what are the minimum benefits an employer needs to provide?

A reader writes:

What do you think are the absolute minimum benefits an employer should provide? I’m a business development consultant, and work with a lot of start-ups assisting in total compensation development. I, of course, try to work with my clients to develop the most competitive benefits package they can afford. However, I’ve often run into the situation where the client believes they absolutely can’t afford even the most basic of benefits. As in, won’t even consider providing PTO or paid holidays until employees have been at their company for 12 months or longer.

I understand my clients’ perspectives to a point — most are in the medical field, and associated at practices prior to opening their own where they were classified as contractors and didn’t receive benefits. So their logic is often, “Well, I’ve never had paid time off. Why should I give my employees any unless they’re working 38 hours a week and have been here more than a year?” Alternatively, they say they want to provide benefits but are so nervous about the cost of starting their own practice they just truly feel they can’t afford it.

I’m of the mind that there should be a basic benefits package factored into total compensation … not just an hourly rate and payroll taxes. I completely understand if they can’t afford to provide 100% paid medical coverage, unlimited PTO, 10 paid holidays, a significant match on a 401k, catered lunches, etc. But some of my clients are completely resistant to even paying for a couple of holidays during the first year, which baffles me … especially when they complain about the cost of employees, but keep hiring as if they can afford to. I look at it like some people look at eating out: if you can’t afford to tip, you can’t afford to eat out … and if you can’t afford any PTO, you can’t afford to hire.

Am I off-base? Is it acceptable or expected that new businesses only offer an hourly rate and nothing else? Or is there a basic employee benefits package that start-up companies should plan to implement when hiring?

I answer this question over at Inc. today, where I’m revisiting letters that have been buried in the archives here from years ago (and sometimes updating/expanding my answers to them). You can read it here.

{ 245 comments… read them below }

    1. KatEnigma*

      Now you’re getting carried away with hyperbole. Those medical office jobs are generally considered light duty work, in comparison to hospital or clinic settings where they might get PTO, but their workload comes a lot closer to a real sweat shop!

      1. Parky*

        That’s bs. Having worked in many fields from food to factory to warehouse to corporate management, all of can be extremely hard work and deserved benefits. Sweatshop isn’t hyperbole to the degree you imply

        1. MarioKart*

          My first ambulance job paid like $11/hr with no PTO unless you’d been there a year, and then you had to accrue it based on hours worked. This was actually not bad for the industry–you had to wait for PTO but it was there, no mandatory overtime, fewer holdovers.
          The margins in healthcare are ridiculously slim, and to people who work in cushy fields that let you WFH and pay all your healthcare premiums don’t always understand that what they have is a luxury. We all did just fine at that company because we were willing to work hard and not be entitled. In return, we got fair pay, overtime whenever we wanted it, and the satisfaction of a job well done.

            1. UrsulaD*

              Agreed, also, I know the “don’t compare US to Europe rule” but other countries have required PTO in the medical field so it clearly can be done.

          1. Tulipmania*

            When someone is criticized by calling them “entitled”, that’s shorthand for them thinking they’re entitled to something they’re really not. But PTO *is* actually something people are entitled to, because they’re human beings and not robots. So yes, healthcare workers demanding PTO are “entitled”: properly entitled to demand it!

          2. Starbuck*

            “eople who work in cushy fields that let you WFH and pay all your healthcare premiums don’t always understand that what they have is a luxury. We all did just fine at that company because we were willing to work hard and not be entitled”

            This is really sad :( You, me, we all deserve better than the treatment that leads to attitudes like this.

            1. yala*

              What’s the saying? There’s two kinds of folks. Folks who say: “I went through that and it sucks, and no one should have to go through that” and folks who say: “That sucked and I went through it, so anyone should be able to.”

              1. Grammar Penguin*

                Or worse: “That sucked and I went through it, so EVERYONE should have to go through the same or worse.”

                Crabs in the bucket.

          3. Artemesia*

            US health care is the most bloated overpriced disaster in the world. France provides better care to everyone for half what we provide in the US and we don’t cover everyone. If the ‘margins are slim’ it is from the ridiculous profits driven to pharma, insurance companies etc.

          4. Bess*

            I’m not sure the characterization of someone working from home who has PTO is entitled, or might not have any perspective on or experience with hourly or intermittent work without benefits, is really accurate or fair.

          5. yala*

            “We all did just fine at that company because we were willing to work hard and not be entitled.”

            It’s really wild when folks frame accepting a crummy situation, lousy pay, and no leave as “not being entitled.”

            I mean, if that’s not being entitled, then being entitled sounds much better. Because what you’re describing does not sound remotely like fair pay (but hey, as much extra work as you want!)

            1. Grammar Penguin*

              You seem to think that working long hours at a hard and even dangerous job ought to afford you a living. How entitled can you get?

              Remember, no matter how “essential” the work, the people who do the work are disposable, interchangeable, and inconsequential.

          6. Database Developer Dude*

            People get sick, and need PTO for that. Doctors appointments sometimes have to be during the day Monday to Friday. People with kids get sick. Calling people “Entitled” who expect PTO, MarioKart, is an insult, and a tone-deaf one at that. I’d say more, but Alison might ban me if I do.

          7. Lola*

            Nope. I work for a nonprofit safety net hospital, operating on the THINNEST of margins and I get unlimited PTO, plus excellent health insurance.

            And in case you think I’m living it up like a fat cat, my office is either 90 or 60 degrees, becuase of the 100 year old boiler, the bathroom frequnetly smells like a sewer, and IT has not been able to solve my email quarantine issues for months. It’s a safety net hospital. I also work my butt off.

            But even my nonprofit hospital factors in benefits.

          8. Lucky Meas*

            Why is being paid even though you got sick a luxury? Surely you don’t want sick people driving the ambulance because they can’t afford time off?

            What if you could get healthcare premiums paid AND have the satisfaction of a job well done?

            1. Grammar Penguin*

              Yeah, my first thought was about how many times this person has gone in to work while contagious.
              You make life and death decisions, while sick, for $11/hr and no benefits, and you think expecting more is entitled?
              Well you’re right. You ARE entitled to more. Entitled, as in, “have earned it.”
              “Entitled” simply means you have a right to something. Register your car and you are entitled to drive it on the street. Buy a movie ticket, you are entitled to enter the theater. Reach your 21st birthday and you are entitled to buy alcohol. Register to vote and you are entitled to cast a ballot.
              The demonization of the word “entitled” or “entitlement”, especially in a work context, is part of a deliberate effort to convince workers that they have no rights. If entitlement itself is discredited, then nobody is entitled to anything.
              Oddly, nobody ever questions the shareholders’ entitlement when it’s time to divide up profits.

          9. House On The Rock*

            I’m sorry you were subjected to these conditions. I hope that, in time, you can realize that you were, indeed, being exploited and that others having it better (or wanting better) doesn’t mean they are “entitled”. The only people who benefit from employees having your attitude are the bosses.

          10. Ace in the Hole*

            Working in garbage for local government. Everyone in my org gets at least 26 paid days off plus additional paid sick leave. Insurance premiums aren’t covered 100%, but cost me about $25/month including coverage for a dependent and vision/dental. We get a pension funded by the employer. We’re paid a living wage for the region.

            I’m well aware many jobs don’t offer these benefits. But that doesn’t mean they *shouldn’t.* If a garbage worker can get paid time off, affordable healthcare, and a pension… why can’t an ambulance driver? Why should someone be content with the satisfaction of a job well done, if they can have that satisfaction AND benefits that improve their quality of life?

      2. Middle Aged Lady*

        The people working medical staff jobs at the clinics are frequent don’t appear to be pulling light duty. You try smiling and checking in and finding info and enforcing mask mandates while answering the phone and it’s an elderly partially dead client and the pharma rep shows up and Mrs Jones doesn’t have her list of new scrips and Mr Smith came on the wrong day and Mrs Johnson is crying bexause she just found out her son has cancer and Mr Peoples needs to have his info transferred because his health insurance doesn’t cover us anymore and I have been on my feet taking bos or sitting i. This chair for hours and so tired of having to manage all these sick people’s emotions and shit someone just sneezed will I bring COVID home? And speaking of which here comes mr maga anti-vaxxer who screams when asked to mask up. Ligjt duty?

        1. Rainy*

          Shout out to the front desk employee at the clinic where my GP practices, who, when I was waiting to be seen for what turned out to be a very weird broken finger and an elderly guy tried to proselytize to me on his way out of his appointment, was responsive to my shout that I was being harassed. Managing crap like that is not light duty.

        2. Grammar Penguin*

          I think people who do their jobs well make those jobs look easy. If you’ve only ever seen competent professionals doing a thing, that thing will look a lot easier than it is.

      3. Ultra Anon*

        Medical Office might be light in physical duty, but they’re just as exhausting. Try dealing with ringing phones, checking in patients, directing lost patients, taking calls from irate patients unhappy that they can’t be seen right now, etc. I did that work for a year and it’s pretty thankless since demands come at you from both sides (clinicians and patients).

