Articles, Blog

How lack of paid sick leave is complicating U.S. virus response

March 7, 2020

JUDY WOODRUFF: As the COVID-19 virus spreads
to communities around the country, state and local officials are warning that a number
of measures may have to be taken to prevent the outbreak from getting worse. But, as William Brangham explains, some of
those steps, such as quarantines, could add even more economic stress. WILLIAM BRANGHAM: One big concern is whether
employers, schools, and communities will require workers to take unpaid sick leave. Roughly 25 percent of American workers have
no sick days. In some lower-wage industries, that percentage is significantly higher. Another
concern, those who get sick and need care could face hefty medical bills. We look at this with two people who know these
issues well. Joseph Leitmann-Santa Cruz is executive director
of Capital Area Asset Builders. They are a nonprofit that works with low-and moderate-income
families in the Washington, D.C., region. And Sabrina Corlette, she is the co-director
of the Center on Health Insurance reforms at Georgetown University. Welcome to you both. JOSEPH LEITMANN-SANTA CRUZ, Executive Director,
Capital Area Asset Builders: Thank you. SABRINA CORLETTE, Center on Health Insurance
Reforms, Georgetown University: Thank you. WILLIAM BRANGHAM: Joseph Leitmann-Santa Cruz,
to you two — first. People are being told, if you’re sick, if
you feel unwell, if you have any symptoms of coronavirus, stay home. Now, that’s great
public health policy. That’s good advice. But, depending on your job, that might not
be such an easy thing to do. JOSEPH LEITMANN-SANTA CRUZ: It is. And one of the biggest challenges is, when
we focus on low-wage workers, right, 43 percent of all workers throughout the United States
are low-wage. And, primarily, they’re in the service industry
that requires in-person engagement. So, for those individuals who are either driving an
Uber, serving coffee, making food, we cannot ask them to work from home. So it’s imperative
that we look at a wakeup situation because of coronavirus as to how the economic system
is set up to enable low-wage workers to also have an equitable opportunity at prosperity. WILLIAM BRANGHAM: Because there’s a clear
conflict there, that if your governor or your public health official is saying, we need
you, if you feel sick, to not go to work, but your boss saying, I need you on your shift,
if you don’t come, you might lose your job. JOSEPH LEITMANN-SANTA CRUZ: And, most importantly,
that family’s finances need for the individual to be generating income. What’s really amazing is that 40 percent of
all households in the United States are considered liquid asset poor. This means that their… WILLIAM BRANGHAM: Liquid asset poor. JOSEPH LEITMANN-SANTA CRUZ: This means that
they’re only one economic disruption away, like not being able to show up for work, from
an economic disruption. That could lead into eviction, homelessness,
foreclosure, bankruptcy. So the system is currently not set up to enable a low-wage
worker to have the ability to show up to work even in a situation like coronavirus. WILLIAM BRANGHAM: Sabrina Corlette, let’s
talk about for people who are uninsured. Let’s say they see these acknowledgments by their
governor or public health officials, saying, if you have symptoms, go to the hospital. If you don’t have insurance, and you go to
the hospital, what happens to you? SABRINA CORLETTE: Right. So we have in this
country close to 30 million people who don’t have any health insurance at all. And a lot
of them are in the same industries and fields that Joseph was just talking about. They are our service workers. And these are
folks who, if they don’t have insurance coverage, they’re less likely to go to the doctor if
they get sick or go to the emergency room if they really, really need care. And they’re… WILLIAM BRANGHAM: Because of fear of a huge
bill. SABRINA CORLETTE: Because of fear of the costs. So, even though the coronavirus test itself
may be covered by the government, that cost, there’s the cost of going to the E.R. or seeing
a doctor. And that can be hundreds or, in some cases, even thousands of dollars. WILLIAM BRANGHAM: And again, if you think
of it from a public health perspective, the idea that people being afraid of going to
get a test that might be crucial for our ability to control an outbreak, that might be hindered
by the fact that they don’t have insurance. SABRINA CORLETTE: Absolutely. And it’s true not just for folks who are uninsured,
but a lot of people who have insurance and even gold standard employer-based insurance
will have high deductibles. And they will also face high out-of-pocket costs. WILLIAM BRANGHAM: Do we have any sense — I
understand that the president has signed this big $8 billion coronavirus piece of legislation
to try to offer aid to states and to researchers and all of that. Are there any protections for people who are
uninsured to help them defray some of these costs? SABRINA CORLETTE: Not in the bill that just
passed Congress this week. I think it’s certainly possible that Congress
could appropriate some money to help compensate hospitals and providers for treating the uninsured.
But, right now, actually, a lot of the folks who are being treated in hospitals are on
Medicare, because they’re older. And so the government is probably picking
up the tab in that respect. WILLIAM BRANGHAM: Joseph, back to you. Your organization advocates for low-wage workers,
and that’s what we have been talking about here. But a mandate for an employer to suddenly
allow their workers to stay home from work, that can have a huge cost on an employer as
well, right? JOSEPH LEITMANN-SANTA CRUZ: It’s a situation
where I put two hats on right now, the advocate and the CEO of my nonprofit. The ability to cover the expenses associated
with any kind of a worker, whether it’s low-wage, or high-wage, is one where there is really
a significant dependency on the ability of that business or that entity to generate income. If a business is not open, it will not get
clients to come and spend money. A nonprofit organization like ours is not able to provide
the services for which we are compensated, we cannot pass on that income to our employees. So there is no magic formula. But it’s extremely
necessary for us to remember that, to the best of my knowledge, that United States is
the only industrialized economy without a national policy or national law that provides
for sick — paid sick days. WILLIAM BRANGHAM: And, Sabrina, would you
imagine that there’s going to be — given this urge that we need people to get care
when it’s required, but yet there might all be these concerns, do you see any sort of
federal or state action that could remedy this concern? SABRINA CORLETTE: Well, we are seeing some
states take action. So, for example, New York, California, Washington state are requiring
private insurance companies to cover the cost of the test, including the doctor’s visit
or hospital visit, without any cost-sharing, so you wouldn’t have to face a deductible
or something like that. But for the uninsured, we really don’t have
a system right now that works for those folks. WILLIAM BRANGHAM: Really, really important
issues. Sabrina Corlette, Joseph Leitmann-Santa Cruz,
thank you both very much. JOSEPH LEITMANN-SANTA CRUZ: Thank you. SABRINA CORLETTE: Thank you.

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