Tuesday, December 23, 2008

Sick leave

In the summer of 2002, I was struck by an evil and mysterious virus.

I'd wake up, in my warm bed in my warm room in the balmy July weather, shivering. Moving very slowly, I'd pull myself downstairs and fix something to eat, after which I'd feel a little better, though still weak and aching all over. But by late afternoon, I'd be shaking again like a malaria victim.

The doctor was sympathetic, reassuring and useful. She told me to take as many off-the-shelf painkillers as the instructions on the box allowed, get plenty of fluids and plenty of rest. After two weeks of this regime, I was sufficiently recovered that I could start taking a little light exercise. She suggested I walk at least as far as the village -- about ten minutes' stroll -- every day.

What astonished me, in that third week, was how weak I was. Like a kitten. Walking those ten minutes would leave me shaking and exhausted. It took me half an hour just to make breakfast, because after every cupboard I opened, every plate I lifted, I had to rest. I've never felt anything like it in my adult life.

After three weeks, I felt myself well enough to go back to work. I still tired quickly, left early, and several people commented on how thin/pale/shaky I looked. But I persevered, and in another week or so I was fully recovered.

What I didn't fully appreciate at the time -- because in England, as in Europe generally, it's standard practice -- was how easy it was to take time off work. I just handed over my doctor's notes, and that was that: three weeks' leave at full pay, no penalties, no paperwork, no questions.

Here in New Zealand, my employers aren't so enlightened. Here, we get five days per year of "sick leave", after which we stop getting paid. This is stupid on so many levels that, in my present diseased state, I can't even count them.

It creates an incentive for ill people to come in to the office, working badly and spreading their germs to other employees. It discourages people from taking time to recover properly, again encouraging them to perform substandard work and endanger their long-term health by coming back before they're really recovered.

"But", John argues, "if we didn't limit sick leave, what would stop people from taking days whenever they felt like it?"

Newsflash: they do that anyway. One or two "mental health days" per year is considered normal. Heck, the mere fact that I just used the phrase "mental health days" and you knew what I meant should be sufficient proof of that. If anything, the five-days-per-year limit incentivises us to take more of them, because otherwise we might not be getting our full quota. But if that runs to more than one or two days per year per employee, then perhaps you should consider that you as a company are doing something wrong. Like these Lemsips I'm quaffing, the "limited days" policy will suppress (some, though not all of) the symptoms, but it's just helping you to continue screwing up.

So here I am, sniffling and sneezing on my colleagues to make my point, and generally doing anything but work. That last is my professional duty: any work I did today would likely be more harm than good anyway.

When I get into Parliament, this "five days" crap is going to change.


Eric Lester said...

I hope you feel better soon.

There isn't really any law (that I'm aware of) about this in the US or the State of Washington. Good employers provide sick leave. Very good employers provide adequate sick leave.

The place I work for lumps all types of leave into one, simply called "paid time off," (PTO). We get about 8 hours every two weeks. New people can't use it for a while, I think 3 months.

This makes the whole thing pretty easy to deal with. One needn't lie. Just take the day off. They do object to more than 2 days of "unscheduled" leave, and it's extremely easy to schedule.

On top of that, I have the ability to telecommute (I'm doing it right now as a matter of fact), so if I did want to work when I was sniffling and sneezing, I could do so and stay home. About 70-80% of my job can be done without going to the office.

Having said all that, this is a remarkably good outfit to work for in this respect. Very few employers around here, with the exception of Boeing and the government, have anything like this.

As a result, I am underpaid (in my opinion). Oh well.

Xygent said...

Healing vibes (or whatever) to you from the extreme eastern shores of the Pacific, vet. House-hunting can wear the best man down.

The sick-day rationale in NZ sounds like the standard one in the U.S. (And here I thought all other developed countries were light years ahead of the United Snakes on this count, just as they have been in not openly letting churlish Cheneyesque éminences grises exercise virtually unlimited authority.)

Why are policies so short-sighted? It's comforting to think that there's some sort of rationale, however faulty, because otherwise we must admit to insanity as our prime workplace ethos. As near as I've been able to fathom, there are a couple of reasons.

One is the focus on near-term results, or rather the inability to think long-term — like the obsession with quarterly profits at the expense of long-term returns from strategic training and capital investment. The other has to do with the need to count things and cite performance indicators to one's higher-ups and, in the case of private-sector companies, to corporate shareholders.

Is it not easier to appear "productive" if one can point to numbers that prove low absenteeism? Never mind that the work force is functioning at 60% of normal capacity because employees are passing viruses back and forth. That's much harder to measure.

