Paid Sick Days and Health: Cost Savings from Reduced Emergency Department Visits
This week, the Institute for Women’s Policy Research (IWPR) released Paid Sick Days and Health: Cost Savings from Reduced Emergency Department Visits, in which my coauthors and I review findings about the connection between health and access to paid sick days, using publicly-available data from the National Health Interview Survey. Our analyses show that, even after controlling for variables like race, age, income, education, chronic health conditions, and access to health insurance, access to paid sick days is associated consistently with better health, greater likelihood of seeking out prompt medical care, and lower use of hospital emergency rooms.
It may surprise some people to learn that 44 million American employees cannot take a paid sick day. If they miss work due to illness or the illness of a family member, they lose pay—and if their employer is not the understanding type, they lose their job. These workers are also unlikely to be able to take time off work to go to a doctor’s office when sick or to obtain routine or preventative care. If they become ill or need an urgent appointment, they are more likely to end up at the emergency room than workers who have paid sick days.
Our analyses suggest that if all American workers had access to paid sick days, 1.3 million fewer emergency room visits would occur each year. Because primary care is significantly cheaper to provide than care in emergency rooms, reducing the use of emergency rooms means a significant savings, even if people still go to a primary care doctor: treating common conditions at a doctor’s office is, on average, over $800 cheaper per visit than treating those conditions in emergency rooms. That means that the 1.3 million fewer emergency room visits would save Americans $1.1 billion in health costs each year.
The findings from this week’s report only scratch the surface of the benefits of paid sick days for both individuals and society. There is every reason to expect that paid sick days produce a wide array of real benefits for workers, their families, their employers, and the public:
- Paid sick days make workers less likely to go to work while sick. This means a reduction in the spread of communicable disease to coworkers and the public. During the H1N1 pandemic, a lack of paid sick days contributed to millions of H1N1 infections, with untold costs for employers, workers, and the public.
- Paid sick days help workers maintain stable employment: they are less likely to voluntarily leave a job where they have paid sick days, and jurisdictions with paid sick days laws protect workers from being fired simply because they missed work for being sick. Reducing employee turnover reduces costs for employers, so everyone benefits.
- Paid sick days for the parents of schoolchildren make them less likely to send sick children to school, reducing the spread of disease to classmates and teachers and thus reducing absence. Paid sick days for parents may mean improved school outcomes for children.
Americans are paying $1.1 billion in preventable health costs ever y year for emergency room visits alone. The total price tag in dollars for the lack of paid sick days is larger than anyone has calculated, but the human costs are even larger: workers and families put off needed care until conditions worsen beyond the ability of doctors to treat; sick workers spread illness to coworkers and customers; and workers are fired for getting sick, putting them and their families at risk of poverty.
Individuals and organizations across the United States are working to promote paid sick days as a solution for these problems. Groups like Moms Rising, the National Partnership for Women and Families, and numerous state and local groups share the experiences of workers and their families—backed up by information from IWPR and other researchers—to convince legislators and the public that paid sick days are a policy that benefits everyone.