Why Don't Americans Take Sick Days?

[Spectral]

Sanders proposed Healthcare system alone which wasn't as good as other systems still would have given us universal health care and was projected to save us an estimated $4,000 per person per year in costs.

This really is wildly implausible though - it ignores various changes that would be necessary that the American public isn't at all enthusiastic about, such as more significantly rationing (the most expensive) care and significantly cutting salaries for medical professionals. There simply isn't enough of the proverbial "waste" that's easy to wave one's hands at to amount to this quantity of cost savings. American healthcare isn't expensive because of a single source of increased costs, but because of a combination of for-profit hospitals, insurance overhead, incompetent government administration, extraordinarily high medical salaries, too much emphasis on "miracle treatments" that cost a fortune to marginal returns, staggering medication costs (this would be significantly helped by single payer), an unusually fat and unhealthy populace, and moral hazard by medical users that don't see costs. There are more as well, but I got sick of listing them.

Single-payer can help a couple of these, especially with good administration, but a number of them are things the American public has absolutely no stomach for.

Note that I'm not arguing against single-payer, I'm just very skeptical of claims that cost-savings on healthcare are feasible in the next decade or two.

[belfpala]

Note that I'm not arguing against single-payer, I'm just very skeptical of claims that cost-savings on healthcare are feasible in the next decade or two.

/between the lines -- like, maybe when the boomers die off. I'm kidding, not kidding.

[Tennis]

In my case, I saved up over 2400 hrs of sick leave which I could use on my retirement for service years credit. Amounted to a year and 4 months of extra service time. I once went 8 years without taking a single hour of sick leave. Only took sick leave when I really need to. Not a stress relief one to go play golf or fish. lol.

Sounds like you're setting yourself up for some serious health problems. Sad!

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Wow they treat you like trash.

10 years of service and that's it?

Over here in a decent job you'd get 4weeks regular vacation, 11 days statutory holidays as well as sick days on top of it.

The company for which I work uses a Paid Time Off (PTO) system where sick days, personal days, vacation days, etc. all draw from the same pool of hours accrued over time. I've been with the company for about ten years, so I have between three and four weeks of PTO every year. If I have more than 40 hours remaining at the end of the year, I lose those excess hours.

On average over the last decade, I've taken a week off about once every two years and called off sick about twice a year. I've thrown away hundreds of hours of time off. Why? Because I want to remain employed for another ten years. I don't exactly love my job, but I have a family to take care of, and I highly doubt I can find any other position that pays this well in this economy.

[Ragedaug]

Pretty much. We also like to attack any type of organized labor that would allow us to change said infrastructure and laws....

I would suspect it's because you are just replacing one overlord for another. At least the first overlord isn't a middleman. On top of that I've personally seen companies go bankrupt and see empty warehouse after warehouse because the organized labor squeezed the company too hard forcing them to shut down.

Either way it's a fine line to tread because companies can (and often do) take advantage of their employees, but organized labor in the U.S. typically isn't about the workers banding together so much as it is outside lawyers and husslers getting paid/rich to rough up management from time to time to justify why you are paying them dues every month.

[kamuimac]

1. Some people feel their company can't function without them.

in some cases it cant - if you have a key position in company then your really cant take days off work whenever you like - example i had to take sick day on friday and and did and so what if i spent over hour of that day on phone making sure that company that supplys me X dont fuck up like they did in samples they sent me - if they did it would either delay me production by couple of days (which i cant afford as this would lead to delay in supplying stuff to shop) or lead to me using subpar product - and im the only one who has good terms with that company as i brough them in as suppliers - ofc other could do the same but it would take htem whole day as they have no clue on many tiny aspects of that product and it that time they would have delays on their own work which is not less important like making new samples for those hwo buy our product or preparing new project for spring/summer collection so that we actually have work after new year.

whenever i hear claims liek this i already knwo that the person who makes them either have rich parents who gave him/her position or work some entry level jobs and are easily replaceable personel. once they will have important position they will understand how it is.