The benefits of enlightened policies manifest mainly in the long term. That makes it iffy attributing improved performance, higher morale, and lower turnover (in the N. American sense) to more liberal sick leave. Someone will always suggest that those are due to better cube-farm layout in a particular department, the acquisition of faster photocopiers, the winning season the local sports team has had, etc.

You'd be more informed than I on this point, but in those European countries where sick leave (and annual vacation) are more humane, hasn't there been a long-standing tradition of taking labor seriously — to the point of accepting union reps as bona fide members of internal corporate or government policy-making committees? In France at least, public protests concerning social policy can actually reverse government policy. That hasn't happened in the U.S. since the 1970s.

Some of us still remember the days when people cited NZ in the same breath with Sweden as an enviable socialist, or social democratic, model. What a pity the legacy of that era seems to have yielded to the Tayloresque American model.



vet said...

Eric, that sounds like a -- not so bad model, but it'd still be problematic if you got the kind of illness that requires more than a couple of days.

X, you're right of course. European labour law (still) varies from country to country. Some take unions very seriously. My former workplace I mentioned in the UK was completely non-unionised, and that's not unusual in modern British companies, but it was still resolutely Enlightened.

What does happen in Europe is a constant, low-intensity squabble between various levels of government (European, national, and regional in those countries that have such a thing) as to who should be setting this kind of law. In general: the more "liberal", in the common sense of the word, politicians are usually in favour of generous standards being mandated at the highest possible level, otherwise (they argue) countries will compete to reduce labour overheads by cutting standards. I don't accept that, because it's a betrayal of the whole "good benefits improve productivity" argument, which I actually do believe in.

Another side-effect of this power struggle is steady bickering over what constitutes acceptable labour standards, and what should be done to enforce them elsewhere. And that way, of course, lies trade protectionism, which to my mind is the single nastiest, most selfish and short-sighted economic policy it's possible for any government to pursue.

The NZ attitude is -- wants to be -- humane, but like many social structures and ideas in this country, it's like it's about twenty years out of date. There exists, for instance, a medical compensation scheme for people injured, whether at work or in private life, whose main purpose is to keep people from suing negligent employers. Of course it has the side effect of making it easy to claim (a pitiful amount -- I think you need to pretty much lose a limb before you get into 4 figures, sort of thing).

At least we still have free hospital care...

Xygent said...

"Free" (i.e., tax-supported) hospital care but not medical care? That kind of arrangement would set NZ apart on the first-world health-plan scene, would it not?

Although, as I understand it, Australia has a quasi-U.S.-like health insurance structure, in part because it, too, is a federal system with distinct regional interests to reconcile across vast expanses. I mention the Aussies only because mutual NZ-Australian influences seem to be strong, despite distance, insularity, and (presumably) a plethora of other differences. (Personally I can't tell the accents apart.)

If NZ does indeed lack publicly financed medical care, that would fly in the face of some models explaining which countries have universal health insurance, which ones have actual socialized medicine, and which one (sing.) does not. The findings were that those countries that industrialized early (like the UK, but unlike the US), those that were of manageable size (i.e., not in the China- India- Russia- US league), and those with dominant homogeneous populations (e.g., the Scandinavian countries, Japan, and others before heavy immigration) were more likely to entertain and adopt universal coverage as an appealing scheme for the collectivity. Thus, at least, claimed Rogers Hollingsworth and others.

All those things applied to political dynamics in the last century. In this one, it's appearing more and more that Peak Oil will soon override all other determinants.

Here endeth the divagation for today.

Xygent said...

Actually, a more complete list of links to Peak Oil punditry can be found here.

vet said...

Okay -- health care is mostly free, i.e. "socialized", as you 'Murricans would put it. But we do have to pay for doctors' visits. (The theory is that this keeps people from pestering doctors with every sniffle, but of course it also -- sometimes -- puts them off from visiting when they need to.)

We also have to pay for prescriptions (usually) and some treatments.

Which is why I'm hestitant to call it unconditionally "free". But for the most part, it is.

Eric Lester said...

Our leave plan is actually more complicated than my sketch. There is a provision ("extended sick leave") for illness that lasts more than 3 days.

The political aspect of all this is depressing. Speaking for the US (if only they knew who their spokesman was at the moment!) we need "single-payer" health care instituted at the Federal level. Anything else will be a cynical ploy to snag votes for some Governor from gullible people.

States that have had pro-labor laws and policies have become states with much less industry. New York comes to mind as a loser, South Carolina a winner. (China, big winner, though not actually a bona fide "State" of the USA.) Of industry, that is. I am oversimplifying a complicated problem in order to make a point.

My own daughter has not had health insurance since she passed the age of 24, at which point I could no longer carry her as a dependent on my employer-provided plan. When she gets sick, she deals with it as best she can. If it's scary, her father starts waving credit cards around. But more often than not, she goes to the emergency room at the local public hospital and throws herself on the "mercy" of the "system." I don't think her situation is rare.

