How Health Care Remade the U.S. Economy

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[–><!–>The change has been particularly visible over the past year, during which health care has been responsible for about a third of all employment growth, while other categories, like retail and manufacturing, have stayed essentially flat.–><!–>

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[–><!–>The nation’s corps of nurses, oncologists, lab technicians, anesthesiologists and other health-related workers has been growing steadily, through recession after recession, going from 9 percent of the total workforce in 2000 to 13 percent today. The government expects that trend to continue, as the nation ages and requires more care.–><!–>

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[–><!–>That blistering growth could cool, however, if Republicans in Congress succeed in passing their flagship tax and spending bill. The Senate version is estimated to cut Medicaid, which accounts for about a sixth of total health care spending, by about a trillion dollars over the next decade. About $82 billion would come out of other health care funding, including Medicare and subsidies under the Affordable Care Act.–><!–>

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[–><!–>As much as politicians may focus on factory jobs, long idealized as the kind of work that could support a comfortable life for people without advanced degrees, health care is now playing that role for more people.–><!–>

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[–><!–>“It’s not like the economy just accepts, ‘Oh, I guess we won’t have enough doctors,’” says Joshua Gottlieb, an economist at the University of Chicago who recently co-wrote a paper on the subject. “New jobs are created.”–><!–>

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[–><!–>Second, people with access to health care have been using more of it. Chronic conditions like kidney disease and cancer have become increasingly prevalent, while America is also getting older, necessitating more care.–><!–>

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[–><!–>And the heavy weighting of the workforce toward health care isn’t unique. As countries get richer and older, more of their employment base shifts into medical fields. Although the United States tends to spend more on health care as a share of its GDP, nine countries in the Organization for Economic Cooperation and Development, including most of northern Europe and Japan, have higher shares of their working population in health care than the United States.–><!–>

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[–><!–>Hiring of health care professionals has been particularly swift over the last few years because the pandemic left a lot of catching up to do. Providers left the bedside en masse, exhausted by the relentless hours and dangerous conditions. Health care employment has still not caught up with its prepandemic trend, and job openings remain elevated over other industries.–><!–>

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[–><!–>The Senate version of the Republicans’ large tax and spending bill, along with other changes by the Trump administration, would result in about 17 million fewer people having health insurance in 2034. Although people without health insurance tend to require more emergency care because they aren’t able to afford preventative visits, it’s not clear how those costs would be absorbed elsewhere. And those may not be the only cuts: The White House has also called for reductions in federal funding for medical education and research, which could constrict the supply of newly trained workers.–><!–>

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[–><!–>Health care is also getting somewhat more efficient. Many procedures can now be conducted on an outpatient basis. Recent pharmaceutical advances, such as diabetes medications that are now widely used for weight loss, appear likely to reduce the prevalence of chronic conditions related to obesity.–><!–>

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[–><!–>And artificial intelligence may be able to cut down on the 20 percent or so of health care employment that is administrative. Some of the tasks that currently burden doctors, nurses and radiologists could also be done more quickly with A.I.–><!–>

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