    2. Artemesia*

      Doctors are the worst. Perhaps it is the way they enter the profession with grinding qualifying courses, long hours and student debt, but they tend to have a really mean attitude towards charity of any sort and benefits. I remember when my second child was born, I had no health insurance (well I had it, but the small college I worked for didn’t include maternity in their coverage) and so delivered at a hospital clinic mostly catering to women on welfare with a sliding cost scale. I mentioned to a relative who was a doctor that I was disgusted by the fact that there was a pool of blood on the communal bathroom floor in the morning and it was still there in the afternoon — it felt so unhygienic. His response was ‘well, these people who demanded minimum wages, what did they expect. We used to be able to hire people to do the cleaning but minimum wage makes it to expensive.’ — he with his Lincoln and country club membership thought it was terrible that janitors got minimum wage and would rather have a filthy maternity ward than pay someone to keep it clean.

      He had a rough time so no one else should be treated well. Ever.

  1. Jaybeetee*

    Understanding that this is US and US norms and US laws…

    I would think regional and industry norms would be a valuable data point here. If most industries of this type offer a certain level of benefits or PTO or whatever, a company offering far below the norm will struggle to attract and retain talent. It’s like buying all your business supplies at the dollar store – ot may cover your needs in the short term, but the poor quality will cost more in the long term.

    Workers are, in some ways, like any other business expense. If you can’t afford to keep the lights on, you can’t afford the business.

    1. Hlao-roo*

      Yes, my first job in engineering (US) had:
      – 11 paid holidays
      – 15 vacation days
      – 5 sick days
      – up to 6% 401k match
      – health insurance (don’t know what % the company paid for, but I paid for some of the premiums)

      Granted, this was for a large company and I know it’s easier for large companies to offer benefits because they employ people whose jobs are to set up health insurance , 401ks, etc. In engineering, I would expect even small companies to start with:
      – 8 paid holidays
      – 10 vacation days
      – 5 sick days
      – health insurance (with some premiums for employees)

      1. WomEngineer*

        Agree. Personally I think health insurance should be a given for any job that requires 4+ years of college (assuming it’s not provided by the government)

      2. Amy*

        To paraphrase Linda Evangelista, as a mid-career professional, I won’t get out of bed for fewer than 24 paid vacation and 11 federal holidays a year.

      3. Gato Blanco*

        I agree that that should be the bare bare minimum. I worked at a start up for a year with terrible wages, but we did have the minimum you listed above, which I would not have wanted to take a job without. But I did immediately jump ship to a job with better benefits at the first opportunity.

      4. JM60*

        I’m in a somewhat junior software engineering position (although “senior” is in my title), and I currently get 12 company holidays a year, and I use 4 weeks of vacation on my employer’s “unlimited” vacation policy. So I basically get ~6.5 weeks – roughly a month and a half – of paid time off per year for fun reasons alone. Any less than a month (~22 business days) of combined holiday and vacation is a hard no.

    2. DJ Hymnotic*

      It’s anecdata for sure, but as regards industry norms, my wife and I both work in healthcare and we have some experience working with healthcare startups. While our current employers offer some very good benefits (as I noted on another AAM article recently, the benefits were a significant draw for my current job) the starting PTO is not among them, and at my last healthcare employer as I recall the PTO was pretty meager. There are a whole host of reasons for why I think this is the case but suffice it to say that I can *totally* see LW’s clients saying the stuff they’re being paraphrased as saying.

      That doesn’t make it right at all, and I believe that such attitudes are directly contributing to the burnout crisis in healthcare. But those attitudes are certainly present.

      1. I Have RBF*

        Not having adequate PTO in health care has always struck me as penny wise, pound foolish. Why? Because no PTO or sick days for an entire year or more guarantees that those people are coming to work sick and infecting their coworkers and patients. That makes everything cost more in the long run than just having the one person out on paid PTO.

        I’ve been in a contract job where I literally could not afford to be out sick, but neither could anyone else in the office! This meant I got every f’ing illness that went through that office. So I had to take unpaid time off because I can’t work when sick (I get mean.) The place was a cesspit of illnesses for the entire time I worked there.

        Another contract job, with lots of other contractors working sick, gave me pneumonia! I lost three weeks, unpaid, that I really couldn’t afford because everyone else came in sick and spread it around.

        No PTO for a year? If it isn’t a contract gig at really good wages it’s a hard pass.

        Also, even contracting houses these days are offering health care after only a few months. Yeah, you have to pay the premiums, but it’s pre-tax and cheaper than the exchanges.

  2. Nobby Nobbs*

    Pre-ghosts Scrooge is not a role model, and anyone who bellyaches over bare-minimum paid holidays should not be employing people.

    1. Cait*

      Agreed. If you can’t afford to give someone a single day off in 12 months, you can’t afford to be in business.

    2. Barb*

      And even Scrooge gave Bob Cratchit a paid day off once per year!

      “You’ll want all day tomorrow I suppose.”
      “If quite convenient, sir”
      “It’s not convenient and it’s not fair. If I was to stop half a crown for it, you’d think yourself ill-used, I’ll be bound.
      And yet you don’t think me ill-used when I pay a day’s wages for no work.”
      The clerk observed that it was only once a year.
      “It’s a poor excuse to pick a man’s pocket once every 25th of December!”

    3. goddessoftransitory*

      YES. Haranguing his employee over wanting one day off a year was supposed to show Scrooge was not a good man or employer!

  3. Some guy*

    The real question is what benefits should the government provide so we aren’t so reliant on employers to meet our basic needs.

    The answer is comprehensive, universal healthcare and affordable public housing.

    1. pope suburban*

      Preach it. Speaking for myself, if I had been able to get medical care and a safe roof over my head, I would have avoided a lot of bad jobs, and I would have been a better employee because I would have been healthy, I would not have been constantly worried about making ends meet, and I would have been able to choose jobs that use the most of my skills/potential. I don’t think anyone has been particularly well-served by my having to take bad, stagnant jobs that I can’t stand, and I doubt very much that I am alone in that. If people were able to pursue the kinds of work they are a good fit for, the quality of service/life/everything would go up for us all.

      1. coffee*

        I also think that having a workforce that’s able to peace out on dysfunctional workplaces would mean that businesses would have more pressure on them to be functional, which would lead to better business and better services. Having a business fail can mean that there’s then space for a better business to replace it.

    2. Moira Rose*

      This is silly. Only an employer can provide PTO. You could make an argument that there should be laws about minimum PTO allowances, and I’d be in favor of said laws, but the government can’t give private employees PTO from their private jobs.

      1. Dust Bunny*

        This. PTO is 100% on your employer. If they can’t afford to staff enough to let people take time off, they don’t have a functional business model.

      2. Cookie Monster*

        They specifically said the answer had to do with healthcare and housing, not PTO.

      3. SpaceySteph*

        Leaving aside the fact that the comment you’re replying to is specifically about healthcare and housing, not PTO…

        Is that not basically what the states that offer parental leave provide? Paid time off funded by the government?

        1. doreen*

          Not always – in New York employees pay 0.455% of wages up to about $400/year to fund paid family leave and employers are required to obtain a rider on their disability insurance policy to provide the benefits. Employers pay for required paid sick leave . Government doesn’t pay for any of it except enforcement.

          1. SpaceySteph*

            But that 0.455% is just a tax, which is how governments get their money. But regardless, the point is that IF the government decided that PTO were something it was interested in providing to citizens, it certainly could do it. It’s not completely impossible, as Moira Rose implied.

            1. doreen*

              That money doesn’t go to the government. The employer withholds it from paychecks and uses it to pay the premium on the insurance rider. I suppose there could be government funded PTO – but I cannot imagine why that is better than mandating that employers provide PTO.

      4. Fluffy Fish*

        How is what Some guy said silly? He specifically stated healthcare and affordable housing, not that government should provide PTO?

        And yes I do believe the government should mandate employer provide a certain amount of PAID time off including maternal/paternal leave.

      5. Ashley*

        Sure, but Some Guy didn’t say the government should be providing PTO. They should be providing universal healthcare so that employers don’t have to incur that expense, freeing up more $$ to give employees other benefits.

        1. I am Emily's failing memory*

          Yep, health insurance is far and away the biggest benefit cost for employers to shoulder. Particularly small employers, where having just one employee out of ten that the insurance company considers high-risk can making a huge impact on premiums. I suspect a lot of small employers hesitate to even set up a group plan knowing how unpredictable the changes in cost from year to year can be just based on the changes in staff composition from year to year, to say nothing of price fluctuations in the insurance industry as a whole, or pricing changes initiated at one insurance company in particular. They’d rather just never offer it than set something up and then have to take it away or massively increase the employee share of payments when they hire their first over-40 staff member and the premiums double.

      6. Some guy*

        I still think this is a policy question. I think the government should mandate a minimum amount of PTO from employers. Other western nations do this.

    3. ecnaseener*

      That’s absolutely true, but I don’t think it’s an answer to LW’s question. If these employers didn’t offer health insurance because the government should provide universal healthcare, it would be like people who refuse to tip because “the restaurant should pay them more.” Of course they should, but they don’t, so you can’t use that as an excuse!

    4. Spearmint*

      That’s all well and good but (1) isn’t really helpful to answer the question and (2) violates the no politics rule.

        1. Spearmint*

          I could have sworn there was an “avoid politics in the comments” rule, but I just checked and it’s not there. Was it removed?

          1. I am Emily's failing memory*

            I don’t think there’s ever been such a rule. The closest thing is Alison has sometimes requested that people whose comment deals with “what you should be able to do” instead of “what you can actually expect to be able to do” should make that very clear in their comment, so that inexperienced workers don’t get the wrong impression and think the “how it should be” comments reflect real workplace expectations, and make poor choices that harm themselves professionally as a result.