[Fugus]

This really is wildly implausible though - it ignores various changes that would be necessary that the American public isn't at all enthusiastic about, such as more significantly rationing (the most expensive) care and significantly cutting salaries for medical professionals. There simply isn't enough of the proverbial "waste" that's easy to wave one's hands at to amount to this quantity of cost savings. American healthcare isn't expensive because of a single source of increased costs, but because of a combination of for-profit hospitals, insurance overhead, incompetent government administration, extraordinarily high medical salaries, too much emphasis on "miracle treatments" that cost a fortune to marginal returns, staggering medication costs (this would be significantly helped by single payer), an unusually fat and unhealthy populace, and moral hazard by medical users that don't see costs. There are more as well, but I got sick of listing them.

Single-payer can help a couple of these, especially with good administration, but a number of them are things the American public has absolutely no stomach for.

Note that I'm not arguing against single-payer, I'm just very skeptical of claims that cost-savings on healthcare are feasible in the next decade or two.

I don't have long to speak as I have to leave soon but I will respond as best I can.

When we first started, I know we would have an explosion of the more expensive stuff and healthcare costs in general for the next few years due to all the ones who couldn't get healthcare now being able to. But after that was done, we wouldn't have to worry about rationing the more expensive procedures compared to what we do now. Many of our more expensive procedures are only required because many people refuse to go to doctors due to the costs to the point they turn minor problems into major ones. With single payer, preventative measures are actually done which keeps many of the more expensive stuff from ever being required. And as someone who has had to deal with the VA healthcare system where they think they can push you out of their system and into the private sector trying to save them money, they have ruined many lives and wastes millions of dollars refusing to do preventative stuff till after the person has got so bad they are required to check them. Just removing the VA's ability to push people out and allowing for preventative checks and stuff be done would save us buttloads of money we now spend when people come in so bad that they HAVE to take them in even if the person can't pay because they waited so long.

As far as cutting the salaries of medical professionals, that I can see as a major cost as the average general practitioner in the US makes $161,000 per year while the other nations the average is closer to about $80,000 or less with only other nation even close to us is the Netherlands where general practitioners make about $117,000 on average. But even taking that into account, we could still go single payer and it would still be cheaper than we have now, even if it doesn't get as cheap as other nations. Even if we came within 5% of our current costs with single payer that would still be considered a win because it would cover everyone and no longer require insurance to be needed.

But here is something to think about in savings:

*Insurance and their 20% profit margin which puts it in their best interests to jack up costs to increase their 20% cut will be gone. Even Tri-Care would be gone. Along with the costs and overhead at the hospital of requiring billing and dealing with 20+ Insurance companies. This would allow the big hospitals to be able to remove an entire section of the building and the costs of dealing with it.

*Medicare and Medicaid and all the money spent on their bureaucracy on who gets what and how to deny people is gone removing that entire section of not just people collecting but also the whole overhead that went along with it is now gone,

*Military funding of the VA Healthcare system along with all the crap they force on their doctors where things get worse because they force their doctors to be shitty due to giving them too many people and not allowing them enough time to properly diagnose them and intentionally lowballing them on symptoms trying to force them onto the private sector till they end up at 100% disability where that isn't an option for them anymore. All those injuries that got worse or people killed costing us more money will be gone and preventative measures become more common will both save us funding to the VA and their overhead along with many problems never getting as bad as they are. I am a personal example of that, I am out of work for life with nerve damage in my spine due to them trying to push me out. If they had did their job and checked there is a 95% chance I would be completely fine now but instead they tried to lowball me and lie on paperwork to cover their asses. Because the doctors are only given about 3-5 minutes to see most people and the VA can and will retaliate against them if they help the patients too much because they don't want to spend the money and they don't want the doctors to give them any information that might help them with a disability claim. ALL of this is gone along with a buttload of long term savings added and all that overhead gone.

Those 3 bullet points alone would save us buttloads of money even if all other things were equal. As they said, even Sanders plan was estimated to save America $4,000 per citizen per year in healthcare costs while giving us 100% coverage.

This ended up longer than I wanted but still good to get the point across. About to leave but will check again later. Have a good one man.

[Cthulhu 2020]

I didn't know you were writing my biography, damn should have told me so I could make sure you got some of your facts right.

1. Actually my family was poor growing up. My mom was a single mom until I was 6. She used her GI Bill to go to school, got into commercial real estate and did well for herself.