And, I hope by now your virus has expired.

Xygent said...

Actually, vet, there are formal definitions for "socialized" in medical and insurance contexts, as well as (obviously) in politics. And it's not just Americans who use them, though it is primarily Amerikans who misuse them.

Socialized medicine is where the system is virtually 100% publicly funded, facilities are publicly owned, and health care (or disease care, if you want to be precise) professionals (including physicians) are employees of the state, as in the UK and some of the Scandinavian countries.

The New York Times (and long-time health-policy reporters like Robin Toner) know good and well what the formal definition is. Yet the paper persists in referring to what Americans call "single-payer" systems (e.g., American Medicare and Canadian medicare, which Canadians ironically do not capitalize) as "socialized" medicine. Their stories enjoy maximum deterrent value that way, which serves the interests of some of its larger advertisers.

What Canada does have, though, is socialized health and medical insurance. The provinces are the sole insurers for mandated services. Physicians and other professionals are paid negotiated fees by the province in which they work, but they are not its employees. Hospitals and clinics may be owned by entities other than governments.

"Single-payer" is actually a term pro-universal-health-coverage Americans invented to replace "Canadian-style system" during the Clinton-era "reform" battles. The 1000+ health insurance companies and their lobbies exploit Amerikan xenophobia by associating the names of foreign countries with health plans. Their foreignness obviously makes the plans incompatible with the notion of American Exceptionalism and therefore "untransplantable".

(Canadians, by the way, have no idea what a "single-payer" system is, even though they live under one of the best examples of one.)

None of this is of particular significance unless you're interested in health policy and actually think universal coverage is possible at the national level in the U.S. But the details above do underscore how erratic, chaotic, and irrational issues as complex as health/ disease care become as soon as they're politicized.

And the American debate generally holds therapeutic value for non-Americans in the First World because it causes them to heave huge sighs of relief in proportion to how much they know about the Amerikan health [sic] care non-system.

Prepare to hear all this stuff over and over, with every imaginable distortion, in a campaign that will last longer than the presidential campaign and possibly cost more, as soon as Obama takes office....

Xygent said...

Eric, I've followed Amerikan health care "reform" attempts for quite some time. There does need to be federal fiscal participation, to be sure. But trying to institute universal health care coverage at the federal level in the U.S. is actually the surest way to see it defeated.

I know this seems counter-intuitive, but there are historical precedents and sound policy rationales.

The Canadian federal government originally attempted to introduce a national program in the late 1940s, but the provinces rejected it because of the perceived federal intervention in their affairs. Then one province, Saskatchewan, decided to go it alone (under a social-democratic premier) in the 1950s, and the rest of the country then followed suit. There was federal enabling legislation and (at first) cost-sharing, but it was the provinces that actually had to pass the laws and set up the funding mechanisms.

Think about it this way: If you wanted to engage in Karl Rove-like subversion, or if you were one of the roughly 800-1000 health insurance companies in the U.S. (which has shrunk since it peaked at 1,500!), would you rather wage battle against health reform at the federal level (where you could focus your resources and wield considerable influence out of public view), or would you rather have to take on public health insurance advocates in 50 states and at the federal level?

The one time the U.S. came close to having universal insurance (then called "compulsory health insurance") was just before WW I. And then it was individual states that were doing it; Wisconsin and NY has plans all ready to go. Then WW I broke out, and it became known that the Germans had pioneered collective health insurance under Bismarck in the late 19th century. And guess what, suddenly it was tainted with the Prussian war-monger image and fizzled.

Single-payer is indeed the best, least intrusive, most economically efficient way of ensuring 100% coverage. But there's theory and there's political reality. Do you realize that Ted Marmor of Princeton, an articulate S-P champion, had a private audience with Clinton around 1992-93? And Clinton openly acknowledged to him then that it was the most elegant solution, but he thought it "not politically feasible" and went with a plan that was almost as complicated as the U.S. military budget.

The one wild card during this 7th or 8th round of reform that may actually tip the scales is one that FDR enjoyed with Social Security (which was originally supposed to include health care): an economic depression. Civil unrest can induce even Republicans to overcome their socialism phobia long enough to throw a bone to working Americans — in the name of cutting socialism off at the pass.

But perhaps you'll forgive me if I don't hold my breath.

Xygent said...

Er, and thanks be unto vet for letting us use his blog, à la TIBU, to wander so far afield from the original post....

vet said...

Umm... thank you, X, for the education. It's most interesting, although I'm firmly in the camp you depict as Heaving Huge Sighs Of Relief that it's Not My Problem.

Best of luck to Obama or anyone he tries to get to tackle it. Sounds like they'll need it.