The Affordable Care Act (ACA) enabled 20 million people who did not previously have health insurance to acquire it, including many with preexisting conditions. On the surface, it may seem like this should be enough to keep employees healthy, but it rarely is. In truth, millions who have healthcare still don't seek standard preventative care because they can't afford to take the day off work.
The ACA may provide health insurance to many who otherwise could not afford it, but it does not provide them with sick days to get checkups. Under the ACA, insurance companies are required to cover preventative checkups, but workers who don't have access to paid sick leave are 1.6 times less likely to have received a flu shot in the past 12 months, 30 percent less likely to have had their blood pressure checked, 40 percent less likely to have had their cholesterol tested, and 19 percent less likely to have even seen a healthcare professional, according to "Paid Sick Leave and Preventative Health Care Service Use Among U.S. Working Adults," a new joint study from Cleveland State University and Florida Atlantic University.
The High Cost of Poor Health
Those who don't seek basic preventative care run the serious risk of developing long-term health issues that could have been caught and controlled.
"Preventive health care is widely known to prevent illness, slow disease progression, reduce health care costs, and save lives," says Dr. Patricia Stoddard-Dare, associate professor at Cleveland State University. "For example, when people become aware they have elevated blood sugar through early detection, they can take steps to improve their glucose tolerance. Over the long term, risk of significant health consequences that could arise from untreated diabetes such as kidney disease, heart attack, and stroke can be minimized."
The same can be said about a number of other preventative health measures, like cholesterol screening, blood pressure monitoring, and cancer screening.
"Health costs are often higher for those who forgo preventive care because conditions worsen and become more complicated," Dr. Stoddard-Dare says. "Workers who receive preventive health care such as cholesterol screenings are better able to detect issues early and control escalation of their condition. Similarly, paid sick leave allows workers to take paid, job-protected leave from work, which allows time to recuperate from illness."
Lack of sick time doesn't just affect the individual, but the entire workplace.
"One important benefit of preventive care is that it can reduce the spread of disease," Dr. Stoddard-Dare says. "For example, we found workers who lack paid sick leave were significantly less likely to receive a flu vaccination, which increases their risk of flu. We know from our previously published research that sick workers who lack paid sick leave are also more likely to attend work when sick. Sick workers can infect their coworkers, clients, and customers."
The risk of infection is more than a minor inconvenience. Dr. Stoddard-Dare makes reference to the H1N1 outbreak of 2009, in which "the CDC estimates workers who attended work while sick infected an additional seven million people."
Business leaders may feel that offering paid sick leave encourages employees to stay home, which lowers productivity. In fact, the cost to the company is much higher when sick leave isn't available.
"Many employers overestimate the burden of offering paid sick leave and underestimate the costs associated with presenteeism – attending work while sick," Dr. Stoddard-Dare says.
Research has found that presenteeism may be even costlier to employees than offering paid sick leave.
"Sick workers are less effective, more likely to make costly errors in production, and are more likely to become injured at work," Dr. Stoddard-Dare says. "For example, workers who have untreated diabetes are more likely to experience symptoms such as fatigue and trouble concentrating, which can impact their work. Cardiovascular disease, hypertension, and diabetes are some of the costliest conditions in terms of presenteeism, so it makes sense to take steps to reduce their occurrence. Workers with more serious, complicated health conditions are more likely to take longer, costlier absences from work to recover. It makes good business sense to invest up front to minimize the long-term increased costs associated with chronically ill workers."
The Responsibility of Employers
Even though 22 other similarly developed countries require companies to provide paid sick leave, the United States does not. In addition, while the ACA survived recent attempts at repeal, its future isn't set in stone. As such, it is up to corporate leaders to rise to this obligation on their own and protect their workforce.
"Uninsured workers, especially those workers who lack paid sick leave, are in a precarious situation," Dr. Stoddard-Dare says. "Not only must they bear the full cost of preventive healthcare services, but they also must often take unpaid time off work to seek care. Another important barrier is these workers can also be fired for taking time off work. For most workers, any one of these barriers would be significant enough to keep them from seeking care."
Employers who make allowances for employee health should see a measurable impact on the bottom line.
"If employers want an effective and productive workforce, they need to provide workers with an opportunity to manage their health," Dr. Stoddard-Dare says. "Most advocates suggest offering a minimum of seven paid sick days annually. In addition to offering paid sick leave benefits, employers need to take the extra step of creating a culture where employees feel they can use those benefits without negative consequences."
There are other ways that employers can help employees stay healthy as well.
"Employers should consider other ways to facilitate preventive health care such as offering flexible work hours or by hosting flu shot clinics and cholesterol screenings at work," Dr. Stoddard-Dare adds.
It is important to note, though, that workplace screenings do not match the full benefits of visiting a primary care doctor.
"For example, workplace health screenings do not typically include a treatment component, such as prescribing medication, which is essential in managing some conditions," Dr. Stoddard-Dare says.
At the end of the day, it's hard to argue with the fact that a healthy workforce is a more productive one. Employee health is an investment any company should be willing to make. Your bottom line will thank you.