2. I didn't know 3 deployments in a combat zone was a "smooth ride", im sure the families of my dead buddies would love to hear that.

See my limited success is based upon my good decision making.

I didn't have kids until I was married
I graduated highschool
I never did drugs or abused alcohol.

That simple really. I don't have a ton of sympathy for those who spend their money on tattoos and booze before feeding their kids or paying their rent.

Lastly, I believe in simple economic freedom. You, as a employee, signed a contract with your employer consentually. I don't think anyone gets a job with a gun to their head. If you feel that you aren't being compensated enough for your labor, or that the company you work for doesn't have a benefits package you like.....search for another job and quit once you find one. That simple.

It is a good idea for employers to provide good pay and benefits, it reduces turnover, builds employee loyalty, and is overall good corporate policy. However, I don't believe employers should do so because the gov't is pointing a gun at their heads, it is counter to the values and ideals our country was based on.

I can work on your biography too!!!

Mr. Batman didn't graduate highschool because he was a depressed goth who refused to do the work. So after dropping out, and becoming a male escort for overweight truck drivers, he finally decided to get his GED since his sphincter couldn't hold in his shit anymore.

Now he lives in his mothers basement, eating soggy cheerios in his dirty Pokemon underwear while jacking off to Hentai. When not jacking, he posts on MMOC-OT using a smug attitude advocating for socialism because "getting a nine to five isn't my thing dude".

Amirte?

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Find me a U.S. gov't program that runs efficiently, in budget, and provides all services promised, and i'd take a second look at single payer.

It's hilarious that you get your panties in a twist when I say you have never been wanting for anything so you can never sympathize with those who are struggling, and yet you've made all kinds of interestingly wrong assumptions about me in the past. Like being unwmployed, emo goth who lives in his mom's basement. So yeah, don't get indignant when someone else profiles you. You do it all the time.

The fact is that those who buy tattoos, drugs and alcohol before feeding their kids or saving up are a pretty small minority of the poor. For the most part the people who can actually afford that stuff and still pay rent have halfway decent jobs and just make bad decisions.

The vast majority of the poor tend to barely have enough money to live. They work 2-3 part time jobs, often 80 hours a week. If they don't get enough hours, they often choose between rent and food. And when you don't want to get kicked onto the street, you go hungry. How often did you deal with that?

And as I said above, I've met far more people who smoke pot as I moved up into a good paying job. A brief history of me? Grew up in a middle class household, got my diploma with honors, went to uni and majored in geology and ecology double major while working two part time jobs, delivering pizzas and assistant butcher. Graduated at the height of the recession with mediocre GPA because I screwed around at first then got serious (F's will haunt you for a long time). After a few years of several part time Jobs I finally got a position as an environmental consultant. I'm now going back to get my associates in IT along with several TCC's so I can break into an even higher pay bracket.

My time working part time I met a lot of struggling people who just couldn't get ahead even though they "made all the right decisions" according to conservatives who like to pigeon hole all poor people into the "just lazy" category.

Two of the laziest people I know went into the military though. They dicked around more than I did and instead of getting their act together and finishing college, they dropped out. One lived with his parents until they more or less forced him out on his own and he joined the army. He was wildly depressed. Held a gun to his head in front of my girlfriend and everything. Extremely unstable. He lied about his medical records and got in, then was deployed to a "combat zone" or high risk zone or whatever, where he sat behind a desk every day in a base.

Now don't get me wrong, I respect our men and women in actual combat rolls, especially the ones who lay down their lives. I heard a rather poignant quote recently from an interview. It went something like... "I have never seen a country on earth that was more Gung ho and fired up to send young men and women off to fight and die. Nor have I seen a populace that, when it comes time to pay the bills of war, to take care of its veterans and consider the impact and refugees that war causes, is more vehement in completely shirking those responsibilities." And it's completely true. A certain demographic just loves the idea of war, of us "taking care of the world".

It's the same part of the populace who wants to keep every single dime they make, and whines when it comes time to pay the bills of living in a civilized and stable society.

You say it is so simple, tell that to the millions of Americans who make all the right choices, apply for 20 jobs a week and get turned down for every single one. For the first few years of the recession the unemployment/underemployment rate of college grads was over 60%, and this wasn't because they all had women's studies degrees. Fresh engineering majors, were still just under 50% unemployed/underemployed.