    5. lilsheba*

      YES!!! The government is supposed to provide for it’s people and take care of them, and THIS is the way to do it, not over pay senators and overpay for stupid crap they buy and make sure the rich stay richer. We should have health care, housing and dare I say food provided for. Those are basic necessities in life, and one shouldn’t go bankrupt trying to get it.

    6. Rachel*

      If the government provided those things, more people could afford to start businesses. It would benefit everyone.

    7. Anastasia Beaverhousen*

      Personally, I don’t understand why businesses don’t see how that would benefit them. Yes, it would probably be more in taxes but not having to pay a portion of their employee’s insurance would offset that. In addition, it would be totally out of the company’s sphere. Don’t need to hire someone to deal with that or put that on the plate of one of your existing workers. You don’t have to worry about liability for managing that. In my opinion, everyone would benefit.

    8. The Person from the Resume*

      I agree that healthcare should not be tied to a job, but in America that’s the broken system we’re currently stuck with. So in answering this question for an American audiance, an employer not providing any healthcare because the government SHOULD is out of step with the culture and other employers. And he’s a jerk.

    9. Artemesia*

      This. I’d love to see the French model and businesses would then not have that cost — of course businesses would be paying higher taxes to help finance health care. but with a state model, you can also control cost better. French doctors live very well, but they aren’t multi millionaires and the bloat of insurance executives, pharma execs and profits is not a drag on their health care.

  4. Jen*

    I find it odd they are hiring a business development consultant and “can’t afford” to give PTO.

    1. Book lover*

      This jumped out at me, too. Funny how the human beings performing the work that makes your business successful are “too expensive.”

      1. pope suburban*

        I worked for a dysfunctional small business that underpaid both inside and outside staff. We struggled, naturally, but found buckets of money to hire a consultant who told the boss a bunch of very basic things (I don’t fault the consultant for this; the boss was failing at the basics and absolutely needed to hear them- from someone he considered human, because we sure didn’t count) that he still largely ignored. I could have lived better than I was living at the time for TWO YEARS for what we paid this guy for maybe a month of coming in to try to help us. Some people insist on seeing employees as cattle or some kind of boondoggle, but consider the “right kind” of people to be worth their weight in gold. It’s exactly the kind of attitude that would lead this letter writer to have these discussions about basic benefits and livable pay.

        1. ferrina*

          I’m a consultant, and that kind of boss is the client that makes us cringe. They’re the ones that come to us and say “How do I get my people to stay with the company? I won’t pay them more and I won’t change my management style.” I can’t give you a magic motivational poster that will make people want to stay at a dysfunctional cheap employer.

          1. pope suburban*

            Right? I really liked the consultant and he had a good head on his shoulders. I think for a boss willing to listen, he would have been well worth the money. He did his best to encourage the boss to treat us fairly, and he gave me some recommendations about books to read to brush up my business-management skills, because he could see that I was receptive and wanting to grow in the role; I think he hoped that this could be an object lesson to the boss on investing in employees. Sadly, there’s no fixing someone’s prejudices if they’re committed to keeping them, so it all came to naught. But I did learn that very real benefits of hiring someone to come in and shine a light on your current practices. I’ve heard horror stories about bad or wasteful consultants, but there are a lot out there like you, this letter writer, and the person we hired too.

        2. A Poster Has No Name*

          I’m sure it also has to do with the boss wanting someone to tell him something different than what employees are telling him. He wanted some easy, quick fix to his problems and was hoping the consultant would give him one.

          1. Bess*

            I feel like this is what a lot of consultants end up having to do–confirming what the management has heard in other areas, but they’re outsiders so it counts?

            1. Anon in Aotearoa*

              Speaking as just such a consultant, you’re absolutely right. Something about coming in wearing an expensive suit (well, in the Before Times) with an expensive laptop and telling the boss the same things her staff are telling her, actually does work. Sometimes. I have a success rate of about 30%, I’d say. I get my invoices paid regardless, but it does hurt when they don’t take my advice.

          2. Dancing Otter*

            What’s the saying? An expert is someone from outside with a suit and a briefcase?
            All too many clients don’t understand their problems and don’t want to hear the solutions.

      2. goddessoftransitory*

        One thing I’ve learned in my years working is that EVERYONE, employers and customers alike, clench at the thought of employees wanting money. They’ll spend seventy bucks on pizza, then pitch a fit about tipping two dollars on pouring-rain Friday night.

        You could certainly argue about the whole tipping culture in America (I sure have) but frankly, it exists. Tipped employees pay taxes on that money, it’s not some clever ruse.

    2. Warrior Princess Xena*

      If this is the sort of consultation I’m thinking of I’m all for it. Way too many of the small business owners I’ve met haven’t thought through things like “do I have an IT guy? Do I know what tax paperwork I need to fill out? What happens when I hire an employee and they suddenly are in the hospital? How do I set up my infrastructure for all the growth I’m expecting?

      But they have to actually listen to the consultant, which as above doesn’t seem to be happening.

    3. Meep*

      As someone who has worked in the start-up world for 6 years (albeit in engineering), I just threw away $100 in defunct business cards. Can confirm, start-ups spend money on a lot of stupid things that they don’t need while neglecting how to keep loyal employees.

    4. Delta Delta*

      I think the flip side of that is that it’s medical professionals who are good at medical stuff but not necessarily good at business stuff. So they engage with an expert in business/benefits, and quickly realize things are different than they thought they’d be.

      1. Wintermute*

        domain competence is a HUGE issue for small businesses.

        You have people who are good cooks, installers, doctors, whatever and they think that will make them a wildly successful restaurateur, contractor, medical practice, etc.

        In reality knowing the work is important, especially when you’re so small that you aren’t paying employees to do all the work while you focus on coordinating and marketing yourself, but it’s far from the most important.

        It’s a subset of the same problem that exists with management– where people get promoted because they’re a great network engineer or a fantastic machine operator, ignoring the fact that as a manager or a foreman you’re working with PEOPLE more than you’re working with routers or CNC machines. As a result you get managers who micromanage (because the work they’re good at) but handle personnel issues, hiring, accountability and the other “human side” things of the work very poorly.

      2. goddessoftransitory*

        Same thing in the restaurant business. A person can be the world’s greatest chef and not get the fundamentals of running an actual eatery.

    5. Ally McBeal*

      Not odd at all! I worked at Conde Nast for a short while, which was and probably still is notorious for (1) paying and treating its employees like garbage and (2) hiring mind-blowingly expensive consultants every 4-5 years to overhaul company structure, which resulted in serious layoffs. No one in management seemed to make the very obvious connection between constant restructuring and constant money woes.

    6. Miette*

      Seriously. That said, if the business has investors, they may be the ones mandating it; a colleague of mine does similar work for early stage tech startups.

    7. Grammar Penguin*

      And that they’ll pay so much for professional advice and then push back on it so hard.
      My advice to LW would be to keep doing what they’re doing as far as they can. Tell them in no uncertain terms what they need to offer if they expect to attract and keep the employees they need.
      If they insist on doing it their way, warn them of the likely consequences. Then let them do what they want, it’s their call. You’ve done all you can and all you’re obliged to do: offer your professional advice.
      When they find they can’t actually hire anyone or their hiring pool is terrible, that’s not your problem. Advise them again what they’re doing wrong.
      If they don’t know enough to listen to a professional opinion that they’ve paid for, their business is not long for this world anyway.

      1. Reluctant Mezzo*

        In the education biz, there’s a Brand! New! Trend! in education about every two years. If you’ve been a teacher for over a decade, you recognize the new one as the same one that came around when you first started. They all have different workbooks and different virtual stuff, but at their heart, there are maybe six different trends that get recycled over time. But school districts spend money on them rather than say, getting teachers new equipment or new textbooks that recognize the Berlin Wall has fallen down now (real example).

  5. Tracy, Essentially Cheesy*

    Employers SHOULD offer a well rounded benefits package but they are not *required* to do that.

    Personally, I always consider any benefits to be a gift.

      1. Tracy, Essentially Cheesy*

        I’ve worked as a contractor and gotten only hourly pay. Not even covered by workers comp.
        So that experience changes my perspective.

        1. Dust Bunny*

          The people I know who have worked as contractors have gotten paid enough to cover these expenses themselves (well above what regular employees were paid in wages/salary for comparable work), so it evened out. If you’re not going to pay me enough to comfortably afford insurance for myself, you’d better be supplying it.

          1. Sedna*

            Yeah, if my employer isn’t covering healthcare or retirement then they had better be paying a LOT to make up for that.

        2. SW*

          I don’t think that we can ignore that reliance on contractors is a deeply flawed approach to employment that can demoralize staff and can limit the pool of candidates to people with the support and structural advantages to endure the precarity. It definitely should not be seen in any way as a universal good.
          What you get in healthcare with this model is the proliferation of traveling nurses who can demand very high wages and have absolutely no investment in your business, leaving you in a vicious circle of spiraling costs or bankruptcy. You pay for it in the end anyway, one way or another.

        3. Bess*

          I have temped and held hourly non-benefited jobs before, but have benefits now. Benefits you get are still not a gift, they are compensation. It doesn’t mean you should take them for granted, of course, but I don’t think it’s fair or right that so many people have to accept work that doesn’t provide them.

        4. WillowSunstar*

          I agree, I’ve also worked as a temp. You had to be at the temp agency for at minimum a year and at the job usually a minimum of 6 months, sometimes a year, before you even got PTO. I had to buy my own health insurance and it was high deductible because that was all I could afford. I couldn’t take a week-long vacation because it would have been without pay and certainly couldn’t be sick for any length of time.

