Sick leave: Germany rising but not the worst in Europe

The need for a doctor's notes means one of:

* I explain to my employer, probably don't get paid for those days, and might face disciplinary action or eventually get fired

* I go to the doctor, making my recovery less likely, increasing my stress levels which are already high due to my body fighting an infection, and risk infecting others or worse, catch something else myself for being made to cohabit space with other sick individuals

* I work even though I'm sick. If I do that from the office, I risk contaminating colleagues - and other people I interact with

There's no winning.

It’s a bit of a chicken and egg issue.

All systems based on trust eventually get abused. Not by everyone of course, but catching a few with their hands in the cookie jar is enough to trigger a rethink on the whole trust-based thing. Most corporate German workers I knew were taking a few extra vacation days a year as sick leave, or using fake sick leave(often weeks or months!) as revenge if their employer didn't give them their desired raise or promotion. Their own admission, it's basically an open secret when you move there. Hell, we had German colleagues that would mysteriously get "sick" exactly before the customer delivery crunch, every-single-time, like clockwork.

The problem is when this becomes culturally normalized, more and more people do it as they see those abusing it get away with extra vacation days so then they think why wouldn't they do it too, otherwise they're suckers, right? And so after a while, the abuse starts to become so rampant and obvious to the employers as well, which leads to increasing the cost of doing business in Germany, and so everyone gets the collective punishment if they still wish to keep their jobs and not lose them to neighbouring countries that have cheaper labor because workers there don't abuse this system(yet). That's the same thing that ended 100% remote/WFH jobs and triggered the return to office mandates, too many people obviously scamming the trust based system pretending to work while actually doing nothing.

>I'm making calls on stuff far larger than my sick days. If you can't trust me on sick days, how can you trust me to do my job?

These policies aren't meant to target the German workers making important decisions who have a lot of bargaining power, but those on menial jobs to keep them working on the hamster wheel. It's what the communist system was designed to do to workers too. You keep them busy all day conforming to stupid bureaucracy and queues, and they're too busy to protest or switch jobs, forcing them into indentured servitude. Merz is a product of Blackrock after all. So it's either a 50 IQ move or a long term 500 IQ move.

Anyway, this isn't the first time in recent history when labor privileges were scaled back in Germany. Agenda 2010[1] did similar things, mostly by defanging unions. The truth is that those crazy good perks were gotten by the working class when Germany was the world industry leader post-WW2, but now Germany's industry output is at a 20 year low(thanks to a series of political and corporate self-owns) so it can't afford the same perks like in the past, and needs to scale back its generosity if it wishes to stay solvent. At the end of the day it's just business, and you need business to fund the welfare state.

[1] https://en.wikipedia.org/wiki/Agenda_2010

You could argue that this is accountability theatre, though frankly for something like a cold - what will a doctor see face to face that they won't on the phone?

It's still a positive amount of faff but pretty tiny.

This article [1] mentions 40% of sick days being from people with long-term (> 6 weeks) illnesses. That's data from one of Germany's large insurers. While I don't know the proportion of those with long-term illnesses, if we assume it's at most 10%, then the average for people with "normal" short-term illnesses is at most 12 days. So much lower.

[1] https://www.deutschlandfunk.de/sind-die-deutschen-wirklich-h...

It's not like the doctor can do anything but take my word for it when I'm in his office anyway. There is no migraine test you can run. So you might as well cut out all the bullshit and let me rest so I can recover better.

The 2 results I see from this change in policy is:

1. People go sick to work and possibly infect other people

2. Doctors give multi day sick notes (when 1 day would have been enough) to not be bothered again the next day, resulting in people being home longer when not needed.

I genuinely don't understand who looked at this policy change and thought "this will probably help with people working more". The only people that will be working more are the "Hausärzte".

Before around the 1960s in many countries if you were sick you called your doctor and they came to your house. The net is telling me that the reasons that this largely stopped are that advances in medical technology led to more reliance on equipment that you really couldn't all around with you to patient homes, that doctors became more specialized, and that as the population spread out more due to the boom in cars doctors couldn't see enough patients a day.

If everyone who wants to take sick time needs a note on day 1 maybe that would be sufficient to have some doctors who just make house calls.

I'd expect that most illnesses that prompt a worker to want a sick day are simple enough that you do not need to fancy diagnostic equipment available at doctor's offices, so that gets rid of one of the main reasons house calls became infeasible.