The fact is that there aren't enough better jobs for everyone. The fact is that the average age working for minimum wage is the mid 30's, not teens.

It's funny because even some of our Randian capitalists are starting to wake up to who is at fault, that it's not immigrants or China who is at fault. But of course they're calling the ultra elite who they once worshipped "traitors" to capitalism. That these elite who have been participating in the expansion of globalization for the last 30 years are secretly communists. It's funny and completely delusional, but at least they're beginning to acknowledge who is at fault.

Atlas isn't just shrugging at them, he's laughing at them.

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Haven't you heard? We will tax all them rich folks right out of the country to Singapore!!

Once it comes time to pay the bills of living in a civilized society, we'll figure out how to get the middle class to pay most of it, and reduce the tax burden of the wealthy below 10% just so they'll stay here. Oh noes, they might move their country of residence, whatever will we do without them! Best keep their effective tax burden at 5% or lower.

[GhostDoctor]

a. What is 'holiday'? Do you mean vacation?
b. Cause we're not lazy as fk like Euros.

Anything of any significance that has been developed or created in the past 150 years has either been completely done by the U.S. citizenry; has been heavily influenced by the U.S. citizenry, or was made possible by what the U.S. model of hard work, creativity, competition, capitalism has given the world.

You're welcome. Now go back to sipping your whatever at your bistro.

You sir, are stupid.

[Sunseeker]

Find me a U.S. gov't program that runs efficiently, in budget, and provides all services promised, and i'd take a second look at single payer.

The problem with this question is that every 4-8 years the "new guy" appoints a bunch of his friends to oversee programs that they were against 4-8 years ago. Often times, this results in drastic budget cuts from the original, approved proposals or additional demands placed on the program that it was not designed to handle. Effectively the CEO (President) has appointed Managers (usually Congress-members) who are actively sabotaging the program in question. Outside of the Post Office example, I don't think you'll find many programs that do run effectively, in budget; but again this is often because people on both sides are undercutting the program and it never gets a chance to actually run properly.

I mean, you can't blame a car for not running properly if you tell it that only 3 wheels are allowed to rotate.

[Tulune]

The problem with this question is that every 4-8 years the "new guy" appoints a bunch of his friends to oversee programs that they were against 4-8 years ago. Often times, this results in drastic budget cuts from the original, approved proposals or additional demands placed on the program that it was not designed to handle. Effectively the CEO (President) has appointed Managers (usually Congress-members) who are actively sabotaging the program in question. Outside of the Post Office example, I don't think you'll find many programs that do run effectively, in budget; but again this is often because people on both sides are undercutting the program and it never gets a chance to actually run properly.

I mean, you can't blame a car for not running properly if you tell it that only 3 wheels are allowed to rotate.

I dunno,

[Kmids]

Ok, I went abit overboard on my last post, and got an infraction.
Note to self, dont post when blackout drunk...
There is so much troll in this thread...
It's funny, still though, how many Americans defend themselves against the European way to live and work.
Most of us have 4-6 weeks paid vacation, paid sick leave, maternity leave and so on, and still you rip us for not working hard.
You guys just dont make any sense, you proclaim your country is so great, and yet your "rights" are just bullshit.
I would rather have all the listed benefits rather than being allowed to have a gun, but yeah, I guess us Europeans are just dumb..

[Akylios]

I'd have to become more educated as to what the key differences with regards to unionization exist in Europe that have allowed it to be more functional, but in the US, they've destroyed everything they touched. One of the biggest problems is the amount of political sway they were able to hold. Local politicians became so indebted to the public sector unions they they turned their cities into shitholes to appease them. Private sector unions just drove the employers away. Public ones ruined cities.

Your unions were overstepping their boundaries if they started messing with politics. That's not their goal at all. They're just there to help negotiate on behalf of their members. That's all they should do.

Anyway, when you have unions for every type of career, from non-educated to very highly educated, how can one union possibly hope to influence politicians more than every other? You'd need some Genghis Khan style union leader to bring them all together on just a single subject, let alone some major long term goal. It's never going to happen. Why should engineers or lawyers throw their lot in with plumbers or convenience store workers?

