaller words, it is not at all obvious that paid sick leave has anything to do with whether people stay at home when they are sick. No, wait, those are the same words, and they are already pretty small. I can only aim so low…

    Anyway, thanks for the non sequitur. Have any more “help” to offer?

  7. Guy, there aren’t any “poor” people with paid sick leave. If you have a job that steady, you’re not “poor.”

  8. In an ideal situation, sick leave shouldn’t be at the discretion of the employee. Employers should be actively sending sick employees home, or telling them to stay home, so they don’t make their co-workers sick and generally because having an unproductive employee around the office is kind of pointless. An employee couldn’t just decide to take off sick, unless they were actually hospitalized, but it would be viewed as “bad” to show up to work with a contagious illness or a serious injury.

    One reason the system has evolved the way it has is that too many employers are too stupid to take this approach. Even the military, which enrolls doctors specifically to make these decisions, tends to err on the side of putting unwell soldiers on duty.

    I’m not sure how to fix this. One approach is to increase vacation days in the US more in line with the number in other developed countries (technically an American company could legally offer its employees no vacation days at all), this might reduce sick leave abuse. I think sick days have become the new vacation days in the same way that disability is the new unemployment benefit. Another approach is to make it financially costly for employers, preferably through fines, to keep sick employees around, especially if they are contagious with something likely to develop into an epidemic.

  9. Intuitively it would seem sensible to think, that isolation during illness slows the pace of illness. Also rest typically heals the individual faster. Personal experience tells that productivity is significantly lower when sick. What other types of day offs do you have?

  10. CBS from the West

    Sick leave abuse:

    Back in the 1990’s I was part of a team investigating sick leave and short term disability in a large national corporation. We found no relationships between the amount of sick time an employee used and their health status (as best we could piece that together from their insurance claims). But there was one, and only one, really huge predictor of high sick time use: reporting to a manager who received negative ratings (of a particular kind) on average from his/her direct reports on a corporate 360 feedback survey.

    Interestingly, we replicated the study a few years later when some of the managers had been switched around within the company. The managers who originally had employees with lots of sick time, brought those high rates of sick time to their new direct reports. The managers who originally had employees with little sick time brought those low rates to their new employees as well, etc.

    The simplest intepretation is that sick time is used as a way of getting a break from an onerous manager. Seriously, companies that want to reduce sick time abuse would best accomplish that by doing something to improve the skills of their managers so their direct reports are less eager to avoid being around them.

  11. Agoraphobic Kleptomaniac

    The paper was responding to your “socialist Nordic” comment.

    I thought your other point was off topic anyway. What people use sick days for is more about culture than it is about how many sick days are offered.

    However, without mandating a minimum of sick days for everyone, you guarantee that people are going to work sick. Even if only 5% of people actually use sick days for being sick (which seems like a very lowball figure), that’s 5% less sick people in the workforce.

    Lets go your way, and not allow any sickdays (since everyone goes to work sick anyway), and see what happens to disease rates.

  12. Nemo –
    The number of sick days mandated by a government is not especially relevant. You are asking the wrong question. It’s the ability to take sick leave at all that has the potential to make a difference.

    And just because we can frame a question does not imply that somebody has the answer at their fingertips. My takeaway is that “free market” approaches are not likely to lead to optimum outcomes with regard to problems that are social, rather than economic.

    Raven –
    So you deny the existence of the working poor? Or am I misreading you?

    Cheers!
    JzB

  13. Spot on! I’ve done that many times myself. Nurse an “illness” with a beer and a dog at the matinee ballgame. It sure did make me feel better!

  14. Have you considered that the stress of bad managers actually does affect people by making them physically sick? It’s not avoidance, it’s real.

  15. CBS from the West

    “Also rest typically heals the individual faster.”

    Actually, that’s not true. While rest seems to be unavoidable with a bad case of the flu, for most diseases where it’s been studied, rest beyond a short initial period actually delays recovery or leads to complications. Just to name a few well studied examples of this: low back pain, heart attacks, hepatitis.

