Unhealthy focus on health care jobs

Think of it as the shot heard round the health care world. A perspective piece on health care spending and jobs in last week’s New England Journal of Medicine seemed designed to incite some revolutionary thinking on the ways that a robust health care sector might not be quite the right prescription for the economy as a whole. The argument is particularly charged since its two authors are based in Massachusetts, the epicenter of what might be called the medical-industrial complex.

The piece by Katherine Baicker of the Harvard School of Public Health and Amitabh Chandra, an economist at Harvard’s Kennedy School, argues that although health care employment has been one of the few bright spots in the job-shedding recession, on balance the healthy job growth in health care is more troubling than encouraging.

Unless it has been accompanied by huge leaps in health outcomes (and there’s very good reason to think it has not), soaring health care spending comes at the expense of other important public and private priorities, they say, such as education, infrastructure, and retirement savings for individuals. “Salaries for health care jobs are not manufactured out of thin air — they are produced by someone paying higher taxes, a patient paying more for health care, or an employee taking home lower wages because higher health insurance premiums are deducted from his or her paycheck,” Baicker and Chandra write. “The bottom line is that employment in the health care sector should be neither a policy nor a metric of success/”

Those are almost fighting words in Massachusetts, however, where something on the order of 1 in every 8 jobs is in the health care sector. The New England Journal piece is titled “The Health Care Jobs Fallacy.”  A piece last week by WBUR’s CommonHealth blogger Carey Goldberg puts the proper Bay State cast on the issue by renaming it “The Golden Goose Fallacy.”

The health care sector in Massachusetts is viewed as such a crucial part of the state’s economy that talk of big efforts to rein in spending are always met with warnings that any overreach could do serious damage to one of the chief engines of the state’s economy.

That makes this discussion in Massachusetts “a political question as well as an economic one,” WBUR’s Sacha Pfeiffer said last week in an interview with Baicker.  “How do you navigate the politics of this?” she asked Baicker

“I try not to,” Baicker said. “That’s why I’m an economist.”

Pressed further, she could only offer her economist’s rational argument, and hope that reason ultimately prevails.  “Saying that we want to devote our health care resources to propping up jobs in a sector that isn’t producing as much health as it could is a really inefficient way to promote job growth and a really inefficient way to provide health care.”

                                                                                                                                                            –MICHAEL JONAS


Middleboro’s showdown with public profanity graduates to the Wall Street Journal’s A-Hed column.


Taunton voters approved a proposed casino by an almost 2-1 margin over the weekend. (Here’s WBUR’s report.) Meanwhile, Middleboro officials are looking to clarify the status of some 500 acres controlled by the Mashpee Wampanoag where the tribe had earlier planned a casino. Banker & Tradesman columnist Scott Van Voorhis writes an obit for the high-stakes casino competition in the state’s eastern half.


NPR’s Nina Totenberg analyzes the crucial clause in the US Constitution that the Supreme Court’s health care decision will hinge on.

Former House Speaker Tom Finneran, who left WRKO last week, waxed political with Keller@Large about the Wisconsin recall and the Brown-Warren race.

Leaders of the Boy Scouts of America dismissed reports that the organization would lighten its restrictions on admitting gays.


Mitt Romney: master of the super PAC, reports the Sunday Globe. Meanwhile, the Republican Party worries that Romney lacks the vision thing. The Atlantic wonders whether anyone on this planet is boring enough to be Romney’s VP pick.

Former Boston TV reporter Gail Huff will be back on the air here soon — this time in two advertising spots for her husband, Sen. Scott Brown. The debate over whether Brown or Elizabeth Warren won’t debate rages on.

The New York Times talks up the Obama campaign’s struggles with Hispanics.

A prominent Nevada developer and lobbyist goes on trial for making illegal campaign contributions to Sen. Harry Reid.


Nashville vies for hip tech workers and some of them are from Boston, the Tennessean reports.

The European debt crisis is rippling its way through the Massachusetts economy, the Globe reports.

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The state will begin a controlled burn at the Freetown-Fall River State Forest to reduce the risk of larger fires at the popular recreation park because of the dry winter and large caterpillar populations defoliating trees.

US Reps. Edward Markey and William Keating sent a letter to the Nuclear Regulatory Commission questioning Pilgrim power plant’s emergency response ability because of staffing levels in the wake of the current lockout.


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Howie Winter doesn’t get arrested for extortion at the age of 83 and escape without Howie Carr firing off a column mocking him.


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The Beat the Press panel takes a look at the usual suspects, those easily and readily quotable sources whose names frequently pop up in stories.

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