I actually do have separate sick leave, but plenty of times at other jobs have had combined PTO, which basically means I’m burning my potential vacation by being sick.
Other times, I’ve not even had sick leave at all, got fired once for taking one day off with explosive diarrhea because I couldn’t afford to see a doctor to get a note on minimum wage.
Some companies are better. Some states have actually somewhat decent protections. Lots of others are complete garbage.
So yeah… A lot of us are jealous of what Europeans have, but not enough so to organize and demand better of our employers and our government