  16. CBS from the West

    It may well be that the stress of bad managers makes people physically sick. We couldn’t find any evidence of that in our study, but our measures of health and sickness were not all that good (insurance claims). Even assuming this effect is mediated by physical illness, it’s still avoidance–except in the most dire circumstances people can and often do choose to come to work when they are sick. And I don’t think anybody said it wasn’t real.

    But the best news is that companies that are plagued by high absenteeism and want to do something about it actually can: they can improve their managers’ skills(through training or replacement) and the employees will use less sick time. That sounds like a win all around to me. (No, I don’t have any financial or other interests in any management training consultancies or anything like that.)

  17. “In a free market, companies should be allowed to decide whether or not to offer paid sick leave to employees.”

    The main clause contradicts the introductory phrase.

  18. What I mean is, employer-employee relations are not a free market, and can hardly be so. The opening phrase suggests that they are, or that they are close to being so.

  19. OK, but this post starts with “we are far behind the rest of the developed world in requiring paid sick leave”, so I thought we were discussing desirable government policy.

    I guess I am really making two different statements. One is that mandating paid sick leave is equivalent to mandating leave in general. (Because, at least in this sense, humans are rational economic actors who respond to incentives.)

    My other statement is that I would like to see some evidence that oh-so-enlightened countries with larger mandated sick leave policies reap better health outcomes. Some recognition that such policies have a cost as well as a benefit (if any) would be a nice bonus.

  20. I can say as a Federal employee, allowed to carry over sick leave from year to year indefinitely in ones career, and who gets 4 hrs of sick leave per pay period (26 times a year), that ample sick leave does not keep people from coming to work to spread germs.

    I’ve heard co-workers say –

    1-Why use a sick day for just a little cold? If I’m going to be unproductive I might as well be at the office getting paid. I’ll save those sick day’s for something really serious.

    2-Already used up my sick leave for the year, OK, yeah…mostly Friday’s and Mondays…it’s a coincidence! Really!

    3-For women, sick days are saved inordinately for more serious health concerns or contingencies, or under family leave, for children’s needs, with coming to work with flu being called “toughing it up”.

    It has never ceased to amaze me, as someone who considers sick days for – yes, for when you are sick (who would have thunk?) – the way in which my peers have exactly opposite attitudes, albeit gleamed discreetly over a couple of decades of conversations here and there. No one’s really blatant about it after all.

    I recall a sick co-worker I kept nagging to “go home”, your of no use here! His response was “what, and blow a sick day I could use one day when I feel good?”

    So I think this whole topic, from an economic standpoint, may fall into a sort of “rational expectations” theory that requires data, rather than assuming people are rational. i.e, don;t assume people are rational on this one, there’s culture, and more.

    On another note my wife has a business and has told her people she will pay them if they get sick with flu this year. But she feels her employees would not abuse this direction. She’s apt to fire someone if she suspected this became a “freebie”.

    On another note, an in-law routinely gets told if she is sick to come to work. Ironically she’s in the Health insurance business! Short of bleeding to death the boss will not take no for an answer. The reason is the tasks at her office are all one employee deep, no backups. Even vacations are planned to where only chunks asked for a year in advance are allowed, to enable contingency planning and schedules coordination. No 1 years notice, leave rejected!

    I’d suspect for a McDonald’s though the 5-days of some mandatory sick leave scheme would end up as 5 “freebie cough cough” days falling on Monday’s and Fridays and then when the person is really sick (later in the calendar year, already depleted of leave) they’d come in to spread germs.

    Some surveys and tests and specific data by situation are definitely needed here before jumping the gun and likely giving a mandate for what would become nothing more than “personal days”.

    I’d actually favor something simple like that without pretense of any greater purpose. This would just be a version of minimum wage laws helping to lift lower bound salaries.

