A line of five cashiers taking food orders inside a crowded McDonalds.

The Cost of Blocking Paid Sick Leave

After three years of negotiations, Congress and President Joe Biden forcibly finalized a labor agreement between railroad workers and rail carrier companies (PBS). The move was a blow to workers who were preparing to hold a nationwide strike for safer work schedules and paid sick leave — dealbreakers at the heart of the contract disputes. The decision to intervene was done to prevent a “devastating” strike from “the backbone of our supply chain” (CNBC). But what does it say to the rest of the country when workers whose absence is enough to cripple our economy cannot afford to take time off?

Some say the United States is lagging behind other “developed countries” when it comes to offering paid sick leave, but this undersells the problem. 93% of countries in the world provide paid sick leave to workers (P.R.I.). The U.S., the wealthiest and most inequitable country in the world (N.Y. Times), is in the minority that fails to do so. The United States also fails to mandate paid parental leave, unlike countries such as Germany, Mexico, and Niger. And U.S. workers aren’t required to receive paid vacation days. In contrast, workers in Algeria receive 30 days every year. (Yahoo! News). The U.S. Family and Medical Leave Act mandates that employers provide unpaid leave for certain conditions but leaves out common illnesses like the flu. Additionally, the act does not protect new hires or small business employees (Department of Labor).


• Stand in solidarity with workers even when it’s inconvenient. Find a local labor organization or strike in your area and learn how you can help support them.

• Support Railroad Workers United and Family Values @ Work.

Contact your state’s representatives and demand they support universal paid leave.

• Learn how you can unionize your workplace with additional support from the Emergency Workplace Organizing Committee.

Since employers in the United States aren’t required to provide paid sick leave, many do not. Fewer than 20 states, including Washington D.C., have a state law requirement. About 32 million workers have no sick leave, with less lucrative jobs less likely to offer sick days (Pew). More than 60% of low-wage workers don’t have paid sick leave (EPI). Such workers are three times more likely to forgo medical care than those who would be paid during their absence (Health Affairs).

The absence of mandatory paid sick leave means people have to choose between working while sick or missing pay and potentially putting their job at risk. 63% of Americans live paycheck-to-paycheck, worsened by rising inflation and stagnant wages (CNBC). For many, the choice between working while sick or losing income by calling out is not applicable. More than 90% of U.S. workers said they went to work while sick because they couldn’t afford to take off, with 64% saying it would cause them a financial strain not to (OnePoll). 

Being forced to work while sick for economic necessity risks not only one’s health but also coworkers and customers. Food workers contribute to 20% of foodborne illness outbreaks, which is unsurprising considering that 12% of food service workers said they’d worked two or more shifts while experiencing vomiting or diarrhea (CDC). And a pre-pandemic survey found that 39% of workers went to work with flu-like symptoms (N.Y. Times). Employers also benefit from paid sick leave as it increases worker productivity and reduces the spread of contagious illness (Better Balance). The common cold alone costs $16.6 billion in productivity loss. It reduces worker turnover, boosts morale, and helped keep businesses during the height of the pandemic by minimizing workplace contagion. 

When companies do offer paid sick leave, it’s often inadequate. Often, workers receive just a handful of days each year (Yahoo! News). Paid Time Off (PTO) policies, which combine vacation and sick days, ensure that employees with medical conditions receive less vacation time than their colleagues (USA Today). Other companies offer inadequate sick leave but allow employees to “donate” sick days to a coworker, leading one Florida teacher to go viral for begging his coworkers for sick days to finish chemotherapy (MarketWatch). Not to mention how cultural stigmas and workplace environments dissuade employees from taking leave. Two in three employees avoided calling out sick from work for fear of being reprimanded by their employer, with 60% saying they felt discouraged by their workplace to call out (OnePoll). 

The result? A “near-guarantee that workers will defy public health warnings and trudge into their workplaces, regardless of symptoms” (Inverse). Low-wage jobs where people of color are overrepresented are the least likely to offer paid sick leave, compounding with other racial disparities in health and healthcare (CDC).

Every worker should accrue paid time to recover from illness as a condition of employment. Unionized workers are more likely to receive paid sick leave than non-union workers. Sick leave and employer-provided health insurance, which union workers almost universally receive (PewEPI), are often priorities when unions fight for concessions from employers. However, as seen recently, more work is still needed to ensure that all workers have adequate work conditions, including taking time to care for themselves, because no one should have to choose between a paycheck and their health.


• The U.S. is in the 7% of countries that don’t offer paid sick leave. 

• Most workers cannot afford to miss work without experiencing financial strain.

• Paid sick leave benefits not only employees but also consumers and employers.

1200 800 Andrew Lee

Andrew Lee

Andrew Lee is a writer and organizer plotting a better world in Philadelphia. His work has previously appeared in Notes From Below, Perspectives on Anarchist Theory, Plan A Magazine, ROAR Magazine, and Teen Vogue.

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