          Note: This was in the early 2000’s, I’m not sure if it’s changed. But that was the norm at the time for temps.

          1. WillowSunstar*

            Also I should add, back then companies would frequently lay off temps right before the deadline, instead of hiring them as perms, so they wouldn’t have to pay benefits.

        5. Ace in the Hole*

          I’ve worked for minimum wage in the past. That doesn’t make every dollar I earn above minimum a gift.

          Benefits are part of your negotiated compensation, just like wages.

      2. Wintermute*

        I think what Tracy is trying to say is not that they’re a present but that they’re a gratuity– something on top to secure your loyalty and dedication. Just like tipping a bartender, it’s not legally required but it’s a good idea for practical reasons as well as ethical ones.

      3. goddessoftransitory*

        Yep. I don’t work for gifts. I work for recompense. Benefits are part of the latter, not the former.

    1. Fluffy Fish*


      Benefits are part of the compensation package. They are not a gift. They are compensation for doing work for the employer.

      Employer/employee is a business relationship. There are no gifts or favors and its terribly detrimental to have that kind of mindset.

      Paying above minimum wage isn’t required either but I expect you don’t view salary as a gift.

    2. Sedna*

      They are certainly not required to provide a benefits package, any more than I am required to spend my time and energy with an employer who doesn’t value me enough to provide basic benefits. And no, basic medical care is not a “gift”.

    3. Just Another Cog*

      Nah, any employer who cheaps out on benefits makes me think they can’t really afford to be in business in the first place. LW’s analogy re: eating out and tipping is spot on!

    4. Peanut Hamper*

      Hard disagree, and a lot of employers are depending on attitudes like yours to low-ball their employees on all sorts of things.

      This is not a helpful attitude to the working class as a whole.

    5. EA in CA*

      I’m an Administrative consultant and Virtual EA. All I do is contract work. Since I need to cover my own insurances and file taxes for myself, my hourly rate is at least 30-40% higher than my rate would be in a similar full-time role. So many potential clients think I am over charging, but when you break it down, they are usually spending less than they would on maintaining a full time employee.

      Calling benefits a gift undervalues it’s significance to your compensation package.

      1. Sydney Ellen Wade*

        Thank you so much for this perspective! I recently started a Virtual EA business and had sticker shock learning about covering my own insurance and filing taxes. I appreciate your insight.

        1. EA in CA*

          I have a background in HR and Payroll as well, so it contributed to how I looked at my pricing structure. It gave me better insight into what an overall compensation package and financial obligation for the employer looks. It definitely costs a lot more than you think to open your own business.

    6. Tracy, Essentially Cheesy*

      Wow I’m sorry to see how different viewpoints are responded to on here. Enough said!

      1. Fluffy Fish*

        I’m sorry you feel attacked but I hope you can take a step back and realize that thinking of benefits as a gift devalues YOU as an employee. And further only benefits the company and the pockets at the top they line.

        It’s not that you have a different viewpoint. People are trying to explain how that hurts employees. I care that all workers are compensated fairly even ones with different viewpoints.

        I see you have done mostly contract work – your fee should cover all those benefits the employer doesn’t provide. If not, please consider that you deserve to be able to afford healthcare and time off.

    7. Beth*

      They’re definitely not a gift–they’re part of compensation.

      You’re right that employers aren’t *required* to offer a well rounded benefits package. But the salary jump I would need to consider taking a job that didn’t come with health insurance, 401k, and/or a reasonable amount of PTO would be pretty substantial. If OP’s clients are going to skimp on the benefits, and aren’t offering wages way above market rate, they’re going to struggle to find good employees.

      1. Wintermute*

        And there’s a lot of people where it becomes a “not at any price” proposition. If you need medication to live or to live comfortably, they’d have to pay you enough you could pay out of pocket without any worries at all for any and all medication and doctor’s appointments required. I added it up for a dear friend who has a number of chronic conditions (we were looking at what kinds of employment might make sense for her limitations as well as the benefits they offered to see if trying to get off disability and into the workforce would end with her any ahead before she started the process– TLDR of it is LOL no). In her case she’d have to earn about 150k to consider it.

        And then there’s the other problem like you mention, a labor **market** goes both ways. My local Taco Bell now offers 17 dollars an hour, (poor but passable) insurance and PTO. If you aren’t going to match them you’re going to get employees that couldn’t even stay employed at taco bell. I mean no disrespect to the chain, I was a night manager at a Taco Bell and I like them as a business and I enjoy the food– but the requirements of employment there are “show up at the interview wearing nothing less formal than relatively recently washed jeans and a t-shirt without stains or holes, having relatively recently showered, and not smelling *too much* like weed or showing signs of being high on hard drugs” and the requirements for ongoing employment are “show up without being too late, be able to function, don’t be outwardly and blatantly insubordinate, don’t totally blow the time-to-serve targets and get the food pretty much accurate and within brand standards, and at least make a passing attempt at looking productive when the boss is watching.”

        If you’re not going to offer 17 dollars an hour plus insurance and a week of PTO for a full-time employee you are going to get people that COULDN’T EVEN meet those standards. There’s something to be said for positioning yourself for a future career and the fact kitchens are hard, hot work that can get chaotic… but you’re not going to be able to get away with charging too much of a premium (in the form of lower pay) towards people already scraping the bottom of the socioeconomic barrel– they need those benefits to survive and they need to pay for the increasing cost of living somehow.

        1. Sedna*

          Absolutely agreed to your first point, and thank you! I chose and continue to work for my employer in large part because of their excellent medical benefits. I have multiple chronic conditions; trying to cover my medication costs alone would require doubling my current salary.

      2. goddessoftransitory*

        Or they’re going to go the really shady/blatantly illegal route and hire illegal immigrants and minors who were separated from their parents at the border, then “fostered” out to people to get them out of the detention centers and ended up working twelve hour shifts in factories. People who think of benefits as “gifts” tend to think of employees as very replaceable “things.”

    8. Ultra Anon*

      I think benefits are a part of your compensation and also somewhat of a gift. Certainly, no company HAS to offer PTO or health insurance, but most of them know that if they want to recruit and retain good employees, they’re going to have to differentiate themselves from other companies in the field. One company could have rather basic health coverage, but the pay is marginally higher than competitors to cover out of pocket expenses (this might be important to people who are covered through their spouse or don’t really see the doctor a ton and are comfortable with more basic coverage). Someone might prefer better health insurance at the sacrifice of some salary because they’ve got a chronic condition or they’re the sole provider of health insurance. I think companies that don’t offer anything by way of benefits would have trouble competing with other companies for a small pool of talent.

      1. Roland*

        I dunno, companies are also not required to pay above minimum wage. Doesn’t mean that any salary over the local minimum is a “gift”.

        1. Ultra Anon*

          I guess gift is probably a bad way to refer to a “benefit.” The benefit of working at ZYX company is that they have pay that exceeds the minimum wage and a package of health insurance/PTO/Retirement options. Certainly something that is not required by law, but is used as a way to recruit and retain workers.

          1. Grammar Penguin*

            If I buy something and pay more than the manufacturing cost of it, that’s not a gift to the seller. That’s me paying market rate for it.
            If I hire someone for more than the absolute minimum required wage, that’s not a gift. That’s me paying market rate for their work.
            Leave the entire idea of “gift” out of this. We’re talking about compensation for work, which varies wildly due to the market for labor. Nobody’s giving anybody anything. This is an exchange, full stop.

    9. Tulipmania*

      You might as well consider your boss refraining from spitting in your face every day as a “gift”, rather than the basics. Serf-brain only benefits the goons at the top.

    10. Lianna*

      I believe that this type of thinking is the reason why the US is so far behind in worker rights. The fact that healthcare which should be a universal right but is tied to employment and seen as a gift or even a benefit is mind boggling to me. Especially given how a single mishap could potentially bankrupt a person.

      Even having days off or sick leave is a gift? That is something I would never have thought anyone could think of it as.

      The problem is that seeing healthcare and other basic worker necessities as benefits is incorrect because those are not really benefits per se. A benefit or gift would be like bonuses, company parties, additional compensation, stocks, etc.

      Healthcare coverage, paid sick leave/PTO, etc. definitely should not be seen as benefits and the fact that employers are obfuscating language as if their company offers something special is really insidious.

      1. I Have RBF*

        Healthcare coverage, paid sick leave/PTO, etc. definitely should not be seen as benefits…

        True, IMO. They should be considered table stakes, along with a living wage, for anyone who wishes to hire people.

        If their business plan does not support these basic things, then they should not be hiring people, and maybe need to rethink being in business for themselves. When you have employees, you need to handle a lot of stuff and expense that sole proprietorships without employees don’t.

        I say this as the owner of a micro-business that does not bring in enough money to employ anyone, much less pay PTO or health insurance. That’s why I have a day job, and my tiny business is a one person show.

      2. Grammar Penguin*

        We don’t have a working class in America, we have a hundred million temporarily embarrassed millionaires.

  6. Warrior Princess Xena*

    My take on benefits is this: you will lose a lot more employees by nickel and diming them for little things than you will lose in money. If you’re in the US and not offering healthcare, you are going to get people who are about one step up from applying to fast food joints, if that, and the moment they get a better offer they are going to leave. Just automatically double in your head the cost of salary for every employee you hire.