  21. Overly large amounts of stress is a sickness unto itself, and if left unchecked can lead to physical sickness. I have a friend right now who has wound up puking in the bathroom on her job due to stress from the strict rules and management. She reported in late to her supervisor due to the incident, with reports from multiple other employees that they heard and saw her throwing up. Management’s reaction?

    Tell her to get a doctor’s note (she has no insurance and not enough money to go to a doctor) showing that stress is causing her to puke, and they’ll avoid docking her the $10 for the incident. Until she does, she’s not to show up for work at all.

    Stress, more so than other sicknesses, has a way of REALLY snowballing and manifesting itself both mentally and physically. So does it really matter whether people are currently getting physically sick from the stress of working for a jerk? Not in my opinion. I tell friends to take sick days (if they can) from that all the time.

    I don’t think of it as “abuse” of sick time at all. I think it’s sick time being used EXACTLY what it was intended for: personal health.

  22. Since when did the US policy start to care about the poor? I think they should just bomb the poor people just as they are bombing poor people around the world. That way, the US will be a much richer place and because rich people have paid sick leave, the society will be healthier and healthcare reform wont be needed…

  23. It is necessary to define terms here as to what constitutes short initial period. Do we mean a day or two. Yes, I agree. But on the other hand, untreated and exacerbated by a lack of initial rest can itself lead to complications.

    Further, what has not been mentioned in the excessive stress inhibiting the immune system’s ability to fight off the disease.

    I agree with Kwak that given what we know about the communicability of disease, staying home with the knowledge that you will not suffer economically is the better policy.

  24. johnnylambada

    Interesting. When I brought my son in to see a doctor a few years ago, he said exactly the opposite to me. Can you site evidence for your assertion?

  25. Again, how do you define poor? It is possible to work fulltime in this society and still be poor, even by the minimal federal standard. Assuming one other person in the household, a person making federal minimum wage is earning $500 more a year than the federal poverty level $14,570. For a single person, the level is $10,830. Given any major urban area in the United States, that sounds poor. I worked among the poor in downtown Miami, one of the poorest cities in the nation. I assure you, you can work fulltime and still be poor.

  26. CBS from the West

    Here is a review article that summarizes the evidence about bed rest in a variety of diseases. If you are interested in one of those specifically, you can learn more from the reference cited. It’s a little old, but to my knowledge none of its conclusions have been overturned by more recent research, and for back pain, in particular, the evidence against bed rest beyond a couple of days continues to mount.

    Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999 Oct 9;354(9186):1229-33.

  27. Dispatch from the actual world of work: y’all are talking as if nobody ever gets seriously ill, and/or is forced to use up sick time for legitimate illness…and let’s not forget another “enhancement” lately in vogue among the cost-cuttingest, skin-flintyest (except for their CEOs’ compensation, of course, which remains obscene) corporations, in which sick time isn’t actually sick time, but part of a “bucket” of potential time off that management refers to as “PTO” (or Paid Time Off)–in which the more you take off to nurse an illness, the less vacation time you end up with, because it’s all out of the same “bucket,” you see.

    Actually, I don’t think I need some sort of cost/benefit justification for Europeans’ sick leave policies; what’s institutionalized over there is a sense of social benefit and social decency around this sort of thing, whereas in America labor exists to be exploited as much as management can get away with, all the while enriching themselves to a degree that, in Europe, would be considered barbaric.

  28. “…who gets paid sick leave — public sector workers, people at big companies, and the highly-paid.”

    As a manager for an government agency that investigates discrimination complaints, I’ve reviewed thousands of company documents related to leave policies and the employees who take it, documents of employers who run the gamut from tiny Moms & Pops to multinationals. I can tell you that this comment from Economix is right on the money. But even getting paid sick leave doesn’t mean that leave will be generous, or that the employee won’t have to run a gauntlet to obtain that leave, or that even justifiable leave (say, hospitalization) will be okayed if it runs past the amount allowed by the employer’s policies. I have seen people work for companies with stiff sick leave limits (say, 4 days a year) who were fired because an injury or illness caused them to miss more than the allotment they were given. On the other hand, I know of companies that gave employees endless leave beyond their policy limits just because the management was good people trying to help. I guess what I’m trying to say is:

    1) Lousy, poorly-paid work usually has little to know sick leave cushion;
    2) Policies can be cruel even when leave is available;
    3) Employers in practice will behave differently from policy, depending on the humanity of the management and the relationship with the employee; and
    4) Without paid leave, we punish the people who can least afford it and create problems of productivity and turnover that employers should be very concerned about.