So no, everyone just worries about putting forth reasonable demands on their own members' behalf.

In the private sector business owners form their own unions btw. So it's never just one massive union trying to bully a single business owner. It's a union negotiating with absolutely every business owner of the same type at the same time. It makes for reasonable negotiations most of the time.

[ArguesWithStrangers]

Your unions were overstepping their boundaries if they started messing with politics. That's not their goal at all. They're just there to help negotiate on behalf of their members. That's all they should do.

Anyway, when you have unions for every type of career, from non-educated to very highly educated, how can one union possibly hope to influence politicians more than every other? You'd need some Genghis Khan style union leader to bring them all together on just a single subject, let alone some major long term goal. It's never going to happen. Why should engineers or lawyers throw their lot in with plumbers or convenience store workers?

So no, everyone just worries about putting forth reasonable demands on their own members' behalf.

In the private sector business owners form their own unions btw. So it's never just one massive union trying to bully a single business owner. It's a union negotiating with absolutely every business owner of the same type at the same time. It makes for reasonable negotiations most of the time.

That seems a more balanced situation to work with. As will all systems though, it's success or failure has far less to to with design and more to do with the personal qualities of the people within it. Any system can be corrupted the second sufficient numbers of people within it decide to be corrupt. That is why in this country we shy away from large power structures, because when they are corrupted, far more people suffer.

[Grim Retailer]

Healthcare is a commodity like any other.

That is not correct. There is an entire branch of economics, Health Care Economics, which models how healthcare is not a commodity like any other.

There are obviously a lot of texts on the subject, although I'd recommend Kenneth Arrows "Uncertainty and the Welfare Economics of Medical Care". It was part of the body of work for which he won the Nobel Prize in economics. It is quite accessible for Nobel Prize level work. Although obviously the field has moved on since then.

Any military treatment facility....... anywhere. Case closed.

This is a bit outside my area of expertize, but as I understand it, the VA has to get a lot of information and clearance from the military before they are allowed to do anything. It is part of the reason for the exceptionally expensive US system that massive resources are expended on gatekeeping. And it does not model a single payer system well for that reason.

You have some legitimate points, but kind of go off the rails into some serious emotional rants which degrade your overall argument. All that aside. You're not exactly comparing apples to apples. The countries which operate large comprehensive healthcare systems typically don't have as large a population, anywhere near as large a military, and have larger central government control than the United States.

This point kind of undermines your own argument. You would expect the economies of scale to make the US system cheaper, not more expensive. Anyway, it is entirely legal to check ones reasoning against reality. Check the health care spending of First World nations from Iceland of 300 000 people to Japan of 125 million. Do you see a relation?

The US is a nearly ungovernable country because our population is enormous, dispersed, and incredibly diverse. We don't have a uniform culture, work ethic, or national identity. This makes "one size fits all" solutions very dangerous. Now none of this is proves a single-payer system is not workable for us. It is just to say that you need to judge the usefulness of one within our circumstances, not that of a few million swedes who's primary occupation is agreeing with each-other all the time.

Isn't that why you have states?

The question begs to be asked, is the lack of options in the heath marketplace due to government interference? My guess is that it is
.

Note that countries with more government control tend to have far more options.

This really is wildly implausible though - it ignores various changes that would be necessary that the American public isn't at all enthusiastic about, such as more significantly rationing (the most expensive) care and significantly cutting salaries for medical professionals. There simply isn't enough of the proverbial "waste" that's easy to wave one's hands at to amount to this quantity of cost savings. American healthcare isn't expensive because of a single source of increased costs, but because of a combination of for-profit hospitals, insurance overhead, incompetent government administration, extraordinarily high medical salaries, too much emphasis on "miracle treatments" that cost a fortune to marginal returns, staggering medication costs (this would be significantly helped by single payer), an unusually fat and unhealthy populace, and moral hazard by medical users that don't see costs. There are more as well, but I got sick of listing them.

With respect, I think your opinion is coloured by perspective. You have grown up in an exceptionally unusual situation, and assume it is the norm. It isn't. The US healthcare system is expensive far beyond other systems, delivers poor results and rations care far more ferociously than other systems.