    But also, don’t nickel and dime the benefits you DO offer. If you can only do unpaid sickdays, then don’t require doctor’s notes for every single sniffle and cough. Same with PTO – if you can’t do paid PTO, don’t be stingy about allowing employees to take time off. Don’t make people sign logs to take office supplies. All the little things Allison says “well, they CAN do it, but it’s a jerk thing to do” – don’t do those. Ultimately there’s a lot of little things companies can do to make their employees’ lives a little easier that are not significantly expensive (Avocado Bob, anyone?) and that take them from “stingy jerk” to “small company with limited revenue”.

    1. CL*

      Agree. I turned down a job this week because the healthcare and other benefits didn’t measure up.

    2. Miss Muffet*

      Hell, even some of the fast food jobs offer benefits if you’re Full Time (and some, like Starbucks, I think? offer it even if you’re part time).

      1. Grammar Penguin*

        There’s the answer to LW’s question: What’s the minimum benefits package you can offer?
        Well, what are the local fast food outlets offering? Tell the clients if they want to hire from the McDonald’s hiring pool, that’s what they’ll get if they go the bare minimum.
        Point out that the fast food sector is offering PTO, 401k matching, etc. and they STILL have trouble hiring grill cooks and cashiers. And they’re trying to hire people with college degrees, specific experience, and professional certifications.

    3. ferrina*


      You get what you pay for. Invest in your employees, and you’ll get a stronger workforce. That means paying fairly, offering strong benefits, encouraging them to take reasonable time off to recharge.

      I know it pays off. I worked somewhere that had unlimited PTO, and before our busy season, I strongly encouraged each team member to take a week off to recharge. When busy season started, they were more productive, more motivated, and had more energy for the long hours. I invested in them, and they invested back in the company. (Will there be some employees that don’t do this? Sure. That’s why you also need strong management skills and infrastructure- to recognize strong performers and reward them, and recognize weak performers and take appropriate action)

      1. General von Klinkerhoffen*

        Giving no PTO is self-defeating because people who never take time off are less productive and more likely to get sick.

        Like, staff at 120% of predicted need, give reasonable PTO (2 weeks minimum, plus public holidays) and sick days, and you’ll actually get quality work from your staff.

      2. Weaponized Pumpkin*

        Economists are often wrong, particularly the belief that people (and therefore businesses run by people) are rational.

        In econ terms, one shouldn’t have to argue there is a right or entitlement to benefits — “enlightened self interest” should motivate the business to offer decent benefits. Dollars invested in benefits pays back because it brings in & retains better workers and results in a healthier, more productive workforce. And being good to people is free.

        But people are not rational. Many refuse to see this reality. Instead, “people just don’t want to to work anymore”, a sentiment that has been around for a hundred years.

        1. ArtK*

          Economists use a different definition of “rational” than many of the rest of us. Their definition is something like “selfish and short-sighted.” In their world, the person who pays $50 for 2-year shoes is more rational than the one who pays $100 for 10-year shoes.

      3. I Have RBF*

        I worked somewhere that had unlimited PTO, and before our busy season, I strongly encouraged each team member to take a week off to recharge.

        This is important on several levels. One, it is management modeling and promoting good work/life balance, even allowing for busy times and slack times. Two, it makes sure that the business has well rested and motivated employees during the crunch period.


      4. Grammar Penguin*

        “You get what you pay for.”
        It always amazes me how anyone can understand this truism, accept it and apply it to literally every other purchase they make, and yet never think to apply it to labor.

    4. Gracely*

      Oh my gods, this.

      Every time you nickel and dime your employees, you are chasing your best people away. Because you’re telling them that you don’t think they’re worth even this small thing. And for goodness’ sake, don’t joke about making them do small/nitpicky things or taking small things away from them, because it’s profoundly unfunny.

    5. Chirpy*

      Agreed, my retail job (midsized regional business, not a national chain) has insurance, PTO, paid sick leave, paid maternity leave, and 401k matching for full-time employees. I mean, it’s not great, but if you can’t beat that minimum standard, you’ll be stuck hiring high schoolers.

      1. SimonTheGreyWarden*

        When I worked retail in 2007, full-time employees had PTO and health insurance and a retirement package. It paid just a little over minimum (which at the time was $7.25, I think) but it was enough in our LCOL area to have an apartment, match my retirement contributions, and even travel.

  7. Richard Hershberger*

    This is an old letter, but I am absolutely sure that these people are today complaining that people don’t want to work.

    1. NotAnotherManager!*

      Had this exactly conversation with my in-laws over the holidays. There are all these unfilled jobs in town! People don’t want to work! So, I asked if they were full-time jobs that included benefits, and of course they weren’t – but apparently people should just work multiple part-time jobs and struggle to make ends meet just like they did in the 70s/80s rather than expect to be treated like human beings.

      To me, if your job pays less than the very stingy unemployment benefits offered by our state, the problem is not the workers.

      1. Just Another Cog*

        Haha, yeah. Some former coworkers were aghast that the unemployed weren’t working fast food jobs that paid $15/hr – which, in our area were split shifts of 2 hours each….so, 4 hours a day. Try to work another job around that.

        1. Elsewise*

          My partner is job-hunting right now and the number of places that pay minimum wage, offer no benefits, but require you to be available for any schedule is absurd! With that setup, no one can afford for this to be their only job, but also they can’t have another job. No wonder they’re understaffed!

        2. Weaponized Pumpkin*

          2 divided 2-hour shifts?!
          *cocks head and squints*
          Nope doesn’t work from that angle either

      2. SW*

        There’s also some amount of evidence that employers are lying about how understaffed they are in order to make them look busier. Which of course has huge repercussions because economists are taking those statements as true and suggesting policies based on the idea that there are so many empty positions.

  8. KatEnigma*

    Doctors are notoriously bad business and money managers. There is a whole cottage industry built up with people like LW, to try to help them.

    In a private practice, most of the time they are going to get off weekends and federal holidays, because the doctor(s) are going to want those off anyway.

    I know that my MIL’s private practice offered 2 weeks PTO and at least in her last practice (she’s moved a lot- sometimes ends up as a partner somewhere but she seems to have issues working with others, so she’s opened at least 2 practices just in the 21 years I’ve been married to her son) she discovered that it was more affordable to give her employees money to buy their own health coverage on the exchange than to otherwise fund a health plan for them. So I think that and a competitive wage are the bare minimum. Making them wait a YEAR is too long. 90 days, maybe.

    1. SpaceySteph*

      My dad is a doctor, and he always said they should require business management courses in med school. You can graduate as a darn good doctor but have 0 clue how to run a business.

        1. NotAnotherManager!*

          Oh, my goodness, YES. Excellent at the legal work, at business (including complying with HR laws).

        2. lilsheba*

          Yes and doctors and lawyers are notoriously idiots when it comes to technology. Computers are way over their heads, I speak from tech support experience.

          1. geek5508*

            When I did field IT support, I LOVED having a law office as a client -they totally understand the concept of Billable Time, and the need for data backups.

            Doctor’s offices, not so much

            1. Avery*

              It varies wildly between law offices. My father’s a lawyer, and he’s horrible with technology. I also work for a lawyer, and at the firm I work for, everything’s electronic, including files, billing, etc.

          2. KatEnigma*

            My MIL is luckily married to her tech support. lol Because otherwise, yeah. My FIL managed to use his experience supporting her offices to get a medical college/teaching hospital tech support job he eventually retired from.

      1. Ultra Anon*

        The days of the small private practice are dwindling though. Many practitioners are merging with provider systems, not because they don’t know how to run a business, but because they can’t compete with larger health systems who can take the bite on progressively lower insurance reimbursements. It’s why you see a lot of smaller practices refusing to see Medicare or Medicaid patients. The reimbursement is shockingly low and they may not have enough of a mix of patients with commercial insurances that could make up for the hit in revenue from government payers.

        1. onetimethishappened*

          I was wondering if a Doctor merged with a health system, I assume the health system provides the pay and benefits to its employees. I wonder if all you mention above plus the fact that the doctor’s either don’t want to or can’t offer benefits factors in.

          Many years ago I read the below linked book. She talked about how her husband who was an OBGYN hardly made any money being in a solo practice. After paying his employees, his student loans and malpractice insurance there wasn’t much left. It was really eye opening to me. This may not be the case every time and for every doctor but it certainly was interesting.


          1. Ultra Anon*

            Doctors employed within a system are paid a few different ways. Some make a straight salary, while others may be paid by the amount of services provided (the fee-for-service model) as the basis for their compensation (their pay may be somewhat based on the number of services they perform and bill). The major benefit is that hospital systems provide health insurance and a back end billing department that keeps revenue flowing in (and does the hiring and training) in addition to access to insurance networks who encourage their subscribers to go to specific health care networks. I’m not sure how it works with malpractice insurance, but I would assume it’s provided by the hospital and you’re not paying your own premium.

      2. Anon for this one*

        But most doctors aren’t running a business? I can see it being offered as an option for primary care docs who want to go into private practice rather than being affiliated with a group or hospital, but that’s a tiny minority of doctors. I’ve seen a lot of doctors in the past year (cancer plus some weird side effects that took a while to track down, plus usual yearly checkups), but other than my dermatologist they’re all affiliated with a hospital or larger medical group.

        1. SpaceySteph*

          The number is dropping, but its still nearly half of Drs in the US that operate some form of private practice.

