We study how public school teachers use paid sick leave. Most US sick leave schemes operate as individualized credit accounts: Paid leave is earned, and unused leave accumulates. We construct a unique dataset of daily leave balances and behavior among 982 teachers for 2010–2018. Sick leave use increases during flu season, and evidence indicates that the average teacher does not use sick leave for leisure, though some subsets of teachers (e.g., the young and inexperienced) do. Usage increases with leave balance; the elasticity is around 0.4. Further, teachers with higher balances are less likely to work sick, particularly during flu season.

German long-term health insurance (GLTHI) represents the largest market for private long-term health insurance contracts in the world. We show that GLTHI’s contract design coincides with the optimal dynamic contract for individuals with constant lifetime income profiles. After estimating the key ingredients of a life-cycle model, we find that, under a variety of assumptions, GLTHI achieves welfare that is at most 4% lower than for the optimal contract. Relative to the gains of replacing short-term contracts with either of the two long-term contracts, this welfare gap is smallest when reclassification risk is high.