The recession means that many workers cannot afford to fall sick in the US.
Like the protagonist of a medicine commercial, Robert says he can't afford to get sick and miss a shift at the upscale restaurant where he waits tables six nights a week in the US capital.
"It's expensive to live in this city," Robert, 31, told RIA Novosti. "You can't just be missing days."
Robert, who asked that his last name not be published because his employer has not authorized him to speak to the media about this job, actually has more access to paid sick leave than many Americans.
He works in Washington, which is just one of three US municipalities-along with one state, Connecticut-to guarantee paid sick leave for employees.
An estimated 40 million American workers have no paid sick leave, which the US federal government defines as a "benefit" rather than a right.
A national debate over mandatory sick pay has grabbed headlines in recent weeks in the US, which has been gripped by a flu outbreak that health authorities say has reached epidemic proportions.
The US is one of the few industrialized nations that does not have a federal law mandating paid sick leave, a situation that critics say pressures ill employees to come to work out of fear of losing a paycheck-or their jobs.
The results, they say, are decreased employee productivity and increased public exposure to infectious illnesses, particularly when workers like Robert and other food service employees-whose jobs involve face-to-face contact with the public-shrug off symptoms and clock in anyway.
According to a 2010 study at the University of Chicago, more than two-thirds of Americans reported going to work while sick. Employees without paid sick leave are 18 percent more likely to show up at work sick and 10 percent more likely to send their sick children to school or daycare, according to the study.
"I'm sure right now as we speak kids are going to school sick," New York City legislator Gale Brewer told WNYC radio in an interview earlier this month. "Their parents cannot take a day off."