There is still the problem of people being spread out, but I'd expect the visits should be pretty quick so maybe it would be possible to do enough per day to handle to load. I think the visits would be quick because the doctor should just need to verify that you have something that justifies taking a day off work. For most cases that's going to be some kind of cold or flu or some chronic condition acting up, which should to quick to check. E.e., the patient has a fever and a cough...you don't have to figure out exactly what they have to know they shouldn't be going into work. Approve the note and collect a blood sample to drop off at the end of the day to get more information tomorrow.

If this is still too much for doctors to handle maybe introduce a new type of practitioner. In the US we have Nurse Practitioners (NPs) and Physician Assistants (PAs).

NPs are licensed registered nurses who get additional training and certification. NPs can diagnose and treat acute and chronic conditions, write prescriptions, order and interpret lab work and imaging, and counsel patients. What they cannot do is perform surgery (although they can assist) and manage complex cases. In some states they cannot prescribe certain drugs like opioids without oversight from a doctor, and in some states they have to work under the supervision of a doctor. NPs do not have to go through a residency, and require about an order of magnitude less clinical training than doctors.

PAs are roughly similar from a patient point of view, but they always work with a doctor. Their training requirements are more doctor-like. Their focus is also more doctor-like, focusing on biological aspects of disease, whereas NPs are more holistic. PAs are also better as generalists, whereas NPs must choose during their schooling a specialty like family car or geontology or pediatrics.

The net is telling me Germany does have non-doctors that can do some of the things doctors do but says none of them are like NPs and PAs who can independently diagnose and treat, so would probably not be able to substitute for a doctor in seeing patients to produce a sick note. It also is telling me Germany has a doctor shortage, so maybe something like NPs or PAs that can take much of the routine load of dealing with routine issues would be a good idea even without the new sick note requirements.

Man, Merz truly is a genius! You can tell he's had so much experience in normal jobs, truly understands the average worker's situation.

Also, generally, I can’t think of a time i had off work where something ultimately failed to be delivered because of it, I’ll typically put in some extra time etc when i’m back if a deadline is looming.

So who really loses?

That's how you see Eastern Europe actually having much fewer sick days from work despite lower life expectancy and a less performant healthcare system than the west. The communist system and post-communist hardship from the economic collapse meant people had no chance but to work no matter what, if they wanted to eat that day. Not going to work because of a cold or headache or things like depression or burnout was unthinkable to the generation that grew up under those conditions and they perpetuated that mindset to Millennials too. Sick leave was only if something was falling off. That's why Eastern European immigrants who migrated west were so valued for their work ethic. Granted, now thanks to Gen-z things are changing for the better and are adopting the more nordic and ladi back mindset on work ethic.

But yes, these are averages between 1 person having 12 weeks and 12 people with 1 week. It's most likely power law distributed, so the average will feel weird.

There are people with cancer, severe car crashes and other horrible but temporary medical conditions in this average.

It's difficult to do a back of the napkin calculation, but you can easily see how 16 colds x 3 days / 2 parents leads to 24 excess sick days for parents per kid (discounting for some overlap when multiple kids are sick) over the first few years.

[1] https://github.com/robert-koch-institut/GrippeWeb_Daten_des_...

Okay, let's consider what laws like this (the existing one) do.

In the US most employers don't care if you take a normal number of sick days, don't require a doctor's note, regardless of whether the law allows them to. Sick days are like vacation days, it's your own business how you use them. This is fine. And if you want to make a major long-term disability claim then you'll be expected to prove it, but that seems overall pretty reasonable?

That's the common case. No major incentive for employers to cause friction with workers who are mostly acting in good faith. Then there are employers who are, let's say, less selective about their employees, will hire anyone willing to do the job, but correspondingly then see a high rate of fraud. These employers want to be able to demand evidence all the time because the sort of people they're willing to hire would be taking three months of paid vacation a year as sick days if they could get away with it.

Since the law applies to everyone, what does a law like that do? In the common case it does nothing because the employer doesn't do it regardless. In the high fraud cause it prevents something good and increases actual fraud.

So the only time it does something good is the uncommon edge case on the other side where the employer requires that even though their employees mostly weren't faking sick days. And because most employers for that type of work don't do that, those employers don't get any major benefit from it anyway and employees don't like it, the ones who do are at a competitive disadvantage, so it stays uncommon.

Which means the main effect of the law is to cause problems for the employers willing to do "second chance" hiring of people who might screw them over, which harms not only the employer but also those workers when employers stop being willing to hire them because the law requires them to take the hit if they do.

dropping phone-in sick calls will sure as hell end those /s

this whole package is driven by populist disinformation.