          Many of those medical groups don’t actually run the day-to-day office. My dad is in one of those groups, but his own private practice (him and 2 other doctors) is still responsible for hiring office staff, renting their own office space, etc. The group provides some back-end support (EMR, HIPAA compliance training, contracting rates with insurance companies) but the individual doctors still operate largely as independent practices.

      3. Susan Calvin*

        I apologize in advance for being European and therefore irrelevant to OP, but I agree your dad is onto something, Steph! Where I’m from, you can also get an advanced degree in many trades, which is often required to be allowed to start your own business. This does not only include licensing for advanced technical knowledge, but crucially also half a year each in both business administration and management/coaching skills (to be certified to hire trainees under the hybrid trade school system).

  9. SW*

    Imagine trying to nickel and dime your healthcare employees in this economy. I can easily imagine the OP’s client immediately complaining that no one with the minimum qualifications applied and/or them complaining how stressed and burnt out their employees are because it’s impossible to hire and retain additional coverage. Hiring people at the bare minimum seems like a good way to kick the unsustainable can down the road and also harm a lot of good employees in the meantime. Like there’s so much burnout in the field already and you’re just going to add to it?

    1. Stitch*

      If they’re trying to hire nurses and PAs they’re definitely not going to get them with those benefits. You might be able to find scribes but not good ones. A good scribe is worth their weight in gold.

    2. Brain the Brian*

      Yep, this exactly. It would be one thing to offer bare-minimum benefits in a field that’s experiencing a lot of worker inflow — I still wouldn’t support it personally, but you could make a business case that if you have lots of job applicants, you don’t need to offer them the most comprehensive benefits package to be a competitive offer — but in healthcare right now? Yeesh, that’s just bad business.

    3. MCMonkeyBean*

      I don’t work in the field so maybe it’s more common than I would have guessed, but at a minimum not offering good health benefits to people in healthcare sounds absurd.

      1. Relentlessly Socratic*

        The term “the cobbler’s children have no shoes” applies far too often in healthcare.

      2. Yoyoyo*

        It seems absurd but it is incredibly common. I work in healthcare and my health insurance sucks and the premiums are expensive. I can only see providers in the system in which I work, which is uncomfortable, and even then my deductible is so high that I’m on the hook for just about everything.

        1. Brain the Brian*

          Maybe it’s just me, but the idea of requiring employees of a healthcare system to see only providers in that system — at least, under insurance-covered care — smacks of conflicts of interest, HIPAA / ADA violations (basically forcing employees to backdoor-disclose medical conditions to their employer whether they are job-relevant or not), and unfair business practices.

        2. Pam Beesly*

          100%. I work for one of the highest-ranked hospitals in the country and it’s the worst health insurance I’ve ever had.

      3. ArtK*

        I left a job at a Fortune 10 company in the healthcare field, just last year. The medical benefits were *horrible*. I now work at a small startup and they’re fantastic, plus unlimited PTO. The startup is not in healthcare.

  10. Natalie*

    I’m wondering if this is where the confusion is coming from: “they were classified as contractors and didn’t receive benefits.”

    Contractors don’t always receive benefits, but often their compensation is higher to make up for that.

    1. Warrior Princess Xena*

      Yeah, general rule for freelance/contractor work is to charge 2-3 times 0f the equivalent full employee salary to make up for all of those benefits you’re not getting.

      1. Weaponized Pumpkin*

        Yes. Having been contractor who paid for my own health insurance and PTO for a long time, I am not overly fixated on benefits in a salaried position — I know I can cover that — but you have to pay me a LOT if you’re not going to give them to me.

    2. Lifelong student*

      And generally under the rules on employee v contractor- they are being misclassified.

  11. Fluffy Fish*

    I expect this is also related to founders expecting employees to care as much about their business/vision/concept and thus act accordingly. The whole I give my blood sweat and tears for this business therefore everyone who works for me should too.

    Also closely related to “we’re a family”.

    It is absolutely a bad business model and a sign of what will be a toxic hellhole.

  12. New Yorker*

    This may not be directly on point, but I am SMH at doctors who all live in the best part of town, send their kids to great schools, etc. but pay their staff as little as possible. Maybe if they paid more, they would not have so much turnover, and their work life and response to patients would be better.

    1. SW*

      I really wish becoming a doctor wasn’t such a hazing process that makes those that survived it feel so much more superior to those who did not or chose not to. Like no, it’s really not helpful to say to your patients, “Well I came into work 3 days after gall bladder surgery!”(true story) No, that’s very, very abnormal but it’s been normalized and that’s very not-good for everyone.

      1. I Have RBF*


        True story: I had appendicitis on a Thursday. My sole coworker’s last day was the next Tuesday. I was admitted for surgery late Thursday evening, spend three days in the hospital, and showed up at work on Monday and Tuesday to get the last bit of knowledge transfer. I then took the rest of the week off, with management blessing. I had PTO and health insurance, because even though it was a startup they weren’t stupid.

    2. Spearmint*

      Yeah, it seems like it’s really common for doctors to devalue and downplay the contributions of non-MD staff (#notalldoctors, of course), at least in my limited experience interacting with doctors in social settings. I found it depressing, especially because they were otherwise very kind people.

      1. Fluffy Fish*

        Sounds ripe for some union action followed by strikes.

        Nothing shows the value of people like them collectively not working in protest of their employers crap.

      2. Grammar Penguin*

        “…otherwise very kind people.”
        Remember the adage, “someone who’s nice to you but rude to the waiter is not nice.” It applies here. Someone who’s kind to people in social settings but unkind to the people they employ is not a kind person.

  13. JMR*

    I work in a related field (biotech), and it’s understood that working for a start-up can be exciting, but that it’s inherently risky. Generally the sign-on packages for start-ups include a generous grant of stock options to make up for the lower salary and lack of job security. If the company succeeds and the options become valuable, the employee can do quite well for themselves in the long run, but there’s a significant risk that the company will never make it to IPO, and it can take a long time, like literally 10 years or more, between when a start-up is founded and when the stock is worth anything. So there’s already risk built into working for a start-up. If a start-up tried to make it even shitter for employees to take that risk, by not even offering them basic benefits like PTO and health insurance, I guarantee that nobody who had any options would choose to work for a start-up over a more established company.

  14. SpaceySteph*

    For starters a Dr’s office of all places should recognize the need for paid sick time. Even if you don’t want to give full PTO benefits, people need the ability to call out sick. My whole family caught covid one month into my new job last year… you don’t get to choose when you get sick.

    1. rayray*

      This brings up a great point. Too many places don’t give PTO right away, or it accrues very slowly. It’s not as if anyone would choose to get infected with Norovirus or Covid in the first month or two, but if it happens, people really need to stay home. If they don’t have a sick day, they may be worried about getting fired and they’ll come in sick and then the whole office gets wiped out.

      1. I Have RBF*

        I lost three weeks pay in the first three months of a contract job because all the other contractors came in sick and they gave me pneumonia. I also had to pay for treatment out of pocket. Thank ghu I didn’t have to be admitted to the hospital.

        Lack of sick pay for contractors sucks and delay on sick pay for regular employees also sucks, for the same reason: People without sick pay come to work sick and infect everyone else.

  15. Arglebargle FNP*

    As a healthcare provider who currently works in a community practice and who has trained in private-practice clinics, these healthcare startups are shooting themselves in the foot by creating conditions that only attract people who have nowhere else to work. Our organization notoriously underpay our front desk staff and therefore can’t attract people with the smarts and experience to think critically and/or understand the needs of the providers and patients, and who neglect basic customer service skills. We have extremely high turnover of our LPN and medical assistant staff because the workers who work hard, understand our patient population, and who are team players get attracted elsewhere because of higher pay and better working hours. All of this causes providers to burn out sooner because they have to handle a high patient load as well as deal with the administrative and/or low level medical triage stuff that these ancillary staff fail to provide, as well as dealing with constant interruptions and questions because the ancillary staff isn’t knowledgeable or empowered enough to take care of issues themselves OR dealing with errors etc that are caused by lesser trained staff (or staff that simply don’t care to do things correctly because it takes a little more effort and thought). Spending money on staff by paying a good, competitive wage and offering decent benefits will attract and RETAIN good staff which will make the general day at a healthcare office MUCH easier, which will meant the providers are happier, which means that they will have more patients who are happier, and who want to come back. This has been proven time and time again: staff turnover in healthcare is inefficient and VERY expensive–however most of the organizations I have worked for prefer to hire expensive consultants (who tell them the same thing over and over) and never really make significant change. It’s extremely frustrating.

    1. SW*

      Agreed. You pay for your staff one way or another, and one of those payments is hiring a bankruptcy lawyer.

  16. Madame X*

    Are these people looking to hire human beings or robots? I don’t understand the mindset of being so tight fisted with the most basic benefits that you would not offer any time off, medical leave, or health insurance.

  17. introverted af*

    My parents own and operate a farm and have a hard time keeping employees. I try not to get too much in their business, but I feel like this is an area they really shoot themselves in the foot. Why work in an extremely rural environment doing manual labor for long days for shit benefits (especially PTO) and ok pay when you could work somewhere for the same amount of pay, less hours and include some benefits?

    1. SW*

      The history of agricultural work is the history of the difficulty of retaining workers when there exists nearly any other, better option. And alongside it is the history of resorting to extreme measures to keep people from leaving, from reliance on undocumented workers to serfdom and slavery. It’s a difficult job and I’m sorry your parents don’t see what a large ask they’re making of people to work for them.