    We need a national policy.

  29. Egads. that should have read: “…little to NO sick leave cushion;”

  30. The Dead Kennedys did a song about that: “Kill the Poor”

  31. Sick days are not as fungible as you seem to think. Most places I have worked require proof of sickness, and, lacking same, they will charge a vacation day. Not only do other countries protect workers with a sick leave requirement on employers, but the average vacation time in most is a month or more!! We Americans are really too driven by money and not driven enough by quality of life (at least those who make the rules, that is the ones with indefatigueable Puritan work ethics).

  32. Plus, in the real world where people change jobs, getting sick near the start time of a job means you don’t have any accumulated sick time, or PTO…

  33. When I owned my own company, I had more than 60 employees most of the time. I told them that I would not permit them to attend work with any contagious condition and that I would pay them for each day they missed. They all appreciated the policy, and, so far as I know, not one abused it, ever. Rarely did an employee exceed 5 days in a year. It is all about caring about your employees and valuing them appropriately. By my experience, companies that do so have very high levels of productivity.

  34. Yes, Min, kind of interesting that we have very extensive labor laws and regulations, and nothing mandating any leave except maternity leave. A little nuts, unless employers don’t believe that quality of life contributes to productivity (which it actually does).

  35. Bayard: “Not only do other countries protect workers with a sick leave requirement on employers, but the average vacation time in most is a month or more!! We Americans are really too driven by money and not driven enough by quality of life (at least those who make the rules, that is the ones with indefatigueable Puritan work ethics).”

    “I can do one year’s work in nine months, but I cannot do nine months’ work in a year.”

    — J. P. Morgan, on why he took three months of vacation each year.

  36. Here is a hypothetical argument for our libertarians:

    Let us imagine a world where – due to computing power and ubiquitous monitoring – we could trace infection vectors sufficiently accurately to prove that on the balance of evidence (the standard of proof in civil litigation) a certain individual was responsible. Let us say someone goes to work sick… and infects the others.

    Are others allowed to sue for damages? Lost labor? Pain and suffering? Development of chronic conditions?

    It is entirely foreseeable that such a world could exist in 30 years. Should such torts be allowed?

  37. There seems to be some confusion about what paid sick leave means. It means that if you are sick you do not come to work but you nevertheless get paid. It does not mean that you are allowed to be sick for a certain number of days per year.

    In other countries where I have worked you do not have a pre-set number of days to be “sick.” In places I know, if you are not sick you work. If you are sick you go see a doctor (of course in other places this is covered by national health care!), he or she assesses your problem, and then writes up a note stating that you will need to take X days off work. You show this note to your employer when you return to work. You get paid either through your employer or some social insurance fund or a combination of the two.

    So far as I know the idea of having a pre-set number of sick days is an odd feature of U.S. employers — who of course do all this in the absence of any government policies. Combined with the fact that the U.S. has absurdly few vacation days, it is not surprising that these sick days come to be seen as a perk, a vacation add-on, and that they get used in ways they were not intended to be used. The irony is that the abuse then serves as fodder for people who think there should be no sick leave policy at all!

    Of course a real government-mandated medical leave policy — in which there was no arbitrary number of days a person would be allowed to be sick, which when you think about it is on the fact of it absurd — would rectify most of these problems.

  38. “In a free market, companies should be allowed to decide whether or not to offer paid sick leave to employees. At the margin, employees who value paid sick leave will flow to companies that offer it and employees that don’t won’t; also at the margin, companies that offer paid sick leave will be able to pay their employees a little less in other forms of compensation. Everything works out for the best.”

