Hillary Clinton, who was diagnosed with pneumonia after being taken ill at an event last week, was doing what millions of American do every year: trying to power through sickness and keep working.
That Americans work when they’re unwell is down to two factors: a culture of “battling through,” and a massive lack of support for the sick.
The US is one of very few developed countries that doesn’t guarantee sick pay. In the OECD group of rich countries, only Canada, Korea, Mexico, Ireland, and Portugal offer as little (pdf, p.127). The US spends less on supporting sick workers compared to other similarly developed countries; though other countries that offer much more support spend less than twice as much.
Germany, for example, offers continued wage payment to workers for the first six weeks they are sick.
Some US employers offer sick leave as part of employee benefit packages, and some states have passed laws guaranteeing some support for those who can’t work because of illness. From 2017, president Barack Obama has ordered that any company that does business with the federal government must offer its employees up to seven days of annual paid sick leave.
But for almost everyone else, not coming to work means not getting paid.
A 2014 survey found that the double pressure of “presenteeism” and the fear of lost income are the what keeps Americans at their desks. More than 40% of workers surveyed by NSF International, a public health organization, said they had too much work to stay home; almost as many said that they couldn’t afford to.