Essential US workers often lack sick leave and health care – benefits taken for granted in most other countries

<img class = "caas-img has preview" alt = "Many nurses do not have paid medical leave. Photo AP / Michael Dwyer"src ="–/YXBwaWQ9aGlnaGxhbmRlcjt3PTcwNTtoPTQ3Ny4zNDM3NQ–/hTHN_T_N_T_N_T_N_M_M_T_N_T_N_T_N_T / 2/2/2/4/4 // "/
Many nurses do not have paid medical leave. Photo AP / Michael Dwyer

The COVID-19 crisis demonstrated the extent to which we depend on the work of others. This is particularly true for essential workers, such as truck drivers, grocery workers and hospital nurses, who ensure that the rest of us remain safe and can get the supplies, food and healthcare we need.

The pandemic also drew attention to the fact that these workers, like all Americans, do not receive many of the basic benefits and protections in the workplace – to like paid sick leave and basic health care – which workers in almost all other developed countries in the world receive, of course.


O Families' First Coronavirus Response Law, approved by Congress in March, offers two weeks of leave for workers who fall ill with COVID-19, but are full of exceptions and cover very few essential workers. Some lawmakers hope to remedy this with “Declaration of the Rights of Essential Workers, ”Which would ensure that around 60 million workers receive 10 benefits during the crisis, including paid sick leave, sick pay, free health coverage and collective bargaining protections.

Although the chances of passing the measure are low, even if it becomes law, the problem would be resolved only temporarily by some workers. When the pandemic ends, much of the American workforce will continue without the basic benefits and protections that are guaranteed in virtually all other developed countries.

I am one work scholar who has been studying labor relations for 40 years. I believe that there are three "rights" in the project that are especially urgent.


Paid sick leave

More than 33 million workers in the USA – almost a quarter of the workforce – does not have access to paid sick leave. The problem is especially serious for employees with lower wages, many of whom are essential workers.

As a result, up to 90% of employees reported that sometimes go to work when you are sick to avoid losing a day's wages or being disciplined or fired.


This is problematic for employees and employers, especially when workers suffer from colds, flu or other viral diseases that are easily transmitted by person-to-person contact. And also was seen as a contributing factor to the current COVID-19 crisis.

While 10 states require paid sick leave, the USA is one of the few countries – such as Somalia, Chad and North Korea – that do not require at least some paid medical leave.

AN study of 22 developed countries found that the average number of paid sick days required was 28. Excluding the zero days in the U.S., policies ranged from a minimum of five in New Zealand to 50 in Norway.


Free medical assistance

The pandemic also drew attention to how many Americans, including essential workers, lack of basic health care.


On 10% of non-elderly Americans – about 28 million people – had no health insurance in 2018. Another 29% of adults had insufficient insurance, which means that they have high deductibles and medical expenses in relation to their income. Lower-paid workers generally pay higher deductibles than their higher-paid colleagues.

This is not the situation for similar essential workers in most countries in the world. AN recent analysis found 112 countries provide universal health care to their citizens. The USA is the sole member of the Organization for Economic Cooperation and Development – a group of 37 industrialized countries – without a national health system.

Right to collective bargaining

One of the main reasons why many American workers do not have sick leave or medical care is that the US differs from more developed nations in another crucial way: the low participation of employees who belong to unions.

Research has found that unions offer many benefits to their members, such as 10% to 25% more earnings – depending on factors such as occupation – and a much higher probability having health insurance. They also amplify the voices of workers, as recently when a union of nurses led protests across the country which helped to raise awareness about the lack of protective equipment.

But in 2019, only 8.3% of nursing assistants, domestic workers and other health care workers in the U.S. were represented by a union. For nurses, therapists and doctors, that number was 13.7%. In comparison, 38% of health care industry in the UK and 80% to 85% of health professionals in Sweden are represented by unions.

In general, only 10% of US workers belonged to a union in 2018, occupying the 31st position in the list of 36 developed countries. This compares to 92% in Iceland, 60% in Finland and 26% in Canada.

One of the main reasons why rates are lower in the US is that weak labor laws Tue failed to protect workers from employer coercion or retaliation when they try to organize.

And the US protections for those trying to organize a union are generally those weakest among developed nations. A study that rated countries' legal protections on a scale of 1 to 5, from best to worst, gave the US a 4, because it was found that employers "had made serious efforts to crush the collective voice of workers". The United States shared this category with Iran, Iraq, Haiti and Honduras.

Giving essential workers these and other benefits would clearly help them to worry less about what happens if they get sick and more about the important jobs they are doing for all of us during the pandemic. And doing the same for all US workers on a permanent basis would make us more prepared for the next one.

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Paul F. Clark has worked with unions on member education programs in the past. Some of these programs are done for free and others involve a small fee. I do not believe that this work constitutes a conflict of interest.

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