    UTTER NONSENSE! Ever hear of an oversupplied labor market? Maybe you should personally experience it.

  39. ““‘The vast majority of employers provide paid leave of some sort,’ said Randel K. Johnson, senior vice president for labor at the United States Chamber of Commerce. ‘The problem is not nearly as great as some people say. Lots of employers work these things out on an ad hoc basis with their employees.’”

    How about abolishing both the fed and the chamber of commerce?

  40. Being a government worker with rollover leave myself, I’m surprised that you don’t appreciate the main reason government employees come to work sick when they could take the time off: many are “banking” their leave in case of some emergency–an accident, a lasting illness–that could lay them up for weeks or months. Banking leave is actually encouraged by my agency and considered good stewardship of one’s time, since we are not offered any kind of short or long-term disability benefits. As our office is getting pretty long in the tooth, people are cognizant that they may need that time for a hip replacement or recovery from heart surgery, or some other age-related problem that could keep them out overlong and seriously hurt their ability to pay their bills. All of which is good reason to encourage not only a national policy on sick leave, but some kind of paid disability as well.

  41. Francois: “So far as I know the idea of having a pre-set number of sick days is an odd feature of U.S. employers — who of course do all this in the absence of any government policies. Combined with the fact that the U.S. has absurdly few vacation days, it is not surprising that these sick days come to be seen as a perk, a vacation add-on, and that they get used in ways they were not intended to be used.”

    I am not sure about that question of intention. Remember, there is a feedback cycle here. Employers know that a certain number of sick days are taken without physical illness, yet they continue to offer a set number of sick days, and do not police occasional “sick” days off.

    As you point out, the number of days per year one is sick is not very predictable. What sense does it make to give an employee a predefined number of sick days? It does make sense to give a predefined number of vacation days. In effect, then, sick days are really days off, but both employees and employers get to pretend otherwise. It is one of those social arrangements that everybody knows, but nobody talks about.

    Furthermore, like store coupons, sick days are not all cashed in. For one thing, many employees believe that they should actually be ill to take a sick day. Even those who take an occasional “sick” day off may be afraid to take too many, in case they actually become sick. So the employer can appear to be more generous with sick days than he actually is.

    In addition, if there is an employee that the employer wants to get rid of, abuse of sick days may possibly give a pretext.

  42. CBS from the West

    “Employers know that a certain number of sick days are taken without physical illness, yet they continue to offer a set number of sick days, and do not police occasional “sick” days off.”

    But there really isn’t any effective way to police sick days off. The commonest brief illnesses (colds, “stomach viruses”, low back pain, migraine headaches, etc.) typically have little or nothing in the way of findings on physical examination, or even in lab tests (which there would be no reason to order for these diagnoses anyway). So making people get a “doctor’s note” just wastes time and money.

    I’ll say it again: if a company has a problem with too many people taking off too much sick time, the most effective thing they can do is retrain or replace onerous managers. Poor managers are the cause of excessive sick time.

  43. nemo, you nailed it. in my experience sick days are used by some for their intended purpose (mostly by professionals) but are abused by others (by support staffers). sorry if that generalization offends some, but anecdotal evidence seems solid.

    maybe mandated sick days should be covered like a sick day from public school…i.e., bring a doctors note proving your illness. the nanny state could certainly muster up coverage for that?

  44. My other statement is that I would like to see some evidence that oh-so-enlightened countries with larger mandated sick leave policies reap better health outcomes.

    Is this a serious statement? After a year of healthcare “debate,” you are still uncertain where the U.S. falls in the ranking of healthcare outcomes?

  45. it is not at all obvious that paid sick leave has anything to do with whether people stay at home when they are sick.

    Are you aware of the existence of hourly workers? Are you aware they receive no pay when they do not clock in for work, absent leave or vacation policies to the contrary? Did you realize hourly workers account for roughly half of the labor force?

