This week we jump into medical leave policy and the quagmire of challenges around finding a balance between creating an economically viable policy that works for employees, especially for those in lower socioeconomic groups and wage bands. The coming flu season is looking like it will be a bear which will add additional challenges to keeping business operations running.
Current medical leave policies that have a ‘bank’ of sick days that only gets deposits as you work and comes with limits that require a costly visit to a physician after 2 days will force some to come into work even when sick. Add on a test for COVID19 that in our own personal experiences ranges from zero all the way up to an astounding $350 and you have a recipe for further extensions of our current pandemic woes. We talk remote testing, something we have seen from the early days of testing during the pandemic and how this can be done whilst ensuring matching test and results to the correct individual.
Putting testing in the same category as vaccines – free at the point of service and perhaps layering on of technology to allow economic scaling would be a big help in moving everyone out of the pandemic doldrums
Raw Transcript
Nick van Terheyden
Hi, this is Dr. Nick on the incrementalist here with incremental insights for better business better health.
Fred Goldstein
And I’m Fred Goldstein with accountable health here helping employers determine how to use their health benefits programs, and how to maximize the health of their employees. So Nick, one of the area’s we’ve been discussing a lot over the period of time, and it’s really gets rather deep as we dig into it, as we’ll find out, I hope this morning, is this concept of rapid testing somebody’s time off benefits packages, how they cover paid leave, etc. Why don’t you open up a little bit and bring up some of the issues here.
Nick van Terheyden
So first of all, thanks to those folks that jumped in on one of our videos gave us both some insights on some of the testing options. You know, I think we had a clear message around this, which is to drive the cost of testing down to as close to zero if not zero at the point. Now, to be clear, nothing is free, there’s always a cost, but you know, at the point of care, so that it’s fully accessible. But when you think about this, and specifically, from a business standpoint, as you think about the challenge for the coming months, we are going into what is going to pan out, and you know, I’m going to stick my stake in the ground and say, this is going to be a pretty big flu season. By the way, I’ve had my flu vaccine, you should too, I had it this past weekend. But if we’re going to see all of this, and we started to see lots of respiratory viruses, we need a policy that allows people to stay at home. Currently, the policies for new employees for all those low wage low income employees is you build up a bank or something, I’m Fred, I’m sure you understand all this better than me. And then Gosh, if you’ve got enough sick leave, you can take some time off, but there’s a cap on it. And if you go past day, two into day three, you must go and see your physician, oh, sorry, that’s going to cost you anywhere from 40 to 120 130, for the consultation, that you have to have to produce the doctor’s certificate to say I’m not sick enough. The incentive here is for people to say, Well, I’m going to come in this is costing me too much. I’m earning 20,000 a year, I’m paying everything on the insurance because I’m on a high deductible plan because that was all I could afford. And I can’t afford the testing. I can’t afford to go see the physician. So I’m just coming in, how do we fix this?
Fred Goldstein
It’s an interesting problem. And you also raise the issue of the test costs itself. So you’re going to add that on to the cost that the employee has to bear, assuming they have some coverage, both from a health insurance side, as well, as you talked about their paid time off for sick leave side. And I know more companies are moving to an aggregate bank have paid time off, but it’s still a nursing problem. So I think the question becomes, as pretty clear, the CDC has told employers, please recommend your employees, they don’t come in when they’re sick. And here you are trying to figure out how to, you know, as an individual, how do I, oh, I need to come in because I can’t afford this. So I think it raises some fascinating issues for employers to consider. And you see some that are obviously on the higher end of a benefits package that can afford these kinds of benefits to Silicon Valley companies that can push out a lot of benefits and afford it within their product. But what about those mom and pop places, those others that are trying to provide a service for their employees at the same time, they’re trying to keep their doors open. And so I think this is going to require some balance of employer responsibility. And potentially, as we’ve talked about, on testing, government responsibility to bring the price down. And that 35% that we’re hearing now, maybe takes it to $14 for a test kit. But that’s not an A small sum for many people or small companies.
Nick van Terheyden
Now, and you know, it’s easy to discount is just $14. You know, for the people that are struggling to pay, the food bill, the utility bill, the rent, look at all the folks that are in, you know, rent hell, and then you add on whether they even have health insurance, and we’re struggling with a $14 charge, which you know, there’s a part of me that says maybe $1, just so that you don’t get some level of abuse, but equally, I even push back on that because you want this as widely available, and identify the abuse in another way and settle that so the people that go and say I’m going to get all these tests and you know, resell them even, you know, look at all the toilet paper hoarders that had guarantees for we don’t want to see any of that. But there are other ways of dealing with this. You’ve got to give access. So maybe you put it outside of the health plan, is that a possibility that says, hey, can we do that? Is that an affordable option? Or is there a way to make it affordable for companies?
Fred Goldstein
Yeah, I think we probably need to take this similar to what we’ve done with vaccines, Nick, the vaccines are free right now. And we probably need to look at that for rapid testing as we begin to look to reopen the economy. And it raises another interesting issue that you really understand well is how do you validate this? Are there technological approaches to validate that i Fred Goldstein, did that test. And here were my results.
Nick van Terheyden
Great point. And, you know, when you you say that, of course, the obvious way, and the way that we’ve seen through the course of this pandemic is you have an online call with somebody, they see your driver’s license through a zoom call, check who you are. And, you know, they see the barcode, all of those things. And that’s going on with some of these platforms. In fact, some of the testing that got referenced in the previous video and thread, but I’ve seen some automation of that with pill taking. We were looking at this to confirm that people were consuming the medications that they were given. And it was all done with a camera and some AI and some clever interpretation. Now, is it open to some abuse? Can people Yeah, sure. But maybe that’s the way that we scale it and scale it affordably so that you can do it anyway, you have a stack of tests. That’s just part of your routine.
Fred Goldstein
Yeah, it really raises some interesting issues. And once you dive into it, they seem to get a little bit more complicated each time we add another layer to that onion. So a really fascinating area to explore. And if companies have any questions about this or want to talk to us about how they might implement various programs around this, please reach out to us at accountable health, LLC Comm. This is Fred Goldstein. It’s been another great week with you, Dr. Nick.
Nick van Terheyden
And this is alternate. I’m the incrementalist here with incremental insights for better business, better health.
