IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v24y2015i6p692-710.html
   My bibliography  Save this article

Sickness Absence, Moral Hazard, and the Business Cycle

Author

Listed:
  • 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.

Suggested Citation

  • 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
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3054
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.3054?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Schmitz, Hendrik & Ziebarth, Nicolas R., 2011. "In Absolute or Relative Terms? How Framing Prices Affects the Consumer Price Sensitivity of Health Plan Choice," IZA Discussion Papers 6241, Institute of Labor Economics (IZA).
    2. Arellano, Manuel, 1993. "On the testing of correlated effects with panel data," Journal of Econometrics, Elsevier, vol. 59(1-2), pages 87-97, September.
    3. Jan Erik Askildsen & Espen Bratberg & Øivind Anti Nilsen, 2005. "Unemployment, labor force composition and sickness absence: a panel data study," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1087-1101, November.
    4. Lindbeck, Assar & Palme, Mårten & Persson, Mats, 2006. "Job Security and Work Absence: Evidence form a Natural Experiment," Seminar Papers 743, Stockholm University, Institute for International Economic Studies.
    5. Ziebarth, Nicolas R. & Karlsson, Martin, 2010. "A natural experiment on sick pay cuts, sickness absence, and labor costs," Journal of Public Economics, Elsevier, vol. 94(11-12), pages 1108-1122, December.
    6. Arai, Mahmood & Thoursie, Peter Skogman, 2005. "Incentives and selection in cyclical absenteeism," Labour Economics, Elsevier, vol. 12(2), pages 269-280, April.
    7. Vincenzo Scoppa & Daniela Vuri, 2014. "Absenteeism, unemployment and employment protection legislation: evidence from Italy," IZA Journal of Labor Economics, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 3(1), pages 1-25, December.
    8. Philipson, Tomas, 2000. "Economic epidemiology and infectious diseases," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 33, pages 1761-1799, Elsevier.
    9. Andrea Ichino & Regina T. Riphahn, 2005. "The Effect of Employment Protection on Worker Effort: Absenteeism During and After Probation," Journal of the European Economic Association, MIT Press, vol. 3(1), pages 120-143, March.
    10. Fahr, René & Frick, Bernd, 2007. "On the Inverse Relationship between Unemployment and Absenteeism: Evidence from Natural Experiments and Worker Heterogeneity," IZA Discussion Papers 3171, Institute of Labor Economics (IZA).
    11. Hansen, Claus D. & Andersen, Johan H., 2008. "Going ill to work - What personal circumstances, attitudes and work-related factors are associated with sickness presenteeism?," Social Science & Medicine, Elsevier, vol. 67(6), pages 956-964, September.
    12. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 115(2), pages 617-650.
    13. Dosi, Giovanni & Nelson, Richard R., 2010. "Technical Change and Industrial Dynamics as Evolutionary Processes," Handbook of the Economics of Innovation, in: Bronwyn H. Hall & Nathan Rosenberg (ed.), Handbook of the Economics of Innovation, edition 1, volume 1, chapter 0, pages 51-127, Elsevier.
    14. David Bell & Steffen Otterbach & Alfonso Sousa-Poza, 2012. "Work Hours Constraints and Health," Annals of Economics and Statistics, GENES, issue 105-106, pages 35-54.
    15. Douglas L. Miller & Marianne E. Page & Ann Huff Stevens & Mateusz Filipski, 2009. "Why Are Recessions Good for Your Health?," American Economic Review, American Economic Association, vol. 99(2), pages 122-127, May.
    16. Millard, Stephen & Scott, Andrew & Sensier, Marianne, 1997. "The Labour Market over the Business Cycle: Can Theory Fit the Facts?," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 13(3), pages 70-92, Autumn.
    17. Mark Gersovitz & Jeffrey S. Hammer, 2004. "The Economical Control of Infectious Diseases," Economic Journal, Royal Economic Society, vol. 114(492), pages 1-27, January.
    18. repec:adr:anecst:y:2012:i:105-106:p:3 is not listed on IDEAS
    19. Buchner, Florian & Wasem, Jurgen, 2003. "Needs for further improvement: risk adjustment in the German health insurance system," Health Policy, Elsevier, vol. 65(1), pages 21-35, July.