  46. I have to add that in the UK it is quite normal for a would-be employer to ask a job candidate for the number of sick days they have taken in the past n years (usually between 2 and 5). This currently suits me, since as a recent graduate, I don’t have 2-5 years employment so my numbers appear at the low end (but then my CV explains that).

    Basically, sick leave is treated by some as vacation-plus (you don’t even have to book it in advance!) but most with serious (or semi-serious) ambitions to move upwards throuhg their careers take only what they need (and would feel no shame at all about declaring 10 days leave in a 2-5 year period).

    Also, the main benefit, from my view, is that you know it is there, so aren’t as worried about getting sick.

  47. Wall Street firms and the New York Federal Reserve is APPARENTLY more important to protect than pregnant mothers, children, and the elderly. From this morning’s (Nov. 5) Today Show on NBC. http://today.msnbc.msn.com/id/33655838/ns/health-cold_and_flu/

  48. The American work ethic has always set a higher standard than European countries. The general idea is that if you are sick more often and require paid time off means that you are weak and not an employee worth keeping. Whether that prevented the spread of disease or not is deferred to less productivity, higher cost, and less profit. As to the motivations of employees, with American workers only expected to take only a minimum amount of vacation time (anywhere from 1 to 3 weeks of vacation,whereas the average across Europe is 5 to 8 weeks)sick time fills the occasional request for a single day off.
    Our work ethic is more concerned with profit rather than protecting the health of the society. The status quo will prevail until the unemployment rate increases to the point where the benefit of sick time is useless to the millions of people on permanent vacation.

  49. The “people will abuse the sick leave” argument is irrelevant, unless you’re making a moral point. The point is not whether people will stay at home when they’re not sick but wether they will be able to stay at home when they are. And this affects mainly people that don’t make much so every day counts. So giving paid sick leave to workers may be equivalent to giving them paid leave in general in terms of total days of leave taken but that does not change the fact that it will probably reduce the number of sick people in workplaces, which is the objective.

  50. I have this great feeling of skepticism about the Swine flu epidemic. It seems as though not so long ago there was a lot of talk about drug companies being unwilling to be in the vaccine business, no profit. I think that there has been a lot of swilling about the flu, a lot of pandering to the fears of the unknown and a lot of unnecessary panic, all to make money, and certainly, there is a lot more money being spent on vaccines this year than at any time I can recall in the past. This has not been difficult to facilitate. Fear mongering is almost always successful and in this case there are actually some facts and reasons to have some cause for caution. And, with liability insurance rates on the rise, I see hospitals forcing their employees to be vaccinated and/or wear masks just to be able to say in court (either the court of public speech or actual legal proceedings) that we did everything any reasonable person could do. And here we are on the roller coaster of fear with someone else making a load or money. Think, there was once a reference to duct tape, while there was fear mongering about white powder.

  51. You seem to be confusing ‘work ethic’ with ‘labour exploitation’.

    And yes, America does exploit its working poor quite effectively.

  52. When I worked in academia, I was either a lab manager or graduate student. In either case everyone was “encouraged” to “tough it out” when they got sick. There are two problems with this philosophy:
    1. Some people are more vulnerable than others. For myself, I don’t get sick often, however when I DO get sick, I can’t fool around. (By the time I was 36 I had had pneumonia twice from the flu) For me – the flu means I had better stay put, watch my breathing and temperature and be ready to go to the ER should things get dicey. Why should I give up PAY when I work 60 hours a week because of this condition. Answer NO WAY – if we are truly CIVILIZED.

    2. It’s not always about the worker. A simple cold to one person can be very serious in an immuno-suppressed person that might be in contact with the worker. There was a grad student in my lab who had lupus and was on immunosuppressive drugs. A simple cold could mean an emergency trip to the hospital. A bad case of flu could mean a week in the ICU – or worse – death.

    The lack of proper or even “accepted” sick leave can have serious consequences that have ramifications far beyond the individual employees health or the need of the employer to have even sick workers on the job. The answer; PAID sick leave for ALL. Anything less is simply not civilized.