The US spends $ 4200 per citizen for government healthcare and $ 4300 for private health care. Not per patient. Per citizen! Other first-world nations pay $ 2900 - 5000 $ per citizen for a UHC system that covers 100 % of the population. ~ 4000 $ per person is what a UHC system on the average actually costs.

Now US overspending, spending beyond that, is basically a crapton of money. Almost twice your military budget. People have spent a lot of effort finding out where the money goes. The big sources is medical waste and overspending, and excessive bureaucracy. From memory, medical salaries are about 6 % of the difference.

Every other developed nation has one single sort of healthcare system, whether Beveridge, Bismarck or NI. Government run, national insurance or for-profit insurance, what have you. Then private enterprise fills in the cracks. (Bar Canada). The problem in the US is, you have a massive number of systems. The VA is Beveridge, employer insurance is Bismarck, Medicare is NI, etc, etc. And all of them do overlapping work and come with a massive amount of bureaucracy and gatekeeping. From memory 60-70 % of the overspending is there.

[belfpala]

Your unions were overstepping their boundaries if they started messing with politics. That's not their goal at all. They're just there to help negotiate on behalf of their members. That's all they should do.

Many unions here represent workers from a variety of industries/companies. Advocating for work health and safety standards, wage standards, and so forth, on the political level, is sometimes the best way to represent their members.

[GennGreymane]

I feel like a lazy piece of shit if I am not working

[Grim Retailer]

On the original question, I get 8 self-certified sick days three times per year. The legal minimum is 3 self-certified days four times per year. I average about 1 sick day per year.

With a physicians certification, sick leave is up to 52 weeks. Although paying the wages is transferred from the employer to the government after 2 weeks.

The minimum vacation is 4 weeks with at least 3 consecutive. No-one has that any more, competition for workforce means everyone has 5 weeks now. People over 60 get 1 extra week. I got 10 weeks vacation plus 1-2 weeks of in lieu.

On the issue of unions, its been my impression that European, or at least Nordic and Germanic, unions consider keeping their business competitive part of their mission. To a far greater degree than US unions, who seem to have a more short-term view of their members interests. I don't know why that developed, maybe US workers tend to be unionized more along the lines of employer rather than profession, or maybe the US is so large that international competition hasn't been on the horizon in the same way as it is in smaller countries.

[Poopymonster]

On the original question, I get 8 self-certified sick days three times per year. The legal minimum is 3 self-certified days four times per year. I average about 1 sick day per year.

With a physicians certification, sick leave is up to 52 weeks. Although paying the wages is transferred from the employer to the government after 2 weeks.

The minimum vacation is 4 weeks with at least 3 consecutive. No-one has that any more, competition for workforce means everyone has 5 weeks now. People over 60 get 1 extra week. I got 10 weeks vacation plus 1-2 weeks of in lieu.

On the issue of unions, its been my impression that European, or at least Nordic and Germanic, unions consider keeping their business competitive part of their mission. To a far greater degree than US unions, who seem to have a more short-term view of their members interests. I don't know why that developed, maybe US workers tend to be unionized more along the lines of employer rather than profession, or maybe the US is so large that international competition hasn't been on the horizon in the same way as it is in smaller countries.

Following suit maybe. Most businesses look at the short term/next quarter reports over the big picture/future. With that mentality coming down from the higher ups, those lower on the food chain follow suit.

[belfpala]

Following suit maybe. Most businesses look at the short term/next quarter reports over the big picture/future. With that mentality coming down from the higher ups, those lower on the food chain follow suit.

Typical, actually. I was head chef and general manager of a place I won't name. I put in some policies that impacted my quarterly report, and was pretty much about to get fired. Until... my annual report showed that I increased revenues by 50% without firing or laying off anyone.

[Masark]

Your unions were overstepping their boundaries if they started messing with politics.

No, it's not overstepping. It's self-defence. Corporations in the USA went to politics to counter unions basically at the beginning, so it's perfectly reasonable for unions to do the same to counter that.

There's a long history of corrupt state governments sending in police and military to attack striking workers. All the demonstrations in the world are rather useless when the other side is willing to simply kill you.

Therefore it is imperative to keep those kinds of people out of office.