      1. Lucky Meas*

        Yeah historically agriculture has resorted to undocumented workers, serfs, slaves, and the farmer’s own kids (who give up schooling to work). Sadly no one has ever considered using carrots instead of sticks.

        1. SW*

          I do understand why. The margins are just so small and there’s so much work to do that it’s very difficult to encourage people who have options to do the work.
          A lot of my queer friends have stars in their eyes about being farmers and I just don’t understand. My grandparents worked so hard to get off the farm; who am I to go back to it? My great-grandmother worked from the moment she woke up until the moment she went to bed.

      2. goddessoftransitory*

        In the book “The Good Old Days–They Were Terrible!” the author debunks tons of “things useta be great way back when, I tells ya” myths, and tons of them were on rural life and farming–which in those times was even more drudging, endless, and backbreaking. One quote I really remember was a young woman working as a seamstress saying that she’d never go back even if they GAVE her a farm–“I had rather starve to death in the town.”

  18. Language Lover*

    This is good advice. Turnover will be an issue without benefits which is expensive and they’ll be without the critical support staff while trying to find someone new.

    Plus, a lot of places probably feel that this is something they can’t afford while launching their own practice but will get to eventually. It’s better to bake this in right away because it will always look expensive and a deduction from overall profits/their own take home that the will to put them in will rarely get higher.

  19. Sunshine*

    My first job out of college was working for a company that gave me 18 vacation days and 12 sick days every year. The owners were Australian and encouraged us to take all of it – I basically worked four-day weeks all summer. I had NO idea how good I had it! My previous job gave us 10 PTO days per year and that was it.

  20. Inkognyto*

    as someone working in a IT in Healthcare, this group is most likely Physicians or similar roles.

    Forming their own business. Even in Healthcare they have their own payscale and methods for bonuses, and could be contract. This means their payscale is already beyond the people they will hire, and they could pay for all of this on their own.

    As part of consulting, charge 30 minutes extra, Take 15 to look for similar roles they tell you they will be hiring. Show them what their competition is offering. If they don’t match it tell them like Alison said, that they will scrape the bottom of the barrel and get all of the ones that won’t stick around.

    My healthcare org offers BONUSES for many roles. So we can attract talent. I could refer many nurse and supporting roles and get $1500-5k or more. They will get similar if they stick around for a year.

  21. Middle Aged Lady*

    Think of what is needed to not be so worried or stressed all the time that they can contribute to the job, and so you can honestly say you are a good employer. If you don’t have the capital to offer dignified employment, you need to go to work for someone else and not start a business.
    The OP may not be able to say that to their clients, but it is nonetheless true. All employees should have paid time off, sick days, holidays and insurance or assistance towards buying it on the exchange, and be paid a living wage. The minimum I ever got was 15 vacation, 12 sick, and 8 holidays. (Non-profit) The max was 24 vacation, 12 sick, and 8 holidays. (University faculty) Also, sick and vacation should be allowed to roll over. No one wants a job where they have to work for a solid year to get any bennies. That’s horrid.

  22. There You Are*

    I co-own a residential and storefront window cleaning business that only has $300K in revenue (not profit, but gross receipts). We have three full-time, hourly employees. We give them 5 paid days off, are super flexible with scheduling around personal needs (doctor’s appointments, things at their kids’ schools, etc.), and we offer a 401k. We can’t afford to match, but we can for sure encourage saving for retirement. We also pay retention bonuses based on profitability.

    We can’t afford health insurance, for us or for our employees, but I sit down with anyone who needs help navigating the ACA insurance plans when it’s time for enrollment.

    1. I Have RBF*

      We can’t afford health insurance, for us or for our employees, but I sit down with anyone who needs help navigating the ACA insurance plans when it’s time for enrollment.

      This is a good thing about the ACA in that it enables entrepreneurs. The bad thing is that, unless you qualify for a subsidy, it’s very expensive.

      IMO, if we had single payer (government provided health coverage) even more people could afford to go into business for themselves.

  23. Dulcinea47*

    You’ll get what you pay for. If they don’t give pto, holidays, or benefits, the only people who will work for there are the desperate ones, who may or may not be good at their job. You need to be a decent place to work if you want to retain decent workers. Most people realize small businesses will have limited benefits but “nothing” and “limited” are different.

    1. goddessoftransitory*

      The trouble is, far too many employers see desperation as an asset–as in “they’re desperate so they’ll never leave no matter what we do!”

      1. Grammar Penguin*

        And that’s how they end up with people who suck at their jobs, make costly mistakes, miss crucial deadlines, piss off the customers, and create new legal liabilities every time they open their mouths.

  24. Michelle Smith*

    “I look at it like some people look at eating out: if you can’t afford to tip, you can’t afford to eat out … and if you can’t afford any PTO, you can’t afford to hire.”

    Brilliant framing of this issue. It’s also critical to remember the DEI implications of this. If you don’t offer health insurance or time off, you’re automatically going to exclude a lot of parents, people with disabilities, etc. who may absolutely need those benefits for their basic survival.

    1. Peanut Hamper*

      Yes, this is a great point, as well. Most people would love to have these benefits, but some people find them completely necessary.

    2. Grammar Penguin*

      And I’m willing to bet that all of OP’s clients are also crappy tippers and huge complainers.

  25. CommanderBanana*

    Hah, I was just about to say that if you can’t afford to tip, you can’t afford to eat out (in America, where we do not pay servers a decent wage) and the same thing applies here.

    Enjoy not having any employees, I guess?

    1. Not Tom, Just Petty*

      I love his idea that as a contractor, he didn’t need benefits. OK, then pay your employees contractor rates. I’ll pay my own insurance if you offer me double and a half of the salary you are offering.

      1. DocVonMitte*

        Startups (not sure about healthcare startups, my background was tech before I went to health insurance) are notorious for using “contractors” but still paying just above min wage with zero benefits.

        After taxes, those employees are making less than they’d make working retail (and many retail places give full-timers benefits now). Most take these jobs with the hope that they’ll quickly move up as the company expands. When that (often) doesn’t happen they leave for greener pastures.

  26. Parenthesis Guy*

    It depends on the business. I can understand not wanting to give paid holidays if you’re open on those days. I can understand not giving PTO or not offering health insurance if you have only a few staff members.

    But in those cases, you need to make it up to the employee by offering higher pay. For example, offering your employees a $10k check instead of offering your own health insurance plan makes sense. Or offering your employees $25 an hour instead of $20 an hour because you don’t give much PTO. Or giving your employees $15 an hour and 10% of yearly profits.

    There are many possible things you can do to get around offering poor benefits while still attracting good employees. If you’re paying $20k above market then offering worse benefits is fine.

  27. Marzipan Shepherdess*

    The point that this is a medical facility adds another twist to Alison’s point that providing no benefits at all will mean that they’ll wind up with a staff who can’t get any other jobs…because no one else will want to work for them. In addition to having a rock-bottom staff, they’ll have a thoroughly demoralized one as they start to overhear snippits of doctors’ chats with each other. Nothing tanks morale faster than having a bare-bones job and listening to OTHER staff members casually refer to their upcoming family vacation in France, their next ski trip, the Lexus that will be their kid’s graduation present, how they’re going to surprise their spouse with a BMW for their anniversary – you get the picture!

    Alison is right: if you can’t afford to give people decent benefits, you can’t afford to hire them in the first place.

    1. Grammar Penguin*

      Yes to the quality of staff they’ll end up with. I remember places I’ve worked where one or two bad employees (lazy/unreliable/toxic/dishonest) seriously hampered everyone else’s work and cost their employers a lot before being let go.
      Now I’m trying to imagine managing a business staffed entirely with such people, where literally everyone working for me is lazy, unreliable, toxic, dishonest, or all of the above, and I’m getting physically ill. No way does such a business survive, let alone succeed, no matter how much they think they’re saving on labor costs.

  28. It is what it is*

    You get what you pay for. The employees you do get will move on as soon as they are able and you will be in a constant state of hiring + training = leaving.

    Expecting employees to wait a year before any time off is ridiculous. In the US perhaps 90 days before paid time off but certainly not one year.

    1. CSRoadWarrior*

      The most I had to wait for benefits to kick in (including using vacation time) was 60 days.

      60 days is reasonable. But a year? No way. That is way too long.

  29. Spicy Tuna*

    I worked a desk job in the HQ of a major airline. No PTO your first year. You could take in year two what you had accrued in the prior year. So, for example, if you started working there in say, April 2019, in 2020, you could have whatever PTO you had accrued in 2019. It was total BS. The turnover was insane

  30. DJ Abbott*

    I guarantee anyone who takes a job like that is planning to stay only until they find a better job.
    Today I heard an ad at the grocery store chainI worked for in 2021 saying, “We’re hiring! Come work for a good salary, PTO, and career potential!”
    When I was there two years ago, everyone was paid minimum wage. PTO was only for the few who were allowed to work full-time. Advancement that came with an increase in salary and benefits was competitive and hard to get, though they were happy to let people take on more responsibility with no additional compensation.

    1. Grammar Penguin*

      Yes, retail and fast food love to advertise the benefits available to FTE but never mention that 80% of their employees part time and that’s not changing.

  31. Goody*

    FWIW, the county I live in passed a law sometime prior to April 2020 that ALL workers are entitled to earn paid time off, at the rate of 1 hour PTO per 40 work hours, regardless of employment status. There is some sort of loophole for towns that have home rule status, I don’t know the details on that.

