By Dave Lindorff
The outbreak of a new swine flu in Mexico, and the potential threat
of a new global pandemic, shines a bright light on a major weakness in
the United States—an employment system where most workers are not paid
or even face getting let go if they get sick and have to stay home from
work, combined with a broken healthcare system where roughly one in six
people have no ready access to a doctor.
What the American failure to mandate employer-paid sick-days means
is that most Americans who don’t feel well go to work anyway, in part
for fear of losing their jobs, and in part because they are already
living so close to the margin that they cannot afford to miss a few
days’ pay.
The result of this is that offices, buses, subway cars and
elevators in coming weeks will be full of highly infectious people who
really should be home trying to recuperate. So even if your employer
does offer you sick leave, you will be placed at risk by other
employers who do not offer that benefit to their workers, or even by
lower-status workers at your own company who don’t get the same
sick-pay benefits you do. (At Temple University where my wife works, it
was only recently, after a long struggle backed by student activists,
that contractor-service guards on the campus received sick pay. Before
that, they had to come to work, sick or not, putting students and
faculty at risk of infection.)
Add to this the fact that nearly 50 million Americans earn too much
to qualify for Medicaid, yet work for employers who don’t provide them
with any health insurance. For such people, going to a doctor is a
serious problem. They probably don’t have the $50-$100 in cash to pay
for an office visit—much less the $200-400 it would cost to bring all
four members of a family—and going to an emergency room at a local
hospital and asking for charity care for something like flu symptoms
could mean a half day in a waiting room (with a lot of other sick
people!). Not to mention that many hospitals cheat on their free care
provision mandate and then dun patients for $2000 for seeing a
nurse-practitioner and getting the advice to take two aspirins and
drink a lot of fluid. And then of course, there’s coming up with the
money to buy a costly drug like Tamiflu.
Who’s likely to do any that without health insurance?
And so, as this latest round of flu starts to spread inexorably
northward from Mexico, we can expect to see it sweep through our
workplaces, and on into our schools, causing misery and no doubt a
large number of deaths that never should have happened.
The joke here, though it is hardly funny, is that businesses will
end up suffering as their workforces are sidelined for weeks, and as
the larger economy, already in a deep recession, suffers a further
blow. Sick workers don’t earn money, and thus have less to spend, and
besides, when whole families are laid up and feeling miserable, they
are not likely to go out on shopping sprees even if they do have money
in their pockets.
It doesn’t have to be like this. An enlightened country would
mandate that all employers offer their employees a minimum of one
week’s paid sick leave per year, so that people could stay home if they
came down with something. This benefit could be made cumulative, so
that a worker would be incentivized not to abuse the benefit, and could
use it in the event of a longer illness or injury.
An enlightened country would also see the self-interest for all in
having a health system that provided care for all. It’s not just a
matter of human decency, though one would hope that would be enough.
It’s also in our own interest that the person who sits next to us in
the office or on the bus have health insurance and ready access to a
doctor when needed.
At a bare minimum, the federal government should set up free
neighborhood clinics able to provide primary health care in every
community where it is determined that there is a lack off access to
physicians.
While we’re at it, school systems should also not be penalized if
students miss days at school because of illness. At present, having
students stay home for medical reasons reduces a school’s federal
funding, as grants are based upon a formula that counts student days
per year. This formulaic approach may lead school administrators to
avoid calling for school cancellations at a time of a possible epidemic.
Hopefully this outbreak of swine flu will turn out to be nothing
serious. But it should nonetheless serve as a wake-up call to the
American public. The next crisis could be a serious outbreak of
human-to-human bird flu, or a dramatic increase in drug-resistant
Tuberculosis or who knows what other communicable disease.
And when it comes to communicable diseases, we had better accept
that we have to be our brothers’ keepers or we will become their
vectors instead.
_________________
DAVE LINDORFF is a Philadelphia-based journalist. His latest
book is “The Case for Impeachment (St. Martin’s Press, 2006). He is
also author of “Marketplace Medicine” (Bantam, 1992). His work is
available at www.thiscantbehappening.net