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Millions of working Americans can't afford to stay off work even if they or their children are ill. They need the day's pay to survive. So they report to their jobs to work at less than full productivity and possibly spread their infections to fellow workers and others. Or they send sick children to school, exposing their classmates and teachers to the risk of infection.

It doesn't have to be that way. And it isn't in the world's other industrialized nations. They guarantee workers paid sick leaves of seven days or more per year financed by government or employers or both. More than 35 countries also guarantee paid time off for workers to care for sick children at home.

Details are being worked out for implementation of an ordinance approved by San Francisco voters that will require employers to grant workers leaves of varying lengths depending on the number of hours they've worked. Several states and some other cities have been considering similar measures, but so far San Francisco is alone in this country in recognizing the obvious need for such action.

Perhaps the best hope rests with Congress. Republicans have blocked previous attempts to pass a federal measure, but key members of the new Democratic majority have put it high on their agenda, second only to raising the minimum wage.

They've introduced bills by Sen. Edward Kennedy of Massachusetts and Rep. Rosa DeLauro of Connecticut that would require employers with 15 or more workers to provide at least seven days a year of paid leave to those who are ill, need to care for ill or injured family members or need to see a doctor for checkups or tests.

A related bill by Sen. Christopher Dodds of Connecticut would amend the 14-year-old Family and Medical Leave Act, which calls for unpaid leaves under such circumstances. The amendment would require employers to provide up to six weeks a year of paid leaves.

Kennedy, now chairman of the Senate's Health, Education, Labor and Pensions Committee, is confident of wining broad support outside Congress for what he rightly calls "a families issue ... a values issue."

But Kennedy warns that members of the GOP minority, despite their incessant claims of honoring such issues, may attempt to defeat the Senate bills with a filibuster on behalf of the business and corporate lobbyists who fiercely oppose the measures as unfair, costly burdens on employers.

There are plenty of effective advocates on the other side, however -- religious, community and women's organizations, labor and liberal groups and others that are working to forge a coalition like that which helped win minimum wage increases in half-a-dozen states last November.

They're lobbying on behalf of the deplorably high proportion of U.S. workers -- nearly half overall and nearly three-fourths of those in the lowest pay brackets -- who do not have paid sick leaves and who in most cases can't afford to take unpaid leaves, no matter how ill they or their family members may become. In the case of sick children, most simply can't afford to pay someone to care for them while they're at work, ironically making less, or at least not much more, than they'd have to pay a caretaker.

Many of those who are forced to work despite their illness are employed as cooks, waiters, and in other service jobs and so frequently expose the general public to serious health hazards.

As studies of employers in other industrial nations show, the public and employers actually could profit from providing all workers paid sick leave. It would cut health care costs by enabling workers to seek early and routine medical care for themselves and family members. That, in turn, would enable them to miss fewer days of work and reduce employee turnover.

Don't forget, too, that sick workers invariably do less work and don't do it as well as healthy workers. Yet they draw the same pay and often in effect cost employers more than a paid sick leave would because of the loss in productivity by them and other workers they infect.

There's no financial excuse, then, nor any other excuse, to continue denying American workers the right to care for their health and that of their families without the penalty of losing income that's essential to their well-being.

Copyright (c) Dick Meister