Elizabeth is a restaurant worker. Wanda is a school bus driver. Rosa works in retail. Gloria works as a home healthcare worker. One thing they all have in common: They don’t get paid sick days at their job.

If we could pass legislation to stop people from getting sick, we could probably all agree on that. But in reality, people do get sick. In some cases they have chronic conditions that require regular medical care. The question is: when people get sick are we better off if they stay home to recover or get medical attention? Or are we better off if they don’t get medical care and instead come to work while ill?

The issue of paid sick days is not simple or one-dimensional. But clearly we are all better off if employees recover from illnesses and get medical care for health problems rather than forgoing medical care and coming to work sick.

Employees who come to work while ill are likely to infect co-workers and the general public. The public health risk is all the more severe because the employees who lack this basic protection are concentrated in service sector occupations, working in restaurants, grocery stores, day care centers and nursing homes. Making sure that workers who prepare our food and care for children and the elderly are not pressured to work while sick is just common sense.

A recent study found that one in eight restaurant workers has gone to work sick twice in the last year, with symptoms including diarrhea and vomiting. Four out of five restaurant workers get no paid sick days. Of the 21 million ‘norovirus’ (food-borne illness) infections per year, roughly half are attributable to sick food employees. According to the Center for Disease Control, food-borne illness lead to hundreds of thousands of hospitalizations and as many as 5,000 deaths annually.

During the height of the H1N1 pandemic, the CDC estimated that eight million Americans came to work with the swine flu. Another seven million Americans caught the swine flu from an infected co-worker.

There are less obvious benefits to guaranteeing employees the ability to get medical care without fear of lost wages or losing a job. When people do not get regular primary care and timely treatment for chronic illnesses, their health often declines and their eventual treatment–often in a hospital emergency room–is far more expensive. We all pay that price.

A University of Chicago study found that employees without paid sick days were twice as likely as those with paid sick days to visit an emergency room because they couldn’t get time off from work to see a primary care doctor. This discrepancy is even more pronounced for the family members of those employees. Workers without paid sick days are five times more likely to have taken a child or family member to the emergency room because they could not take time off from work.

If you think these are anomalies in an otherwise perfectly functional healthcare system, think again. According to the state Department of Public Health, in 2008 there were 47,000 “preventable hospitalizations” in Connecticut–inpatient treatment that could have been avoided with timely primary care services. The cost of those preventable hospitalizations: $1.2 billion.

This is one reason why healthcare professionals–including the Connecticut State Medical Society and the Connecticut Nurses Association – support a reasonable paid sick days policy. Like the lack of affordable health insurance, the lack of paid sick days is a serious barrier that prevents families from getting timely and effective medical care. The cost isn’t just measured in dollars and cents; it is measured in health.

Business lobbyists claim providing paid sick days is too big a burden for employers. But the fact is, most Connecticut businesses have a much more generous paid leave policy than the minimum standard proposed by the legislation. They do so because providing paid sick days is good for the bottom line. When people come to work sick they don’t get a lot done, they get other people sick, and they stay sick longer–all of which leads to a costly drain on productivity.

There are more subtle benefits as well. When employees come to work sick, quality suffers. According to Jonathan Kantrowitz, owner of small publishing company: “Employees are more likely to have accidents and are more likely to make costly mistakes” when they come to work sick.

Another benefit is loyalty. Restaurant owner Louis Lista put it this way: “My experienced and dedicated workforce is due, in no small part, to the fact that I show respect to my employees by providing paid sick days. That has helped my business navigate the waters of this recession.”

Human resources consultant Scott Macdonald says that he advises his clients to implement paid sick days policies because they have “a positive effect on productivity, employee morale, employee satisfaction and engagement, and bottom-line success.”

There will still be some who say it should be left to individual businesses to decide what is best for them. But when it comes to protecting health and safety, citizens expect their government to set standards that protect the public welfare. We don’t let anyone who drives a car determine their own personal speed limit. We don’t let polluting factories come up with their own standards of “clean water.”

Individual business owners can disagree about the impact on their bottom line. The real issue is whether ensuring access to paid sick days benefits the public. By improving access to timely medical care, reducing the spread of illnesses in the workplace and providing a little economic security for working class families, the benefits of such a policy far outweigh the costs.

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