With the health of the U.S. economy so much in the news these days, it seems natural to also analyze the health of the average U.S. worker, considering how much influence the latter has on the former. That analysis, considering the current state of the national healthcare system, does not paint a pretty picture.

There are two sides to this issue. The first is the more obvious of the two: the actual cost of healthcare. During the past decade, that cost has skyrocketed in relation to other business costs. In fact, it's skyrocketed in relation to just about any other product or service, with the possible exception of oil and college tuition. Every year, businesses and corporations have passed more of the cost of their health insurance programs on to their employees. Despite all of this, politicians have been unable to hammer out a workable solution. But at this point, that's only one half of companies' worries in regards to the cost of an unhealthy workforce. There's another facet to the issue, one that can be just as costly, if not more so.

Counting the cost

This second facet involves the cost of lost productivity - in other words, the cost of millions of employees who are too sick to work. These workers fall into three distinct categories, which are listed below:

• Those who do not work at all due to the fact that they suffer from an illness or disability

• Those who miss time from their jobs because of a health problem (or multiple problems)

• Those who don't miss time from work, but still experience a loss of productivity due to a health ailment or one suffered by a member of their family

Examining the results of the Commonwealth Fund Biennial Health Insurance Survey can bring the picture more into focus and help determine exactly how many Americans fall into one of these three categories. For example, according to the survey, an estimated 18 million Americans between the ages of 19 and 64 are not working and have a disability or chronic disease or do not work because of health reasons.

Then there's the issue of sick days and/or time off work. The survey data indicated that 69 million workers took sick days in 2003. In addition, 64% of respondents said they had missed at least one day of work in the past year because of their health problems or a family member's health problems. This time off translates directly into lost productivity.

Also hampering productivity are those employees who come to work even though they're sick or a member of their family is sick. This "presenteeism" (as opposed to "absenteeism") has a profound effect on both individual companies and the economy overall.

According to the Commonwealth survey, 55 million workers reported that they were unable to concentrate on the job because of illness, either theirs or a family member's. As you might imagine, those workers without paid sick leave are more likely to show up for work when they're sick or ill.

These shouldn't be viewed as costs, but rather as an investment. When you consider how much it costs when employees (or their family members) are unhealthy, it's an investment that's well worth it in the long run.