    20. Shapiro, Carl & Stiglitz, Joseph E, 1984. "Equilibrium Unemployment as a Worker Discipline Device," American Economic Review, American Economic Association, vol. 74(3), pages 433-444, June.
    21. Robert Nuscheler & Thomas Knaus, 2005. "Risk selection in the German public health insurance system," Health Economics, John Wiley & Sons, Ltd., vol. 14(12), pages 1253-1271, December.
    22. Johansson, Per & Palme, Marten, 1996. "Do economic incentives affect work absence? Empirical evidence using Swedish micro data," Journal of Public Economics, Elsevier, vol. 59(2), pages 195-218, February.
    23. Bratberg, Espen & Monstad, Karin, 2012. "Worried Sick? Worker Responses To Organizational Turmoil," Working Papers in Economics 08/12, University of Bergen, Department of Economics.
    24. Laxminarayan, Ramanan & Brown, Gardner M., 2001. "Economics of Antibiotic Resistance: A Theory of Optimal Use," Journal of Environmental Economics and Management, Elsevier, vol. 42(2), pages 183-206, September.
    25. Johansson, Per & Palme, Marten, 2005. "Moral hazard and sickness insurance," Journal of Public Economics, Elsevier, vol. 89(9-10), pages 1879-1890, September.
    26. Puhani, Patrick A. & Sonderhof, Katja, 2010. "The effects of a sick pay reform on absence and on health-related outcomes," Journal of Health Economics, Elsevier, vol. 29(2), pages 285-302, March.
    27. Barmby, Tim & Larguem, Makram, 2009. "Coughs and sneezes spread diseases: An empirical study of absenteeism and infectious illness," Journal of Health Economics, Elsevier, vol. 28(5), pages 1012-1017, September.
    28. repec:bla:scandj:v:96:y:1994:i:4:p:561-66 is not listed on IDEAS
    29. Leigh, J. Paul, 1985. "The effects of unemployment and the business cycle on absenteeism," Journal of Economics and Business, Elsevier, vol. 37(2), pages 159-170, May.
    30. Audas, Rick & Goddard, John, 2001. "Absenteeism, seasonality, and the business cycle," Journal of Economics and Business, Elsevier, vol. 53(4), pages 405-419.
    31. Davies, Rhys & Jones, Paul & Nuñez, Imanol, 2009. "The impact of the business cycle on occupational injuries in the UK," Social Science & Medicine, Elsevier, vol. 69(2), pages 178-182, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. 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.
    2. 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.
    3. 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).
    4. 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.
    5. 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.
    6. 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).
    7. 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.
    8. Stefanie Thönnes & Stefan Pichler, 2019. "Sickness absence and unemployment revisited," Working Papers Dissertations 53, Paderborn University, Faculty of Business Administration and Economics.
    9. Ángel L. Martín-Román & Alfonso Moral & Sara Pinillos-Franco, 2024. "Are women breaking the glass ceiling? A gendered analysis of the duration of sick leave in Spain," International Journal of Health Economics and Management, Springer, vol. 24(1), pages 107-134, March.
    10. 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.
    11. 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.
    12. 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.
    13. 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.
    14. 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.
    15. Johanna Catherine Maclean & Stefan Pichler & Nicolas R. Ziebarth, 2020. "Mandated Sick Pay: Coverage, Utilization, and Crowding-In," NBER Working Papers 26832, National Bureau of Economic Research, Inc.
    16. Carlo Alberto Biscardo & Alessandro Bucciol & Paolo Pertile, 2015. "Who should monitor job sick leave?," Working Papers 18/2015, University of Verona, Department of Economics.
    17. 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.
    18. 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.
    19. 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).
