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.”
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.”
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