  32. onetimethishappened*

    I just can’t imagine not being able to have any time off in a year. People need breaks, and time off to go to the doctor, or do other things that are not open on Saturday and Sundays. If you have kids or family to care for you are really SOL.

    I interviewed for a job that said you could not call off or be late even once in the 1st day 90 days (pre covid). I had 3 really small kids at the time, it was in the dead of winter. I can’t guarantee that my kids won’t get sick or bring home some atrocious illness. I get really sick at least once if not twice per winter. I turned down the interview process.

    1. onetimethishappened*

      In addition to the above. I mentioned this interview was in the winter. This was before WFH and my region gets slammed with a couple of snow storms. People in this area and pretty understanding of weather related delays. I was worried that I would be fired for being late due to weather.

      1. Donkey Hotey*

        At my previous job (before COVID), if the business shut down for a snow storm, the hourly people could either use PTO to get paid or else go unpaid. The salaried people got paid, no matter what.

    2. boof*

      I think it’s gotta be no paid time off, not no time off ever? Because the latter indeed really doesn’t make any sense.

      1. DJ Abbott*

        Yes, but many people can’t afford to take unpaid time off. So either way they’re screwed.

        1. boof*

          I get that there’s a big psychologic difference, but I’m not entirely sure there’s an actual financial difference between “you get $X per year and 4 weeks paid time off” and “you get $Y per year and no unpaid time off” (if Y => (X/11)*12 )
          (what I’m getting at is it really depends if the wage is equivalently more than the place that has paid time off; but in reality we usually don’t have access to these numbers most of the time except maybe if getting multiple job offers at once)

  33. CSRoadWarrior*

    No benefits? No thanks! At the end of the day, those companies will only attract employees who cannot find a job elsewhere, and risk them jumping ship much sooner than expected for another employer willing to offer benefits. In other words, an unusually high rate of turnover.

    Also, I cannot imagine not having any paid vacation, health insurance, or even a 401K when at a job. These are just three such examples. It is a deal-breaker for me, as well as many others.

  34. Bird Lady*

    I feel like there is probably a legal answer in this regarding federal, state, and county labor laws and there is a human answer. The human answer is that people need time off. Full stop. I can’t imagine missing my grandmother’s funeral or going to work ill.

    Also, are the costs that prohibitive to offer at least a non-matching 401K? I know at an org I worked for the cost was about $4/ month.

  35. I'm Just Here For The Cats!*

    Am I wrong that I thought part of the ACA was the requirement that employers must provide/offer health insurance to full-time employees? The way Alison answers this it sounds like it’s not required. Or did this change?

    The reason why I thought it was required was that people were penalized after ACA went into effect because they didn’t have health insurance. My mom had to pay on her taxes in 2014 because she didn’t have insurance because her work said she never filed, even though she did. I helped her through their portal. We went to the local coffee shop because we didn’t have internet and she didn’t qualify for anything through the ACA website.

    1. Mac (I Wish All The Floors Were Lava)*

      I’m not an expert but I think maybe it’s one of those things that doesn’t apply to businesses under a certain size?

    2. Rocky Mountain (not) High*

      I’m real rusty on that, but I believe the requirement to provide health coverage is only for those employers with 50 or more full-time or full-time-equivalent employees. There is a formula to determine if the business meets the 50 FTE threshold, and it always made my head spin.

      From what I understand about the tax penalties, the penalty applied if you had the option of employer coverage but declined to enroll. Or if you didn’t have employer coverage, you were expected to enroll in a plan through the Healthcare.gov or state marketplace. Wading into waters I barely grasp, I believe this requirement was to incentivize younger & healthier people who may otherwise choose to gamble on not having coverage, which due to insurance math would keep the cost of coverage for everyone down.

  36. Book lover*

    To answer the OP’s actual question, here’s the absolute minimum I expect in my field (corporate operations) and at this stage of my career (20 years experience):

    — 10 Federal holidays
    — 25 days PTO
    — Decent health insurance, with the company covering a significant part of the premiums
    — 401k + at least 3% match

    Not dealbreakers, but expected
    — STD + LTD
    — Vision and dental
    — Paid parenting leave (at least three months)

    Stuff I do not care about and would never factor into a decision:
    — free lunches
    — gym memberships
    — transportation and parking stipends (but I get why this is important to others)

    It’s not “entitled” to demand a package like that and not a “gift.” It’s part of my compensation and what the market I operate in will bear. And, of course, I also believe that benefits like that should be far more standard and not limited to people in my position.

    I wish more employers would push back against the race to the bottom.

  37. boof*

    I mean, I get it; it’s a little weird that our job (in the USA at least) is so tied up with retirement, health insurance, etc. In theory work in = money out and why is it so much more complicated then that? Supposedly it started with one of the world wars when wages were frozen, so employers tried to come up with a bunch of other compensation instead.
    But that is the world we live in. If someone’s not going to offer health insurance etc, better be prepared to pay however much more it would take for the employee to buy it out of pocket. Same with tips; the servers are making well below min wage because tips are expected (in the USA) so better pay for the service you’re getting; and if you don’t like the system get the laws changed THEN maybe don’t have to tip routinely, just don’t not tip and basically steal from people.

  38. Rocky Mountain (not) High*

    I agree with everyone saying that if you can’t afford to properly & fully compensate employees, then you can’t afford to have employees. Full compensation includes basic benefits like paid time off and at least some kind of gesture towards healthcare coverage. And appropriately classifying nonexempt employees who should be receiving overtime! In addition, this attitude of “well I got a raw deal so everyone should” is at the root of so many problems in the U.S. It’s deeply selfish, short-sighted, and just flat out MEAN.

    Side story:
    I spent some time as an HR Consultant to small businesses, and a large portion of my client base was doctors’ offices. They were some of the absolute worst human beings I have ever come across. They offered next to no benefits, paid as little as possible, treated their staff like horseshit, and were just generally awful at every opportunity. I had one that, no joke, tried to fire an employee while she was on maternity leave because her baby was born with health issues. Their argument was 1) she took too much time off for maternity leave (job-protected by the state) and 2) because her baby had health issues and she was a single mother, she was probably going to be taking off all the time take care of them (zero evidence that this was the case). The layer cake of HELL NO that I plopped on them was immense, and in retaliation the client was a dick to me the rest of the time I worked with them.

    I hated that job, and mostly because of the clients (all of them, not just medical). I’ve been suspicious of small businesses ever since. I spent the majority of my time trying to talk greedy assholes into not shitting on their employees just because it wasn’t technically illegal (that bar is on the floor, y’all). And most of the time I was unsuccessful. It was some of the most disheartening work I’ve ever done.

    1. Middle Aged Lady*

      In my limited experience there are people who go into business for themselves because they don’t work well with others, and believe they are ‘the heart and soul of this country’ when they are, in fact, petty tyrants.
      Thanks for the corroboration!

  39. It’sAlwaysSunny83*

    As someone who is UK based the conditions in the US constantly blow my mind.
    I work in Healthcare, when I worked in the public sector I got 30 days holiday plus 8
    Public holidays. Full sick pay for 6 months and then half for 3 months. I also had a matched pension. Plus other benefits.
    I now work in the private sector, I get slightly less holiday and sick but I get double the pay plus yearly bonus at 5%.
    I do know we have offices in other countries including the US and they’re on different contracts and they see what they can get away with!

    1. Middle Aged Lady*

      In the 50s we decided healthcare and childcare were ‘communist’ and we have lived with that BS ever since.
      This is a harsh country. It didn’t used to always be so.

  40. Owlet101*

    I worked for a company like this one in 2019 (desperate times call for desperate measures.)

    You would not get paid holidays until you worked there for 3 months. No health insurance. No 401(k) or vacation (1 week) until you worked there a year. Sick days were discouraged (I don’t think they were paid until you made it your year anyways.) If a holiday fell on a weekend you did not get the Friday or Monday off. Also, you could not take the day before or after the holiday off and still get paid for the holiday.

    I was there for 4.5 months. Including me at least 8 people left in that time. One of which was a single mother of 5 who did not have anything else lined up. My boss came in after Christmas with a cold. Which I in turn brought home to my fiancé.

    Your clients say that they cannot afford to give good benefits, or any benefits. If that’s the case you could argue that they can’t afford not to. Because without good benefits they will be in a constant state of high turnover. Sinking money into recruiting, hiring, and training. Money that could be used in other ways.

  41. Donkey Hotey*

    When I started my previous job, the one glass door review of the place mentioned that they were stuck in the 70s. When I interviewed, I figured they meant the cork wall boarding. But then I saw their benefits. Privately held, generational shop (meaning the CEO was the sin of the guy who started the business). Zero paid holidays and zero sick time for the first six months. (I started in November, so no pay for Thanksgiving, Black Friday, Christmas Eve, and Christmas Day. New Years Day was not considered a holiday at all.) Two week’s vacation available after twelve months. No company match on the 401K. Suffice to say, I took the job.
    They would insist that they offered few benefits because the new hires would take advantage of sick time… and then work people 50 hours a week in a building so cold they gave everyone heavy sweatshirts rather than turn up the heat. And then they would complain that they couldn’t find anyone to work for them.
    When I left, after five years, my new job (at a publicly held shop) came with a 50% pay raise, three weeks PTO at day one, plus the entire building shut down for the week between Christmas and New Years. I’m grateful my time helped me move up, but I wouldn’t wish that first year on anyone.

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