QUALITY: Unhealthy Trends in Employee Benefits

I am guilty of going to work when I'm sick. I admit to workaholic tendencies, but the real reason that I choose to cough my way through a day is because, as a working mother, most of my lost work days are due to my kids' illnesses and doctor appointments. Many of us hard-working, competitive Americans have our reasons for this practice of showing up to work sick. We load up on OTC medicine and suffer our way through a contagious illness, while sharing our germs with our not-so-grateful co-workers. When we get really sick, though, some of us don't have the luxury of staying home. It would mean unpaid leave or cutting into scant, precious vacation days.

This is troublesome for our already problematic health care system. When illness goes untreated, it can lead to more serious conditions that require higher-priced services and drug treatments. Increased health care costs ripple through the system:

1. Premiums go up for the insured (employers and individuals)
2. Uncompensated care costs for providers increase
3. The uninsured have more financial strain

That's why we noticed yesterday's LA Times story on how employers are cutting back on paid sick days. We understand how these benefits can seem expendable in a world of tight budgets and fierce global competition, but we also realize that these policies are counterproductive for business. It is no surprise that poor health reduces an individual's capacity to work which negatively affects workplace productivity. But as we also reported in our issue brief, "Why Insurance Matters," employee productivity takes a huge hit when employees show up at work sick. So much so, that one study found that worker impairment due to chronic health conditions costs an employer more than absent workers and actual medical expenses combined.

The trend to cut back on sick days also seems to fly in the face of all the efforts companies and health plans are making to offer wellness and other preventive programs at work (the subject of a BCBS Association briefing next Monday, we'll probably write about it). Employers all over the country are encouraging their employees to become more active in their own health by offering personal health care records and wellness programs.

The National Partnership for Women & Families has organized a huge coalition (called The Healthy Families Act Coalition) around supporting federal legislation that would mandate paid sick days.

So, how should employers encourage a healthy workplace without providing benefits that are cost prohibitive? A couple of ideas:

1. Telecommuting. For those jobs that can be performed at home, telecommuting is the perfect answer for someone who isn't so sick that they can't get some work done but risks infecting the rest of the office. Employers should be flexible about allowing it in these situations.
2. For jobs that are not telecommutable, allow workers to make-up their hours during other shifts rather than forego pay that they really need.
3. Calculate sick leave in hours, not days. A doctor's appointment need not require a day off, so workers should not be penalized for more time than they are actually gone. Really, there's no sense promoting wellness and prevention and then penalizing workers if they get preventive screening and care.
4. Consider contracting with a nearby clinic to administer flu shots, check-ups to employees and their families.
5. Institute low-cost wellness programs. Disseminate health tips via e-mail and organize walks at lunchtime.

These types of low-cost investments will create healthier, happier, and more productive (and less absent) employees. And that's nothing to sneeze at.