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Sickness Absence, Moral Hazard, and the Business Cycle

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  • Stefan Pichler

Abstract

The procyclical nature of sickness absence has been documented by many scholars in literature. So far, explanations have been based on labor force composition and reduced moral hazard caused by fear of job loss during recessions. In this paper, we propose and test a third mechanism caused by reduced moral hazard during booms and infections. We suggest that the workload is higher during economic booms and thus employees have to go to work despite being sick. In a theoretical model focusing on infectious diseases, we show that this will provoke infections of coworkers leading to overall higher sickness absence during economic upturns. Using state‐level aggregated data from 112 German public health insurance funds (out of 145 in total), we find that sickness absence due to infectious diseases shows the largest procyclical pattern, as predicted by our theoretical model. Copyright © 2014 John Wiley & Sons, Ltd.

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  • Stefan Pichler, 2015. "Sickness Absence, Moral Hazard, and the Business Cycle," Health Economics, John Wiley & Sons, Ltd., vol. 24(6), pages 692-710, June.
    • Handle: RePEc:wly:hlthec:v:24:y:2015:i:6:p:692-710
    DOI: 10.1002/hec.3054
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    2. Victor Aguirregabiria & Jiaying Gu & Yao Luo & Pedro Mira, 2020. "A Dynamic Structural Model of Virus Diffusion and Network Production: A First Report," Working Papers wp2020_2014, CEMFI.
    3. Pichler, Stefan & Ziebarth, Nicolas R., 2017. "The pros and cons of sick pay schemes: Testing for contagious presenteeism and noncontagious absenteeism behavior," Journal of Public Economics, Elsevier, vol. 156(C), pages 14-33.
    4. Stefan Pichler & Nicolas R. Ziebarth, 2015. "The Pros and Cons of Sick Pay Schemes: Testing for Contagious Presenteeism and Shirking Behavior," Discussion Papers of DIW Berlin 1509, DIW Berlin, German Institute for Economic Research.
    5. Ángel Martín-Román & Alfonso Moral, 2017. "A methodological proposal to evaluate the cost of duration moral hazard in workplace accident insurance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1181-1198, December.
    6. Maclean, J. Catherine & Pichler, Stefan & Ziebarth, Nicolas R., 2020. "Mandated Sick Pay: Coverage, Utilization, and Welfare Effects," IZA Discussion Papers 13132, Institute of Labor Economics (IZA).
    7. Pichler, Stefan & Ziebarth, Nicolas R., 2015. "The Pros and Cons of Sick Pay Schemes: A Method to Test for Contagious Presenteeism and Shirking Behavior," IZA Discussion Papers 8850, Institute of Labor Economics (IZA).
    8. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2015. "Who should monitor job sick leave?," Working Papers 18/2015, University of Verona, Department of Economics.
    9. Boris HirschBy & Daniel S. J. Lechmann & Claus Schnabel, 2017. "Coming to work while sick: an economic theory of presenteeism with an application to German data," Oxford Economic Papers, Oxford University Press, vol. 69(4), pages 1010-1031.
    10. Manuel Flores & Melchor Fernández & Yolanda Pena-Boquete, 2020. "The impact of health on wages: evidence from Europe before and during the Great Recession," Oxford Economic Papers, Oxford University Press, vol. 72(2), pages 319-346.
    11. Jenni Blomgren & Mikko Laaksonen & Riku Perhoniemi, 2021. "Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study," IJERPH, MDPI, vol. 18(12), pages 1-14, June.
    12. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2019. "Job sick leave: Detecting opportunistic behavior," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 373-386, March.
    13. Stijn Baert & Bas van der Klaauw & Gijsbert van Lomwel, 2018. "The effectiveness of medical and vocational interventions for reducing sick leave of self‐employed workers," Health Economics, John Wiley & Sons, Ltd., vol. 27(2), pages 139-152, February.
    14. Aaviksoo, Evelyn & Kiivet, Raul Allan, 2016. "Influence of the sickness benefit reform on sickness absence," Health Policy, Elsevier, vol. 120(9), pages 1070-1078.
    15. Diby, Akissi S. & Lengagne, Pascale & Regaert, Camille, 2021. "Employment Vulnerability of People With Severe Mental Illness," Health Policy, Elsevier, vol. 125(2), pages 269-275.
    16. Stefanie Thönnes & Stefan Pichler, 2019. "Sickness absence and unemployment revisited," Working Papers Dissertations 53, Paderborn University, Faculty of Business Administration and Economics.
    17. Stefan Pichler & Nicolas R. Ziebarth, 2020. "Labor Market Effects of U.S. Sick Pay Mandates," Journal of Human Resources, University of Wisconsin Press, vol. 55(2), pages 611-659.
    18. Stefan Pichler & Katherine Wen & Nicolas R. Ziebarth, 2021. "Positive Health Externalities of Mandating Paid Sick Leave," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(3), pages 715-743, June.
    19. Thomas Leoni & René Böheim, 2018. "Fehlzeitenreport 2018. Krankheits- und unfallbedingte Fehlzeiten in Österreich – Präsentismus und Absentismus," WIFO Studies, WIFO, number 61487, April.
    20. Hilla Sumanen & Olli Pietiläinen & Minna Mänty, 2017. "Self-Certified Sickness Absence among Young Municipal Employees—Changes from 2002 to 2016 and Occupational Class Differences," IJERPH, MDPI, vol. 14(10), pages 1-12, September.
    21. Pichler, Stefan & Ziebarth, Nicolas R., 2019. "Reprint of: The pros and cons of sick pay schemes: Testing for contagious presenteeism and noncontagious absenteeism behavior," Journal of Public Economics, Elsevier, vol. 171(C), pages 86-104.
    22. Pichler, Stefan & Ziebarth, Nicolas R., 2024. "Sick Leave and Medical Leave in the United States: A Categorization and Recent Trends," IZA Policy Papers 206, Institute of Labor Economics (IZA).
    23. A. Cazenave-Lacroutz & A. Godzinski, 2017. "Effects of the one-day waiting period for sick leave on health-related absences in the French central civil service," Documents de Travail de l'Insee - INSEE Working Papers g2017-06, Institut National de la Statistique et des Etudes Economiques.

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