In a nation of disparity, getting sick remains an equal opportunity proposition. The flu bug does not discriminate.

But the equity ends there. Calling in sick is more costly in America to those who can afford it least, and we all share the burden via infected workplaces, schools and child care.

More Americans than ever before — 71 percent of private industry and 91 percent of state and local government workers — have access to paid sick leave.

But among the ten percent of workers who earn the least, only 31 percent have paid leave, compared with 92 percent of the top ten percent of wage earners.

In Nevada, where so much employment is concentrated in the service sector, the Institute for Women’s Policy Research estimated in 2015 that half of the state’s private sector workforce had no paid sick leave. Even members of the powerful Culinary Union forego pay when calling in sick, according to spokeswoman Bethany Khan.

“I think that we need to be reasonable when it comes to sick leave,” Governor Steve Sisolak told the Current earlier this month. “I think everybody agrees it’s a necessity, a certain amount of it. I think to quantify it is going to be the difficult part and I’m anxious to see what the Legislature comes up with.”

“At least seven days,” says Erika Washington of Make it Work Nevada, a non-profit dedicated to helping working families. “Seven is the bare minimum.”

But in the resort industry, seven absences in one year can land a worker, even a union member, perilously close to termination.

“Governor Sisolak has shown that he can bring many sides to the table and if that can happen for paid sick leave, that is something that the Culinary Union could support,” says Khan.

Unlike most developed nations, America lacks a national policy on sick leave, leaving it to the states, and increasingly to cities, to pass legislation.

Currently, the District of Columbia and eleven states have laws mandating paid sick leave for at least some employers. Nevada is not one of them.

Under Nevada law, state employees receive paid sick leave, which may accumulate year to year. Those who accumulate 90 days may carry only one-half forward to the next year. According to state law, a state employee with a long-term or chronic illness with no sick leave available may use leave that has accrued but has not been carried forward, if authorized by the Department of Personnel.

Private sector workers are at the whim of their employers.

In 2017, Governor Brian Sandoval vetoed Senate Bill 196, which would have required businesses with 25 or more employees to pay sick leave to full-time employees. Sandoval said the measure would pose a “substantial cost to businesses, particularly small businesses.”

But data from the U.S. Census indicate the cost to employers is negligible.

Sick leave for private sector employees, as a percentage of total compensation per hour worked, varied by region of the country from a low of .8 percent to a high of 1 percent.

In the Mountain West region, which includes Nevada, an hour of work costs an employer, on average, $33.06, including mandated benefits. Only .29 cents or .9 percent, goes to sick pay.

State Senator Joyce Woodhouse has filed a bill draft request regarding sick leave for private sector employees. She says details are not yet available.

Paid sick leave is available nationwide to 62 percent of workers in small businesses, 79 percent in medium-sized companies and 87 percent in large.

Fifty percent of construction, extraction, farming, fishing and forestry workers have access to paid sick leave — the lowest rate of all sectors, followed by the service industry, where only 52 percent of workers earn paid sick leave.

Nevada’s gaming and tourism industry employs close to 430,000 workers, according to the Governor’s Office of Economic Development. Some of the state’s biggest employers don’t offer access to paid sick leave. Others refuse to even discuss their policies.

“All MGM Resorts employees are eligible for paid time off from work. The amount of time off granted depends on job grade level, length of service and union bargaining agreements,” a company spokesperson said, declining to elaborate.

“Wynn offers paid leave that can be used for the employees choice of either vacation or sick leave,” said spokesman Michael Weaver.

Khan, spokeswoman for Culinary Local 226, says most gaming companies the union represents have a “point system,” which allows employees to accumulate demerits as they take unpaid sick days.

Sick calls result in demerits that can add up to termination, sources say. The “points” are usually removed from an employee’s record on work anniversaries.

“We don’t comment on employee benefits,” said Lynne Ravenscraft, Marketing Director of the South Point, a non-union resort owned by Michael Gaughan.

A spokeswoman for Las Vegas Sands, which owns the non-union Venetian and Palazzo, said the company was “unable to participate” in this story.

“We have not been able to have conversations with folks who are at non-union hotels,” says Leo Murietta of Make the Road, a non-profit dedicated to building the power of working class communities “to achieve dignity and justice.”

“We don’t comment on our company policies,” said spokeswoman Lori Nelson of Station Casinos, which owns close to two dozen properties in Southern Nevada. The non-union stalwart is fighting orders from the National Labor Relations Board to recognize union votes and engage in collective bargaining with the Culinary at several of its properties.

Station Casinos workers interviewed for a 2016 report called Banking on Unsafe Conditions: Placing Profits Before Protection of Casino & Hotel Workers’ Human Rights in Deutsche Bank’s U.S. Supply Chain, said they fear being disciplined or terminated for calling in sick.

The report is authored by Fatma E. Marouf, Co-Director of the Immigration Clinic, University of Nevada, Las Vegas William S. Boyd School of Law; Sameer M. Ashar, Co-Director of the Immigrant Rights Clinic at U.C. Irvine School of Law; and Jennifer J. Rosenbaum of the Robina Foundation Human Rights Fellow at Yale Law School.

Some companies lack dedicated sick pay but offer paid time off, which they say can be used at the employees’ discretion Such arrangements are common but increasingly under scrutiny, especially in jurisdictions such as New Jersey, which requires immediate accrual of sick leave for all employees, not just full-time workers, who traditionally receive paid time off.

Sick leave is among the human rights included in the International Covenant on Economic, Social, and Cultural Rights, a United Nations treaty.

In March 2016, the UN Committee on Economic, Social and Cultural Rights wrote that “paid sick leave is critical for sick workers to receive treatment for acute and chronic illnesses and to reduce infection of coworkers.”

The UN Committee’s general comment on paid sick leave said “[l]eave due to illness or other reasons should not be deducted from paid annual leave.”

Some U.S. jurisdictions are requiring a two-tiered system, in which companies that offer paid time off, but not dedicated sick leave, provide a higher rate of accrual than those that offer PTO and paid sick leave, too.

Retail workers, who often lack full-time schedules, frequently go without paid sick leave.

“Most of the folks we are organizing work in retail because their schedules are not consistent and it makes it difficult for them to live,” says Murietta. “When they are sick they can’t take the time off. It makes them nervous so they won’t take it.”

A measure before the 115th Congress, the Healthy Families Act, would have required employers with 15 or more workers to provide up to 7 paid sick days per year. Smaller companies would not have been required to pay sick leave but would have guaranteed an employee’s right to return to work without reprisal.

A version of the bill has yet to be filed in the new Congress.