    20. Aaviksoo, Evelyn & Kiivet, Raul Allan, 2016. "Influence of the sickness benefit reform on sickness absence," Health Policy, Elsevier, vol. 120(9), pages 1070-1078.
    21. 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.
    22. 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.
    23. Thomas Leoni & René Böheim, 2018. "Fehlzeitenreport 2018. Krankheits- und unfallbedingte Fehlzeiten in Österreich – Präsentismus und Absentismus," WIFO Studies, WIFO, number 61487, March.
    24. 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.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Stefanie Thönnes & Stefan Pichler, 2019. "Sickness absence and unemployment revisited," Working Papers Dissertations 53, Paderborn University, Faculty of Business Administration and Economics.
    2. 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.
    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. Pichler, Stefan & Ziebarth, Nicolas R., 2015. "The Pros and Cons of Sick Pay Schemes: A Method to Test for Contagious Presenteeism and Shirking Behavior," VfS Annual Conference 2015 (Muenster): Economic Development - Theory and Policy 112940, Verein für Socialpolitik / German Economic Association.
    5. 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.
    6. Bratberg, Espen & Monstad, Karin, 2015. "Worried sick? Worker responses to a financial shock," Labour Economics, Elsevier, vol. 33(C), pages 111-120.
    7. René Böheim & Thomas Leoni, 2014. "Firms' Sickness Costs and Workers' Sickness Absences," NBER Working Papers 20305, National Bureau of Economic Research, Inc.
    8. Vincenzo Scoppa & Daniela Vuri, 2014. "Absenteeism, unemployment and employment protection legislation: evidence from Italy," IZA Journal of Labor Economics, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 3(1), pages 1-25, December.
    9. Ziebarth, Nicolas R., 2013. "Long-term absenteeism and moral hazard—Evidence from a natural experiment," Labour Economics, Elsevier, vol. 24(C), pages 277-292.
    10. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2012. "Sick Leaves: Understanding Disparities Between French Departments," Working Papers DT50, IRDES institut for research and information in health economics, revised Oct 2012.
    11. 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.
    12. Mohamed Ali Ben Halima & Thierry Debrand & Camille Regaert, 2011. "Arrêts maladie : comprendre les disparités départementales," Working Papers DT39, IRDES institut for research and information in health economics, revised Feb 2011.
    13. Annalisa Scognamiglio, 2020. "Paid Sick Leave and Employee Absences," LABOUR, CEIS, vol. 34(3), pages 305-322, September.
    14. René Böheim & Thomas Leoni, 2020. "Do Employees’ Sickness Absences React to a Change in Costs for Firms? Evidence from a Natural Experiment," Scandinavian Journal of Economics, Wiley Blackwell, vol. 122(2), pages 553-581, April.
    15. Nicolas R. Ziebarth & Martin Karlsson, 2014. "The Effects Of Expanding The Generosity Of The Statutory Sickness Insurance System," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 29(2), pages 208-230, March.
    16. Gürtzgen, Nicole & Hiesinger, Karolin, 2020. "Dismissal protection and long-term sickness absence: First evidence from Germany," ZEW Discussion Papers 20-040, ZEW - Leibniz Centre for European Economic Research.
    17. Konstantinos, Pouliakas & Ioannis, Theodossiou, 2010. "An Inquiry Into the Theory, Causes and Consequences of Monitoring Indicators of Health and Safety At Work," MPRA Paper 20336, University Library of Munich, Germany.
    18. Goerke, Laszlo & Pannenberg, Markus, 2015. "Trade union membership and sickness absence: Evidence from a sick pay reform," Labour Economics, Elsevier, vol. 33(C), pages 13-25.
    19. Hesselius, Patrik, 2007. "Does sickness absence increase the risk of unemployment?," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 36(2), pages 288-310, April.
    20. Sebastien Menard, 2021. "Optimal sickness benefits in a principal–agent model," Social Choice and Welfare, Springer;The Society for Social Choice and Welfare, vol. 57(1), pages 5-33, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:24:y:2015:i:6:p:692-710. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.