An ailing paid-leave bill and the ripples of good health

If the 2014 election had produced a different state House majority, a bill to bring paid sick leave to more Minnesota workers would have been on this session's most-watched list. It had been teed up by the 2014 Women's Economic Security Act and had friends in high places in the House DFL caucus.

Elections matter. The House majority switched from DFL to GOP hands. That's why at a news conference last Tuesday, pleaders for this year's almost-invisible bill regarding paid sick leave included a few clergy members, seniors, nurses, low-wage workers, one employer, two fidgety toddlers — and just one legislator, Senate Assistant Majority Leader Katie Sieben.

Sieben, DFL-Cottage Grove, is chief Senate sponsor of a bill that would extend a benefit for paid sick leave and parenting leave to a large share of the 1 million Minnesota workers who lack it today. It would employ a funding scheme akin to Social Security's, taxing both employers and employees 0.1 percent of wages to create a special fund administered by the state Department of Labor and Industry. Employees could tap that fund for up to six weeks of slightly reduced pay during a qualifying leave of absence in a given year.

It's a creative approach. The debate it might generate one day would be a wonk's delight to cover. But given the bill's bleak prospects in the reconstituted House, it's been slow to get a hearing in either chamber. This week for sure, Sieben has been told; "maybe" this week was the word for the House version sponsored by Rep. Ryan Winkler, DFL-Golden Valley.

Also at Tuesday's briefing was state Health Commissioner Dr. Edward Ehlinger, a sparkplug in any conversation about health's connection to societal well-being. He came touting his agency's new "White Paper on Paid Leave and Health," produced in response to a 2014 legislative request. Not surprisingly, it concludes that the lack of paid sick leave is bad for Minnesotans' health.

That's not just workers' health. It's everybody's.

Consider: Most food-preparation and service jobs don't offer paid leaves for reasons of illness. These low-wage jobs are typically held by people who cannot afford to miss even a day or two of income. When they get sick, they often work anyway.

The result: "In Minnesota, at least 208 outbreaks of foodborne illness were linked to employees working while sick between 2004 and 2013," the white paper says. Further, "579 outbreaks were associated with person-to-person transmission in public settings between 2004 and 2011." Those are only the reported and confirmed cases. It's a good guess that there were a lot more.

The occupations least likely to provide paid sick leave are also ones that require close contact with the public — food service, care for the elderly and disabled, and health care. Ironically, institutions dedicated to healing may also be inviting the spread of disease via their employee benefit policies.

Of course, workers without access to paid leave experience the brunt of the negative consequences. Those consequences are not trivial. The absence of paid sick leave is associated with higher rates of on-the-job injuries, less use of preventive care, and poorer maternal and infant health outcomes, the white paper says.

Concentrate those ills in certain populations, and they take on larger significance. The white paper notes that it's not a coincidence that "communities most negatively impacted by factors associated with poor health — poverty, unsafe or unstable housing and hunger — are also disproportionately affected by inadequate access to paid sick and family leave." My guess is that the much-decried educational achievement gap could be on that list as well.

The white paper does not quantify the cost of those associated effects to employers or taxpayers. Numbers of the latter type are on the way, Ehlinger said. He expects that Minnesotans will be surprised at how costly to all of us are individual employers' decisions not to pay some of us to stay home when we're sick.

The issue of paid sick leave, it seems, isn't just about money and politics. It's also about health and social justice — and that puts it right up Ehlinger's alley. He left clinical practice three decades ago because he saw that treating sick people one at a time, or even 40 to 60 per day, would not make his community healthier. Illnesses associated with poverty, homelessness, alcohol and tobacco use, workplace injuries and lack of access to preventive care overwhelmed his clinic's capacity to keep up.

That's why he reoriented his career to public health.

As commissioner, and as the head next year of the national association of state health commissioners, Ehlinger is on a mission to make health a bigger consideration in all manner of public-policy decisions — transportation, education, criminal justice and the lot. Making better health a driving consideration in those realms may be one of the best ways to rein in health care costs, he says.

I'll buy that point and add one of my own: Considering the health component in public policies might sand off the sharp partisan edges those policies have acquired. After all, everybody is for health, right?

I wonder if transit might not be such a fighting word if its potential to improve health (and thereby save money) were better known. Housing subsidies might not be in such short supply if the health implications of housing instability, particularly for young children, were better understood. Raising the minimum wage might not seem so onerous if its opponents knew that the life expectancy difference for Minnesotans in the second-highest income quintile is 3.5 years longer than those with incomes in the lowest quintile.

A state requirement that employers provide paid sick leave to their employees can be seen as a business/labor conflict, requiring the party backed by the state's business lobby and the party with Labor in its name to fall into their customary competing camps. Or it can be understood as an idea for improving the health of all Minnesotans, particularly those whose well-being is lagging, and for saving money in the long run. The fellow in charge at the Health Department seems ready and able to help sell the latter idea.

Lori Sturdevant is a Star Tribune editorial writer and columnist. She is at lsturdevant@startribune.com.