Precarious work, sickness absence and risk sharing between employers, employees and social insurance

Abstract Background The COVID-19 pandemic has revealed the importance of social protection systems including income security when health problems arise. Particularly the protection of those with precarious work felt short in some countries. For some time there has been an interest in the European variation in sick-pay schemes but still we still lack knowledge on country differences and similarities. This is particularly the case regarding precarious workers, while they have higher chances for sickness absence. Our aim is to understand, in the context of precarious work, the differences in risk sharing of sickness absence between employer, worker and social insurance. Methods Data had been collected in a study on sickness absence follow-up regimes in nine countries (the Nordic countries (Sweden, Denmark, Finland, Norway and Iceland) and in Germany, the Netherlands, Belgium and the UK). Comparative statistics were collected and scholars familiar with their countries system were invited to answer a list of 51 questions on system characteristics. Data were re-analysed from the perspective of precarious work, using actor-network theory and insider-outsider theory of employment. Results Countries with shorter employer periods of sick pay have stricter follow-up responsibility for employers as they are regarded gatekeeper except for The Netherlands. The tax-based systems that target all citizens offer more protection for precarious workers while the employee-focused systems define their target population more strictly, leaving precarious workers underserved. There is a large difference in how self-employed are supported or not. Conclusions Despite small economic differences in the nine countries studied, the systems for dealing with sickness absence in the context of precarious work vary largely. Even though, in all systems those with secure jobs seem insiders and those with precarious work outsiders. Social protection systems should be updated to avoid an increasing inequality. Speakers/Panellists Anita Tisch Working time and Organization, Federal Institute for Occupational Safety and Health, Dortmund, Germany Angelique De Rijk Department of Social Medicine, Maastricht University, Maastricht, Netherlands


Background:
In the context of the COVID-19 pandemic, shifting employment and occupational health social protections of low-wage and self-employed digital platform workers are described and compared. Specifically, we examine how, across advanced economy countries, laws, policies, and collective agreements protected the health of low wage (e.g., service workers) and digital platform workers (usually classified as self-employed) including during the first three waves (2019-2021) of the COVID-19 pandemic. The overall goal is to inspire conversation, comment, critique and new research questions to tackle the issue of the employment, work and health of low wage workers and self-employed digital platform workers.

Methods:
Taking a comparative focus on eight advanced economy countries, this paper identifies legal efforts to address employment misclassification and challenges related to employee definitions that vary by the legal act. Debates about minimum wage and occupational health and safety standards as these relate to worker well being are considered. Finally, we discuss promising changes introduced during the COVID-19 pandemic that protect the health of low-wage and self-employed workers.

Results:
Overall, we describe an ongoing ''haves'' and a ''haves not'' divide, with on the one extreme, traditional job arrangements with good work-and-health social protections and, on the other extreme, low-wage and self-employed digital platform workers who are mostly left out of schemes. However, during the pandemic small and often temporary gains occurred and are discussed.

Conclusions:
In the context of an evolving social contract during the COVID-19 pandemic, this paper provides views on avenues for policy reform and research from employment and occupational health specialists across eight advanced economy countries.
Abstract citation ID: ckac129.376 Precarious work, sickness absence and risk sharing between employers, employees and social insurance

Background:
The COVID-19 pandemic has revealed the importance of social protection systems including income security when health problems arise. Particularly the protection of those with precarious work felt short in some countries. For some time there has been an interest in the European variation in sick-pay schemes but still we still lack knowledge on country differences and similarities. This is particularly the case regarding precarious workers, while they have higher chances for sickness absence. Our aim is to understand, in the context of precarious work, the differences in risk sharing of sickness absence between employer, worker and social insurance. Methods: Data had been collected in a study on sickness absence followup regimes in nine countries (the Nordic countries (Sweden, Denmark, Finland, Norway and Iceland) and in Germany, the Netherlands, Belgium and the UK). Comparative statistics were collected and scholars familiar with their countries system were invited to answer a list of 51 questions on system characteristics. Data were re-analysed from the perspective of precarious work, using actor-network theory and insideroutsider theory of employment.

Results:
Countries with shorter employer periods of sick pay have stricter follow-up responsibility for employers as they are regarded gatekeeper except for The Netherlands. The tax-based systems that target all citizens offer more protection for precarious workers while the employee-focused systems define their target population more strictly, leaving precarious workers underserved. There is a large difference in how selfemployed are supported or not.

Conclusions:
Despite small economic differences in the nine countries studied, the systems for dealing with sickness absence in the context of precarious work vary largely. Even though, in all systems those with secure jobs seem insiders and those with precarious work outsiders. Social protection systems should be updated to avoid an increasing inequality.