The Obama Administration’s recently announced regulations mandating health plans cover preventative care without charging co-pays to the consumer are a significant step forward, but they alone won’t ensure Americans get the preventive care they need.
A critical component of preventative care is access. For individuals who have finite time off work and no paid sick days, accessing the preventative care that will keep them healthy is more easily said than done. Many can’t access care simply because they cannot afford to take time off of work. Eighty percent of low-income workers do not have paid sick days. Forty percent of working mothers who have children with asthma or other chronic diseases do not have paid sick days.
Federally mandated paid sick days can go a long way toward ensuring a healthy nation by giving more workers the flexibility to balance work demands and their health and make time for doctor’s appointments and other preventative care measures.
The Healthy Families Act would allow full-time employees to earn up to seven days of paid sick time annually. Workers could use this time off for doctor appointments and to obtain preventative care. Receiving such care for health risks such as blood pressure, diabetes, and cholesterol, as well as vaccinations and pre-natal care, improves health and lower overall health care costs.
Preventative care reduces mortality from chronic health conditions, and it improves maternal outcome for women and their babies. Nonetheless, some advocates report that women tell them “they’re afraid to miss time from work when they have prenatal appointments. They are faced with the choice of coming to work or missing work and losing their jobs. That is their reality.” According to Health and Human Services Secretary Sebelius, one in eight children has not visited a doctor in the past year, and one in five women over 50 has not received recommended mammogram in the last five years.
Paid sick days are shown to significantly decrease the frequency of delaying care for family members among those with health insurance, indicating that paid sick days may facilitate access to care. In turn, facilitating access to preventative care can lead to less frequent hospitalization and other expensive treatment.
Being able to take the necessary time off is especially critical for people who access health care at crowded health facilities where it is possible to sit for hours in a clinic waiting for a scheduled appointment time. Slipping away on a lunch break or trying to make an appointment for a Saturday is simply not realistic.
Further, workers in jobs that don’t provide paid sick days will lose the needed income or, in some cases, are concerned their employer may retaliate if they take needed time off. A new study shows that approximately one-sixth of workers report that they or a family member has been told they would be fired, suspended, or otherwise punished if they missed work due to illness (or has in fact been punished).
Providing paid time off for preventative care would benefit not only employees, but also employers. It would lead to a healthier workforce overall, resulting in productivity gains and decreased health insurance costs. As a leading human resources firm put it, an “often overlooked benefit of having a healthier workforce is increased productivity. Healthier employees spend less time away from work, have fewer work-related injuries and spend less time operating at reduced capacity.” The firm also confirms the cost benefits of managing chronic conditions: “It’s no secret that chronic conditions cost insurance companies (and therefore employers) more money than anything.”
The preventative care drum beat will continue: next year, Medicare patients will have access to free prevention services, such as annual wellness visits. The question remains whether workers will be able to access the care they need by taking paid time off of work to get it. If we are to truly improve the health of this country, we must ensure that not only the benefits are in place but also the opportunity to access those benefits.