The U.S. is the only wealthy nation in the world not to guarantee paid leave from work for new parents or individuals or families battling illness, and lately, policymakers on both sides of the aisle have suggested it’s time for this to change. The two competing plans right now, when put in perspective, would be either the stingiest or the fourth-stingiest plan among the advanced economies. And what we know about what works and is feasible is now more robust than ever.
On Wednesday, the WORLD Policy Analysis Center and UCLA School of Public Health released the most comprehensive report of paid family and medical leave research around the world. Based on review of over 5,500 studies, medical analysis, and economic analysis of individual countries, Jody Heymann, the study’s senior author, says it’s clear that if the U.S. implemented a program aligning with the study’s findings, “families would be less likely to fall into poverty, women would have better economic outcomes in terms of their earnings, which contributes to family earnings, and the U.S. would be every bit as able to compete and have as low an unemployment rate.”
Many people in the U.S. think of paid leave as a business benefit, or even a luxurious perk, that employers should provide. But this study shows that most countries have succeeded by providing it as a social insurance scheme—implemented through a public program or social security system. Here are five key findings about what makes these systems work well.
1. Even the U.S.’s long-shot policy is only half the ideal length.
While the U.S. has only recently started debating how to give Americans paid leave—six weeks for parents in the Trump budget, 12 weeks for paid family leave in a Democratic proposal—the study concludes that for best results, people need up to 6 months of leave. The authors cite breast-feeding (which is associated with lower incidents of ear infection, respiratory infection, and childhood obesity, to name just a few), reduced child care costs (infant care is enormously expensive), lower incidence of postpartum depression, and women’s long-term earning potential (longer leave means fewer women drop out of the workforce all together) as just a few of the health and economic reasons for this recommendation.
The study also shows that while some pregnancies allow women to safely continue working right up until they give birth, in many cases paid leave policies have to be used to cover antenatal care so women can go on bed rest or whatever else is needed to ensure the safety of their pregnancies through birth. If mothers get to use six months of paid leave and determine when to start the clock, an additional program for antenatal care isn’t necessary. In the U.S., where leave tends to be minimal and often unpaid, the need for a strategy for pregnancy-related leave is clear.
Additionally, around half of Organisation for Economic Co-operation and Development (OECD) countries offer part-time leave options. The study found that allowing workers to take paid leave on a part-time basis can be critical for allowing multiple family members to play a role in parental, self, and elder care, and creates less of a burden for employers.
2. You don’t need to be a long-time employee to qualify.
The study also concludes that there’s no detriment to allowing people to take leave regardless of how long they’ve been in their current job when they need it. The vast majority of OECD countries with paid parental leave do not have employer-tenure requirements, and 17 of them have no tenure requirement regarding paid leave for personal illness. That’s because most countries don’t fund paid leave directly through employers, so tying accessing the benefit to an employer doesn’t make sense. But what if workers take advantage? What if people hop around to different jobs, taking leave willy-nilly?
The authors conclude: “There is no evidence that countries need to have job-specific tenure requirements to be economically competitive.” This is a far cry from the U.S., where even qualifying for unpaid leave offered under the Family and Medical Leave Act requires workers to have been working full-time for the same employer for 12 months. (Washington state’s new paid leave law requires the same.) With the rise in short-term hourly, contract, and independent work, this standard is destined to exclude many of the workers who need it most.
3. We don’t need exemptions for small businesses—it’s feasible to cover everyone.
The study concludes that making paid leave policies inclusive of all workers is both economically feasible and hugely beneficial to individual families. Currently FMLA only applies to employers with more than 50 employees. Work for a small business? You don’t qualify. While in the U.S., “the burden on small business” is often cited as a barrier to basically any progressive social program like paid family leave; other countries have shown this isn’t actually a problem, at least if you treat paid leave like a social insurance program like Social Security.
Only two OECD countries allow small businesses (which they define as fewer than five employees) to opt out of their paid leave systems, and even then, those workers are still covered through the social insurance program. In practical terms, this means a small business—even a three-person catering firm—doesn’t have to pay for one of its precious workers to take leave. Instead, that worker draws from their publicly held insurance, and the caterers can hire a temp until they return.
4. Money matters: Leave has to be affordable and equal.
Another area where countries differ is how much of someone’s regular income they should receive while on leave. Under the Kirsten Gillibrand’s proposed FAMILY Act, workers taking leave would receive up to 66 percent of their regular income. Under the plan being debated by Republicans right now, the average wage replacement rate would be even lower: 45 percent.
In contrast, authors of the study recommend a minimum of 80 percent wage-replacement rate. Why? First, paid leave is a critical tool to keep families out of poverty. In countries where the minimum wage is above the poverty level, an 80 percent wage-replacement rate works well across the board. But in places like the U.S., where the minimum wage is generally far below the poverty line, Heymann and lead author Amy Raub suggest a wage floor should exist so all families can afford to take leave. Forty-five percent—or even 66 percent—of $7.25 an hour, the current federal minimum wage, just isn’t enough to cover rent, food, and other necessary parts of life, and many low-wage workers simply couldn’t afford to take paid leave, even if they had the right to it.
Second, because men are likely to earn more, and there is cultural stigma attached to men providing care, a high wage-replacement rate helps ensure equal uptake by men and women. The study found that men took more leave when the replacement was at least 80 percent. When men take leave, it leads to more equal distribution of child care and housework. It also decreases the likelihood that employers will discriminate against women whom they expect to be primary caregivers and be less available for work.
The other key to getting men to take leave: Make sure there’s an extra incentive for nonbirth parents to take leave, or a “daddy quota” that allots extra time to families where both parents use leave. This is especially important as the U.S. thinks about extending family rights and benefits to LGBT families, who have often been denied the same amount of leave for adoption as for birth. Also good food for American policy thought? Include a provision that grants more leave to single parents. Only five OECD countries currently do this and the U.S. could jump to the head of the pack by doing so as well.*
5. On family care, the U.S. could lead the pack.
Though most people associate paid leave with new parents, this study goes far beyond this to look at families and the need for leave across a lifetime. The authors, which include doctors and public health experts, look at the top three causes of death in the U.S. to estimate what amount of family and medical leave would be sufficient to help people take care of themselves and family members from childhood illness through end-of-life care. (Caring for oneself is actually the main reason people currently use the unpaid Family and Medical Leave Act.)
Their takeaway: Six months of leave would more than allow for people to recover or deal with severe illnesses including the three leading causes of death in the U.S.—cancer, heart disease, and diabetes. There’s little evidence to suggest that people would abuse this, the report found, and lots that shows it would allow them to heal faster or—especially in the case of end-of-life care to die more peacefully—with their families present.
Another area where the U.S. could take the lead on new policy would be in defining family more broadly and practically than others have. According to the study, “Only 8 OECD countries allow workers to take paid leave to care for family members broadly, without limiting the types of relationships that are covered.” With more flexible definitions of family, as the U.S. has already implemented in some policies, care responsibilities could be shared among family members of love, blood, or choice.
When asked if there’s one country the U.S. should look to as a model for its own future policy, Heymann said, “Overwhelmingly, all of the high-income countries are models for us.”
Correction, Feb. 28, 2018: The piece originally misstated that nine countries, not five, provide additional leave to single parents.